HESI Computerized Adaptive Testing Test Bank With Answers (424 Solved Questions)

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Pageof1172HESI Computerized Adaptive Testing(CAT) Test Bank With Rationales.HESI Computerized AdaptiveTesting(CAT) Test BankQuestion 1A nurse is counseling the spouse of a client who has a history of alcohol abuse.What doesthe nurse explain is the main reason for drinking alcohol in peoplewith a long history of alcohol abuse?A.They are dependent on it.B.They lack the motivation to stop.C.They use it for coping.D.They enjoy the associated socialization.✓Ans- aAlcohol causes both physical and psychological dependence; the individualneeds the alcohol to function. Alcoholism is a disorder that entails physical andpsychological dependence. Because alcohol is so physiologically addictive, theclient's body craves the alcohol, so most clients lack the motivation to stopbecause they will go into withdrawal. Clients who abuse alcohol have numbedtheir ability to utilize other coping mechanisms, soalcohol is used as an excusefor coping. People with alcoholism usually drink alone or feel alone in a crowd;socialization is not the prime reason for their drinking.Question 2How do adolescents establish family identity during psychosocial development?Select allthat apply.A.By acting independently to make his or her own decisionsB.By evaluating his or her own health with a feelingof well-beingC.By fostering his or her own development within abalanced family structureD.By building close peer relationships to achieveacceptance in the societyE.By achieving marked physical changes✓Ans-ac

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Pageof2172An adolescent establishes family identity by acting independently for takingimportant decisions about self. They also need to foster their developmentalong with maintaining abalanced family structure. Health identity is associatedwith the evaluation of one's own health with a feeling of well-being. By buildingclose peer relationships, an adolescent develops a sense of belonging,approval, and the opportunity to learn acceptable behavior.These actionsestablish an adolescent's group identity. The sound and healthy growth of theadolescent, with marked physical changes, helps to build an adolescent'ssexual identity.Question 3A clinic nurse observes a b-year-old client sitting alone, rocking and staring ata small, shiny top that she is spinning. Later the father relates his concerns,stating, "She pushes meaway. She doesn't speak, and she only shows feelingswhen I take her top away. Is it something I've done?" What is the mosttherapeutic initial response by the nurse?A.Asking the father about his relationship with his wifeB.Asking the father how he held the child when she was an infantC.Telling the father that it is nothing he has done and sharing the nurse'sobservations of thechildD.Telling the father not to be concerned and stressing that the child will outgrowthisdevelopmental phase✓Ans- cThe nurse provides support in a nonjudgmental way by sharing information andobservations about the child. This child exhibits symptoms of autism, which isnot attributable to the actions of the parents. Asking the father about hisrelationship with hiswife or how he held the child when she was an infantindirectly indicates that the parent may be at fault; it negates the father's needfor support and increases his sense of guilt.Telling the father not to be concerned and stressing that the child willoutgrow this developmental phase is false reassurance that does notprovide support; the fatherrecognizes that something is wrong.Question 4What is most appropriate for a nurse to say when interviewing a newly admitteddepressedclient whose thoughts are focused on feelings of worthlessness andfailure?A.”Tell me how you feel about yourself."B."Tell me what has been bothering you."C."Why do you feel so bad about yourself?"

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Pageof3172D."What can we do to help you while you're here?"✓Ans- aBecause major depression is a result of the client's feelings of self-rejection, itis importantfor the nurse to have the client initially identify these feelingsbefore developing a plan of care. Later discussion should be focused on othertopics to prevent reinforcement of negative thoughts and feelings. "Tell mewhat has been bothering you" is asking the client to draw a conclusion; theclient may be unable to do so at this time. Also, depression may be related notto external events but instead to a client's psychobiology. Asking why does notlet a client explore feelings; it usually elicits an "I don't know" response. "Whatcan wedo to help you while you're here?" is beyond the scope of the client'sabilities at this time.Question 5A client is admitted to the mental health unit with the diagnosis of majordepressivedisorder. Which statement alerts the nurse to the possibility of asuicide attempt?A.”I don't feel too good today."B."I feel much better; today is a lovely day."C."I feel a little better, but it probably won't last."dD."I'm really tired today, so I'll take things a little slower."✓Ans- bA rapid mood upswing and psychomotor change may signal that the client hasmade a decision and has developed a plan for suicide. "I don't feel too goodtoday"; "I feel a little better, but it probably won't last"; and "I'm really tiredtoday, so I'll take things a little slower" are all typical of the depressed client;none of these statements signals a change inmood.Question 6During a group discussion it is learned that a group member hid suicidal urgesand committed suicide several days ago. What should the nurse leading thegroup be preparedto manage?A.Guilt of the co-leaders for failing to anticipate and prevent the suicideB.Guilt of group members because they could not prevent another's suicideC.Lack of concern over the suicide expressed by several of the members in the groupD.Fear by some members that their own suicidal urges may go unnoticed and that theymaygo unprotected✓Ans- dAmbivalence about life and death, plus the introspection commonly found inclients withemotional problems, can lead to increased anxiety and fear amongthe group members. These feelings must be handled within the support andsupervisory systems for the staff; the group members are the primary concern.Guilt that the group's leaders or members might feel because they could not

