HESI Compass Module 4 Psychosocial Alterations

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Sample questions from HESI Compass Module 4 Psychosocial Alterations

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During a community crisis visit, a 42-year-old client who lost employment yesterday says, "I cannot think straight. Rent is due, and I have no idea what to do." The client denies thoughts of self-harm and identifies a supportive sister. Which response best applies crisis-intervention principles?

   • A.Identify the most urgent concern and develop one achievable action with the client.
   • B.Recommend that the sister assume responsibility for the client's finances.
   • C.Encourage the client to postpone all decisions until the distress resolves.
   • D.Explore how childhood experiences shaped the client's response to failure.

   Rationale: Crisis intervention focuses on the immediate problem and restoration of effective coping through manageable actions. Exploring childhood experiences may be appropriate later but does not address the current crisis. Postponing every decision promotes helplessness, while transferring financial responsibility unnecessarily reduces autonomy. Mobilize available supports without taking control away from the client.

2. 2.Refer to the client's chart. Which actions should the nurse take now? Select all that apply.

   • A.Allow the client to leave alone after obtaining a promise not to attempt suicide.
   • B.Delay precautions because the client denies intending to act today.
   • C.Initiate continuous observation according to the suicide-precaution protocol.
   • D.Arrange for firearms to be secured outside the client's access through an appropriate support person.
   • E.Ask directly about current intent and access to other lethal means.

   Rationale: The 1500 disclosure of a loaded handgun and a goodbye message indicates substantial risk despite the earlier denial of immediate intent. Continuous observation, direct assessment, and restricting access to firearms address the specific findings. Delaying precautions based on denial alone fails to integrate the plan, means, and preparatory behavior. A promise not to attempt suicide does not establish safety or replace urgent evaluation.

3. 3."Everyone would be better off without me," says a 16-year-old student during a private meeting with the school nurse after being bullied online. Which response should the nurse make first?

   • A.What activities usually help you feel more confident?
   • B.Are you thinking about killing yourself?
   • C.Would you like me to explain why bullying happens?
   • D.Your classmates will probably forget about this soon.

   Rationale: The statement suggests possible suicidal thinking and requires a direct, nonjudgmental question. Asking about suicide does not create suicidal thoughts and helps determine immediate risk. Exploring coping activities is useful after assessing safety, while explaining bullying does not clarify risk. Predicting that classmates will forget offers false reassurance.

4. 4.At an outpatient follow-up, a 67-year-old widower reports considering an overdose but says, "My granddaughter needs me, so I would never do it." Which nursing action is most appropriate?

   • A.Focus on grief counseling because the client has identified a reason to live.
   • B.Document that the granddaughter eliminates the immediate suicide risk.
   • C.Assess the proposed medication, available supply, intent, and timing.
   • D.Ask the granddaughter to call weekly instead of arranging further assessment.

   Answer and rationale are in the full material.

5. 5.Inside a disaster shelter, a 35-year-old parent whose home was destroyed paces and repeatedly asks where to obtain formula for a 3-week-old newborn. The parent is oriented and denies thoughts of harm. What is the priority intervention?

   • A.Encourage the parent to attend a long-term parenting course.
   • B.Ask the parent to describe every event leading to the disaster.
   • C.Explain that material losses are less important than surviving.
   • D.Help the parent locate infant supplies and identify a support person.

   Answer and rationale are in the full material.