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HESI RN · HESI Mental Health · Age Specific Nursing Care

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Showing all 5 practice questions with expert explanatory rationales.

Question 1 of 5

A 91-year-old female client with dementia is being seen by the home health nurse. Both she and her husband, who is 92 years old, were very active until her dementia became debilitating. Since that time, the client does not recognize her husband or children, forgets how to eat and dress, and wanders about the house day and night. Her husband wants to keep her at home to care for her, but the nurse notices that he is increasingly tired with each visit. What is the nurse's priority intervention for the nursing diagnosis of caregiver role strain?

A. Discuss strategies to coordinate care and other responsibilities
B. Encourage involvement in support groups
C. Identify resources to include financial, legal, and respite care
D. Stress the importance of self-nurturing

Expert Explanatory Rationale

Correct Answer: Discuss strategies to coordinate care and other responsibilities

Question 2 of 5

A client who is diagnosed with schizoid personality disorder is isolative, does not speak to her peers, and sits through the community meeting without speaking. Her mother describes her as shy and having few friends. Which would be an appropriate nursing diagnosis for this client?

A. Anxiety related to a new environment as evidenced by isolation and not talking with peers
B. Impaired social interaction related to unfamiliar environment as evidenced by isolation and not talking with peers
C. Ineffective coping related to new environment as evidenced by isolation and minimal interaction with others
D. Disturbed thought processes related to a new environment as evidenced by isolation and minimal interactions with others

Expert Explanatory Rationale

Correct Answer: Impaired social interaction related to unfamiliar environment as evidenced by isolation and not talking with peers

Question 3 of 5

A 10-year-old boy is diagnosed with gender dysphoria. Which assessment finding would the nurse expect?

A. Having tea parties with dolls
B. A compromised sexual response cycle
C. Identifying with boys who are athletic
D. Intense urges to watch his parents have sex

Expert Explanatory Rationale

Correct Answer: Having tea parties with dolls

Question 4 of 5

A nurse works a rape telephone hotline. Communication should focus on:

A. Explaining immediate steps victims should take;
B. Providing callers with a sympathetic listener.
C. Obtaining information for law enforcement.
D. Arranging long-term counseling.

Expert Explanatory Rationale

Correct Answer: Explaining immediate steps victims should take;

Question 5 of 5

Which nursing strategy leads patients to respond more positively to limit setting?

A. Confront the patient with the inappropriateness of the behavior.
B. Explore with the patient the underlying dynamics of the behavior.
C. Reflect back to the patient an understanding of the patient's distress.
D. State clear disapproval of the behavior, and support its consequences.

Expert Explanatory Rationale

Correct Answer: Reflect back to the patient an understanding of the patient's distress.

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