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Pageof4172prevent another's suicide will probably be a secondaryconcern of the groupleader. Lack of concern over the suicide expressed by several of themembers inthe group is not a primary concern, but this should be explored later todetermine the reason for such apparent indifference, which may be a mask tocover true feelings.Question 7Which screening report will help the nurse determine skeletal growthin a child?A.Electroencephalogram reportsB..Radiographs of the hand and wristC..Magnetic resonance imaging (MRI)D..Denver Developmental Screening Test✓Ans- bSkeletal growth in a child can be determined from the ossification centers. At eto f monthsof age, the capitate and hamate bones in the wrist are the earliestcenters. Therefore radiographs of the hand and wrist will help determineskeletal growth in the child.Electroencephalogram reports will help assess a child's brain activity. MRI isused to scanthe internal structures of a client. The Denver DevelopmentalScreening Test is used to understand developmental issues of a child.Question 8A client describes his delusions in minute detail to the nurse. How should thenurserespond?A.Changing the topic to reality-based eventsB.Continuing to discuss the delusion with the clientC.Getting the client involved in a social project with peersD.Disputing the perceptions with the use of logical thinking✓Ans- aDecreasing time spent on delusions prevents reinforcement of psychoticthinking. Discussing reality-based events improves contact with reality.Encouraging discussion willgive validity to the delusion. The client will havedifficulty getting involved in a social activity; the activity will not stop thedelusion. Challenging the client may increase anxiety.Question 9A nurse working on a mental health unit is caring for several clients who are atrisk forsuicide. Which client is at the greatest risk for successful suicide?

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Pageof5172E.Young adult who is acutely psychoticF.Adolescent who was recently sexually abusedG.Older single man just found to have pancreatic cancerH.Middle-age woman experiencing dysfunctional grieving✓Ans- cOlder single men with chronic health problems are at the highest risk ofsuicide. This is because men have fewer social supports than women do. (Menare less social then womenin general.) Less social support at times of stress canincrease the risk of suicide. Also, chronic health problems can lead to learnedhelplessness, which can lead to depression.People who are acutely psychotic as a group are at higher risk for suicide, butthey do not have the suicide rate of older single adult men with chronic healthproblems. An adolescentwho was recently sexually abused, although severelytraumatized, does not have the risk ofsuicide of an older single man withchronic health problems. Dysfunctional grieving is prolonged grieving that ischaracterized by greater disability and dysfunctional patterns of behavior.Although people with complicated dysfunctional grieving may be at risk forself- directed violence, they do not have the suicide risk of older single menwith chronic health problems.Question 10Which stages would the nurse explain that a toddler goes through, according toFreud'stheory? Select all that apply.A.OralB.AnalC.PhallicD.GenitalE.Latency✓Ans- abAccording to Freud's theory, a toddler goes through the oral and anal stages.The phallic stage is seen in children between the ages of c to f years. Thegenital stage is seen during puberty through adulthood. The latency stage isseen in children ages f to ab years of age.Question 12A client is found to have a borderline personality disorder. What behavior doesthe nurseconsider is most typical of these clients?A.IneptB.EccentricC.ImpulsiveD.Dependent✓Ans- c

