Question

The occupational health nurse is working with an employee who was just notified that their child was involved in a motor vehicle collision and taken to the hospital. The employee states, "I can't believe this. What should I do?" Which response is best for the nurse to provide in this crisis?

Answer 1

Correct Answers:

Call for transportation to the hospital.

Rationale :

🟢 In a crisis situation, the nurse must first address the immediate, practical needs of the individual.

🟢 The employee is emotionally overwhelmed and cannot make decisions independently.

🟢 Providing direct assistance such as arranging transport to the hospital ensures timely access to the family member and reduces emotional distress.

🟢 This approach is part of crisis intervention, focusing on safety and immediate action.

🟢 Emotional processing can follow after the basic needs have been met.

Distractor Analysis :

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Answer 2

Correct Answers:

A sense of loss.

Rationale :

🟡 The client reports multiple recent life changes, including divorce, job loss, and relationship breakup—all representing cumulative losses.

🟡 Loss is a major precipitating factor for depression, especially when compounded.

🟡 These losses can lead to feelings of hopelessness, worthlessness, and grief.

🟡 Addressing the theme of loss provides insight into the emotional impact and supports grief work.

🟡 Other symptoms like low self-esteem may result from the underlying grief process.

Distractor Analysis :

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Answer 3

Correct Answers:

Altruism.

Rationale :

🔵 Altruism is a mature defense mechanism in which one copes by helping others.

🔵 The client continues to care for her ex-husband’s parents despite the divorce, which reflects selflessness as a way to manage distress.

🔵 While supportive, it may also indicate suppressed emotional needs.

🔵 Identifying this helps the nurse explore if the behavior is truly healthy or masking avoidance of self-care.

🔵 The intervention should balance support for her values with assessment for personal burden

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Answer 4

Correct Answers:

Wait for the client to respond.

Rationale :

⚫ Depressed clients often exhibit psychomotor retardation, requiring extended time to respond.

⚫ Waiting shows patience and presence, promoting trust without adding pressure.

⚫ Interrupting or asking new questions may increase withdrawal or agitation.

⚫ Silence in therapeutic communication allows space for the client to process thoughts and emotions.

⚫ This fosters a nonjudgmental environment and supports rapport.

Distractor Analysis :

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Answer 5

Correct Answers:

Assess and report the client's electrolyte status to the healthcare provider.

Rationale :

🟣 Bulimia nervosa often results in electrolyte imbalances from purging behaviors (e.g., vomiting, diuretic use).

🟣 Hypokalemia and hyponatremia can lead to cardiac dysrhythmias and seizures.

🟣 This physiological risk takes priority over behavioral issues in initial care.

🟣 Reporting lab values allows for timely medical intervention and stabilization.

🟣 Ongoing care will include therapy, but medical stability comes first.

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Answer 6

Correct Answers:

Thiamine.

Rationale :

🔴 Wernicke-Korsakoff syndrome is caused by thiamine deficiency due to chronic alcoholism.

🔴 Thiamine is critical for neural function and memory preservation.

🔴 Prompt administration can reverse acute confusion and prevent progression.

🔴 Other medications (like chlordiazepoxide) are used for withdrawal but won’t address the root cause of neurological symptoms.

🔴 Preventing permanent brain damage is a nursing priority in this syndrome.

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Answer 7

Correct Answers:

Educate the client about the purpose and side effects of the medication.

Rationale :

🟠 Educating the client promotes adherence to treatment and informed decision-making.

🟠 Understanding the drug’s purpose helps the client actively participate in recovery.

🟠 Knowledge about side effects ensures the client can recognize adverse reactions early.

🟠 This is especially critical when starting a new medication for addiction.

🟠 Empowering the client supports long-term relapse prevention.

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Answer 8

Correct Answers:

Give concise and firm directions for hygiene and dressing.
Assign the client to a single room.
Invite the client for a walk when client's energy is high.

Rationale :

🟤 A. Give concise and firm directions for hygiene and dressing.

🟤 Clients in mania need clear structure and redirection to prevent overstimulation.

🟤 C. Assign the client to a single room.

🟤 Reduces environmental stimuli, helping to manage hyperactivity and inappropriate behavior.

🟤 D. Invite the client for a walk when energy is high.

🟤 Walking provides non-competitive physical outlet for excess energy and builds trust.

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Answer 9

Correct Answers:

Insert peripheral intravenous catheter.

Rationale :

🟢 The client is confused, hemoccult-positive, and unable to take oral meds—indicating risk of fluid and electrolyte imbalance.

🟢 IV access is crucial for hydration, lab draws, and medication administration.

🟢 Addressing circulation and hydration supports hemodynamic stability.

🟢 Other actions follow once access is established for care.

🟢 This prioritizes ABCs (circulation) in acute withdrawal with GI loss.

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Answer 10

Correct Answers:

Remain calm and use a matter-of-fact approach.

Rationale :

🟡 Highly anxious clients benefit from calm, structured communication to reduce escalation.

🟡 Emotional contagion may worsen anxiety if the nurse appears nervous.

🟡 A matter-of-fact approach conveys reassurance and control.

🟡 Avoid probing questions until the client’s anxiety has decreased to a manageable level.

🟡 Therapeutic presence de-escalates panic-level anxiety.