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Pageof6172Impulsive, potentially self-damaging behaviors are typical of clients with thispersonalitydisorder. Inept behavior, by itself, is not typical of clients with anyspecific personality disorder. Eccentric behavior is more typical of the clientwith a schizotypal personality disorder. Dependent behavior is more typical ofthe client with a dependent personality disorder.Question 13An older adult, accompanied by family members, is admitted to a long-termcare facilitywith symptoms of dementia. What initial statement by the nurseduring the admission procedure would be most helpful to this client?A.”You're a little disoriented now, but don't worry. You'll be all right in a few days."B."Don't be afraid. I'm your nurse, and everyone here in the hospital is here to help you."C."I'm the nurse on duty today. You're in the hospital. Your family can stay with you for awhile."D.”Let me introduce you to the staff here first. In a little while I'll get youacquainted with ourunit routine."✓Ans- bFamiliarity with the environment and a self-introduction may help promotesecurity and feelings of trust. Telling the client "You're a little disoriented now,but don't worry. You'll be all right in a few days" denies the client's feelingsand provides false reassurance. A self-introducing one's self followed by tellingthe client that of being in the hospital and that thefamily may stay for a whiledenies the client's feelings but does provide self-introduction and orientationregarding the client's location. A person under stress cannot assimilate muchinformation; verbiage could lead to more confusion.Question 14Which identity may fail to develop if the adolescent fails to feel a sense ofbelonging andacceptance?A.Sexual identityB.Group identityC.Family identityD.Health identity✓Ans- bFailure to feel acceptance and belonging results in failure to establish a groupidentity. A lack of physical evidence of maturity can predispose the adolescentto fail to establish a sexual identity. Adolescents depend on these physical cuesbecause they want assurance ofmaleness or femaleness and do not wish to bedifferent from their peers. If an adolescent fails to foster independence andbalance in the family structure, it may hamper family identity. Healthyadolescents evaluate their own health on the basis of feelings of well- being,ability to function normally, and absence of symptoms.

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Pageof7172Question 15In her eighth month of pregnancy, a bd-year-old client is brought to thehospital by the police, who were called when she barricaded herself in a ladies'restroom of a restaurant. During admission the client shouts, "Don't come nearme! My stomach is filled with bombs, and I'll blow up this place if anyonecomes near me." What does the nurse conclude that theclient is exhibiting?A.Ideas of referenceB.Loose associationsC.Delusional thinkingD.Tactile hallucinations✓Ans- cDelusions are false fixed beliefs that have a minimal basis in reality. This is asomatic delusion. Ideas of reference are false beliefs that every statement oraction of others relatesto the individual. Loose associations are verbalizationsthat sound disjointed to the listener.Tactile hallucinations are false sensoryperceptions of touch without external stimuli.Question 16Which should the nurse encourage for a school-age client diagnosed with achronic illnessto enhance a sense of accomplishment?A.Wearing make-upB.Making up missed workC.Participating in sports activitiesD.Participating in creative activities✓Ans- bMaking up missed work is an activity the nurse can encourage to enhance asense of accomplishment for a school-age client who is diagnosed with achronic illness. Wearingmake-up is often encouraged for an adolescentclient. Participation in sports activities enhances the development of peerrelationship in the school-age child. Participating in creative activities allowsthe school-age child to learn through concrete operations.Question 17A nurse is caring for a client exhibiting compulsive behaviors. The nurseconcludes that thecompulsive behavior usually incorporates the use of whichdefense mechanism?A.ProjectionB.RegressionC.DisplacementD.Rationalization✓Ans- cDisplacement is the unconscious redirection of an emotion from a threatening

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Pageof8172source to a nonthreatening source. Projection is the attribution of one'sunacceptable feelings and thoughts to someone else. Regression is the returnto an earlier, more comfortable level ofbehavior; it is a retreat from the present.Rationalization is the attempt to make unacceptable behavior or feelingsacceptable by justifying the reasons for them.Question 18A client is admitted for a biopsy of a tumor in her left breast. The clientstates, "I know it can't be cancer, because it doesn't hurt." What is thenurse's most therapeutic response?A.”Let’s hope that it isn't malignant."B.”What do you know about breast cancer?"C."Most lumps in the breast are not malignant.”D."Has your primary healthcare provider told you that it wasn't cancer?"✓Ans-bAsking what the client knows about breast cancer allows the nurse to assessthe client's understanding of breast cancer and to clarify any misconceptions.Saying that they should hope that the growth isn't malignant avoids anopportunity to teach, and it is a type of falsereassurance. The statement mayactually increase feelings of hopelessness if the lesion is determined to bemalignant. Although correct, stating that most lesions are benign provides afalse sense of security and avoids an opportunity to teach. Asking whether theprimary healthcare provider has told the client that it wasn't cancer focuses onwhat the primary healthcare provider said rather than on what the client knowsand may limitfurther communication of feelings and beliefs.Question 19A nurse in the emergency department is assessing a client who has beenphysically andsexually assaulted. What is the nurse's priority duringassessment?A.The family's feelings about the attackB.The client's feelings of social isolationC.The client's ability to cope with the situationD.Disturbance in the client's thought processes✓Ans- cThe situation is so traumatic that the individual may be unable to use pastcoping behaviorsto comprehend what has occurred. Assessing emotions thatoccur in response to news of the attack will occur later. The client should be thefocus of care at this time. Social isolationis not an immediate concern. Coping

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Pageof9172skills, not thought processes, are challenged at this time.Question 20A client is admitted to the psychiatric unit with the diagnosis of obsessive-compulsive disorder. The client washes her hands more than b0 times a day,and they are raw and bloody. What defense mechanism does the nurseconclude that the client is using to easeanxiety?A.UndoingB.ProjectionC.IntrojectionD.Displacement✓Ans- aUndoing is an act that partially negates a previous one; the client is using thisdefense mechanism to atone for unacceptable acts or wishes. The client is notattributing self- thoughts or impulses to another person or group, which iscalled projection. The client isnot absorbing into the self a hated or lovedobject (introjection). Displacement is the transferring of feelings from oneperson, object, or experience onto another, less threatening person, object, orexperience.

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Pageof10172Question 21The parents tell the nurse that their preschooler often awakes from sleepscreaming in the middle of the night. The preschooler is not easily comfortedand screams if the parents try to restrain the child. What does the nurseinstruct the parents?A.”Always read a story to the child before bedtime."B."Intervene only if necessary to protect the child from injury."C."Discuss counseling options with the primary health care provider."D."Try to wake the child and ask the child to describe the dream."✓Ans- bWaking up screaming from sleep at night indicates sleep terrors. The nurseshould advise the parents to observe the child and intervene only if there is arisk for injury. Reading a story before bedtime helps to calm the child beforesleeping, but it does not ensure that thechild will not have a sleep terror. Thereis no need for professional counseling, because sleep terrors are a commonphenomenon in preschool-age children. The child is not aware of anybody'spresence during a sleep terror, so it is not appropriate to wake up the child; thismay cause the child to scream and thrash more.Question 22A client who was forced into early retirement is found to have severedepression. The clientsays, "I feel useless, and I've got nothing to do." What isthe best initial response by the nurse?A.”Tell me more about feeling useless."B."Volunteering can help you fill your time."C."Your illness is adding to your current feelings."D."Let's talk about what you'd like to be doing right now."✓Ans- aAnopen-endedresponseencouragesfurtherdiscussionandallowsexploration of feelings. Telling the client that volunteering will help pass thetime ignores the client's feelings. The depression is not adding to the feelings;the feelings are causing the depression. Asking the client to talk about whatthe client would rather be doing ignores the client's feelings.Question 23What characteristic is most essential for the nurse caring for a client undergoingmentalhealth care?A.EmpathyB.SympathyC.Organization

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Pageof11172D.Authoritarianism✓Ans- aEmpathy—understanding and to some extent sharing the emotions of another— encourages the expression of feelings. Empathy is an essential tool in caringfor emotionally ill clients. Sympathy, or feeling sorry for someone, may furtherdecrease the client's feelings of self-worth. Although organization may help theclient accept limits andorganize activities, it is not as important as empathy. Anauthoritarian approach will emphasize the client's weak ego and lack of self-esteem.Question 24When visiting hours are over, a nurse approaches a client with paranoidschizophrenia, who shouts, "You're the one that made my lover leave me."What conclusion does the nursemake about the client?A.The patient is disoriented.B.The patient is actively hallucinating.C.The patient feels a sense of vulnerability.D.The patient needs to have limits set after calming down.✓Ans- cThe client's low self-esteem precipitates doubt of the lover's feelings, creatinga sense of vulnerability. This statement reflects the client's low self-esteem,which is projected onto the nurse as part of the delusion. The client'sstatements do not reflect disorientation but instead reflect false beliefs, whichare common in clients with paranoid schizophrenia. Theclient's statements donot represent hallucinations because they are not false sensory perceptions.Setting limits after the fact is not effective in any situation; limits must be setwhen the problem occurs.Question 24During a survey, the community nurse meets a client who has not visited agynecologist after the birth of her second child. The client says that hermother or sister never had annual gynecologic examinations. Which factor isinfluencing the client's health practice?A.Spiritual beliefB.Family practicesC.Emotional factorsD.Cultural background✓Ans- bFamily practices influence the client's perception of the seriousness ofdiseases. The client does not feel the need to seek preventive care measuresbecause no family member practices preventive care. The client is not