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RN HESI Mental Health with NGN Exam

No.

1 :
The occupational health nurse is working with an employee who was just notified that their child was involved in a motor vehicle collision and taken to the hospital. The employee states, "I can't believe this. What should I do?" Which response is best for the nurse to provide in this crisis?

3 :
A woman who attends a stress management group reveals to group members that though she recently divorced, she continues to care for her husband's aging parents. Which psychological mechanism should the nurse address in the plan of care?

4 :
The nurse interacts with a client who is very depressed and slow to respond to questions. The nurse asks the client to describe current feelings, but the client looks down at the table. Which action is best for the nurse to implement?

5 :
A young adult client is admitted to a psychiatric facility with a diagnosis of bulimia nervosa. Which nursing intervention has the highest priority?

6 :
A client with chronic alcohol dependence is diagnosed with Wernicke-Korsakoff syndrome. The client is experiencing memory loss and confusion. Which medication should the nurse administer to help alleviate the client's symptoms?

7 :
The nurse is preparing a client for discharge after treatment for cocaine abuse. The client is taking home a prescription for a new medication to control cocaine cravings. Which intervention is most important for the nurse to implement?

8 :
The nurse is planning the care for a client who is hospitalized with a bipolar disorder. The client wanders the hallways, talks excessively, and makes sexual comments about the staff. Which intervention(s) should the nurse include in the plan of care? Select all that apply.

9 :
Two days after being admitted with alcohol withdrawal, a client has constant liquid stools and abdominal cramping. The emesis and stool are hemoccult positive. The client is confused and refusing to take oral medication. Which action should the nurse implement first?

10 :
During admission to the psychiatric unit, a client is extremely anxious and reports being worried about the sun coming up the next day. Which intervention is most important for the nurse to implement during the admission process?

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RN HESI Mental Health with NGN Exam

No.

1 : The occupational health nurse is working with an employee who was just notified that their child was involved in a motor vehicle collision and taken to the hospital. The employee states, "I can't believe this. What should I do?" Which response is best for the nurse to provide in this crisis?

3 : A woman who attends a stress management group reveals to group members that though she recently divorced, she continues to care for her husband's aging parents. Which psychological mechanism should the nurse address in the plan of care?

4 : The nurse interacts with a client who is very depressed and slow to respond to questions. The nurse asks the client to describe current feelings, but the client looks down at the table. Which action is best for the nurse to implement?

5 : A young adult client is admitted to a psychiatric facility with a diagnosis of bulimia nervosa. Which nursing intervention has the highest priority?

6 : A client with chronic alcohol dependence is diagnosed with Wernicke-Korsakoff syndrome. The client is experiencing memory loss and confusion. Which medication should the nurse administer to help alleviate the client's symptoms?

7 : The nurse is preparing a client for discharge after treatment for cocaine abuse. The client is taking home a prescription for a new medication to control cocaine cravings. Which intervention is most important for the nurse to implement?

8 : The nurse is planning the care for a client who is hospitalized with a bipolar disorder. The client wanders the hallways, talks excessively, and makes sexual comments about the staff. Which intervention(s) should the nurse include in the plan of care? Select all that apply.

9 : Two days after being admitted with alcohol withdrawal, a client has constant liquid stools and abdominal cramping. The emesis and stool are hemoccult positive. The client is confused and refusing to take oral medication. Which action should the nurse implement first?

10 : During admission to the psychiatric unit, a client is extremely anxious and reports being worried about the sun coming up the next day. Which intervention is most important for the nurse to implement during the admission process?

1 :
The occupational health nurse is working with an employee who was just notified that their child was involved in a motor vehicle collision and taken to the hospital. The employee states, "I can't believe this. What should I do?" Which response is best for the nurse to provide in this crisis?

3 :
A woman who attends a stress management group reveals to group members that though she recently divorced, she continues to care for her husband's aging parents. Which psychological mechanism should the nurse address in the plan of care?

4 :
The nurse interacts with a client who is very depressed and slow to respond to questions. The nurse asks the client to describe current feelings, but the client looks down at the table. Which action is best for the nurse to implement?

5 :
A young adult client is admitted to a psychiatric facility with a diagnosis of bulimia nervosa. Which nursing intervention has the highest priority?

6 :
A client with chronic alcohol dependence is diagnosed with Wernicke-Korsakoff syndrome. The client is experiencing memory loss and confusion. Which medication should the nurse administer to help alleviate the client's symptoms?

7 :
The nurse is preparing a client for discharge after treatment for cocaine abuse. The client is taking home a prescription for a new medication to control cocaine cravings. Which intervention is most important for the nurse to implement?

8 :
The nurse is planning the care for a client who is hospitalized with a bipolar disorder. The client wanders the hallways, talks excessively, and makes sexual comments about the staff. Which intervention(s) should the nurse include in the plan of care? Select all that apply.

9 :
Two days after being admitted with alcohol withdrawal, a client has constant liquid stools and abdominal cramping. The emesis and stool are hemoccult positive. The client is confused and refusing to take oral medication. Which action should the nurse implement first?

10 :
During admission to the psychiatric unit, a client is extremely anxious and reports being worried about the sun coming up the next day. Which intervention is most important for the nurse to implement during the admission process?