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Pageof12172influenced by spiritual beliefs in this instance. An individual's spiritual beliefsand religious practices may restrict the use of certain formsof medicaltreatment. Emotional factors such as stress, depression, or fear may influenceanindividual's health practice; however, this client does not show signs ofbeing affected by emotional factors. The client is said to be influenced bycultural background if he or she follows certain beliefs about the causes ofillness and uses customary practices to restore health.Question 25A client tells the nurse, "A man is speaking to me from the corner of the room.Can you hearhim?" How should the nurse respond?A.”What's he saying to you? Does it make any sense?"B."Yes, I hear him, but I can't understand what he's saying."C."I don't hear him. There's no one in the corner of the room."D."No, I don't hear him, but is it making you uncomfortable to hear him?"✓Ans- dThe statement "No, I don't hear him, but is it making you uncomfortable tohear him?" points out reality, identifies potential feelings, and prevents thenurse from supporting the hallucination. Asking what the man is saying to theclient and whether it makes any sense isnontherapeutic because it supportsand focuses on the hallucination. "Yes, I hear him, but I can't understand whathe is saying" is nontherapeutic because it supports and focuses on thehallucination; also, it is not truthful. Although denying hearing the voice andpointing out that there is no one else in the room points out reality, thisstatement does not focus on the client's feelings.Question 26What is the priority nursing objective of the therapeutic psychiatric environmentfor aconfused client?A.Helping the client relate to othersB.Making the hospital atmosphere more homelikeC.Helping the client become accepted in a controlled settingD.Maintaining the highest level of safe, independent function✓Ans- dThe therapeutic milieu is directed toward helping the client develop effectiveways of functioning safely and independently. Helping the client relate to othersis one small part ofthe overall objectives. The therapeutic milieu allows someitems from home to make the client less anxious; however, the objective is notto duplicate a home situation. Helping the client become accepted in acontrolled setting is a worthwhile objective but not as important as workingtoward the maximal degree of safe, independent function.

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Pageof13172Question 27Before an amniocentesis, both parents express anxiety about the fetus's safetyduring thetest. Which nursing intervention is most appropriate in promotingthe parents' ability to cope?A.Initiating a parent-primary healthcare provider conferenceB.Reassuring them that the procedure is safeC.Explaining the procedure, step by stepD.Arranging for the father to be present during the test✓Ans- cGiving the parents information about what to expect during the procedure willhelp allay their fears and encourage their cooperation. The nurse should beable to provide information and interpretation of procedures for clients; a delayin answering questions may increase a client's concerns. Amniocentesis is alow-risk procedure; however, some complications may occur. If the father isuninformed, viewing the procedure may increasehis anxiety, even though hispresence may be comforting to the mother.Question 28A young client who has just lost her first job comes to the mental health clinicvery upset and says, "I just start crying without any reason and without anywarning." How should thenurse respond initially?A.”Do you know what makes you cry?"B."Most of us need to cry from time to time."C."Crying unexpectedly can be very upsetting."D."Are you having any other problems at this time?"✓Ans- cThe response "Crying unexpectedly can be very upsetting" identifies theclient's feelings. Asking, "Do you know what makes you cry?" is an unrealisticquestion; the cause of anxietymay not be known. "Most of us need to cry fromtime to time" moves the focus away from the client. "Are you having any otherproblems at this time?" disregards the client'scomment; it is a direct questionthat may impede communication.Question 29A client is admitted to the hospital with the diagnosis of severe anxiety. Whatshould thenurse's plan of care for a client with an anxiety disorder include?A.Promoting the suppression of anger by the clientB.Supporting the verbalization of feelings by the clientC.Encouraging the client to limit anxiety-related behaviorsD.Restricting the involvement of the client's family during the acute phase✓Ans- b

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Pageof14172Freedom to ventilate feelings serves as a safety valve to reduce anxiety. Thesuppression ofanger may increase the client's anxiety. Encouraging the client to limitanxiety-related behaviors is not therapeutic; it may increase the anxiety that the clientis feeling.Restricting the involvement of the client's family during the acute phase may ormay not behelpful; the client's family may provide support to the client.Question 30Windows in the recreation room of the adolescent psychiatric unit have beenbroken on numerous occasions. After a group discussion one of the adolescentsconfides that anotheradolescent client broke them. What should the nurse dowhen using an assertive intervention instead of aggressive confrontation?A.Confront the adolescent openly in the group, using a controlled voice and maintainingdirect eye contact.B.Knock on the door of the adolescent's room and ask whether the adolescent wouldcomeout to talk about the situation.C.Approach the adolescent when the client is alone and, after making direct eye contact,inquire about the involvement in these incidents.D.Use a trusting approach toward the adolescent and imply that the staff doubts theadolescent's involvement but requests a denial for the record.✓Ans- cA private confrontation with presentation of reported facts allows verification; acalm, direct manner is most assertive. Confronting the adolescent openly in thegroup, using a controlled voice and maintaining direct eye contact, isaggressive confrontation, not assertive intervention. Knocking on the door ofthe adolescent's room and asking whether the adolescent would come out totalk about the situation places control in the hands of the client rather than thenurse, and this may lead to aggressive confrontation. Using a trustingapproachtoward the adolescent and implying that the staff doubts the adolescent'sinvolvement but requests a denial for the record is not assertive intervention; itis manipulation and is not truthful.Question 31A 6-year-old child with autism is nonverbal and makes limited eye contact. Whatshould thenurse do initially to promote social interaction?A.Encourage the child to sing songs with the nurse.B.Engage in parallel play while sitting next to the child.C.Provide opportunities for the child to play with other children.D.Use therapeutic holding when the child does not respond to verbal interactions.✓Ans- b Entering the child's world in a nonthreatening way helps promote trust andeventual interaction with the nurse. Using therapeutic holding may be necessary whena child initiates self-mutilating behaviors. Singing songs with the child participating orprovidingopportunities for the child to play with other children is unrealistic at this

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Pageof15172time; playing with others is a long-term objective.Question 32What is an important aspect of nursing care for a client exhibiting psychoticpatterns ofthinking and behavior?A.Helping keep the client oriented to realityB.Involving the client in activities throughout the dayC.Helping the client understand that it is harmful to withdraw from situationsD.Encouraging the client to discuss why interacting with other people is being avoided✓Ans- aKeeping the withdrawn client oriented to reality prevents further withdrawalinto a privateworld. A gradual involvement in selected activities is best. Helpingthe client understand that it is harmful to withdraw from situations is futile atthis time. The psychotic client is unable to tell anyone the reason for avoidinginteraction with others.Question 33A nurse is volunteering on the community crisis hotline. What is the finalobjective of thecounseling process?A.Reducing anxietyB.Exploring feelingsC.Developing constructive coping skillsD.Accomplishing the debriefing process✓Ans- cPast coping behaviors have been inadequate in resolving the current crisis; newcoping skills are needed to manage anxiety-producing conflicts. Reduction ofanxiety is an earlyobjective. Exploration of feelings is an immediate objective.Accomplishment of the debriefing process is an early objective.Question 34An infant is born with a bilateral cleft palate. Plans are made to beginreconstruction immediately. What nursing intervention should be included topromote parent-infantattachment?A.Demonstrating positive acceptance of the infantB.Placing the infant in a nursery away from view of the general publicC.Explaining to the parents that the infant will look normal after the surgeryD.Encouraging the parents to limit contact with the infant until after the surgery✓Ans- aBy demonstrating acceptance of the infant, without regard for the defect, thenurse acts as arole model for the parents, thereby encouraging theiracceptance. Infants with cleft palates can remain in the newborn nursery; they

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