HESI Compass Saunders Module 4 Exam Psychosocial Alterations

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Sample questions from HESI Compass Saunders Module 4 Exam Psychosocial Alterations

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

1. 1.In an outpatient clinic, a 24-year-old client with schizophrenia says, "The television is sending me secret messages." The client is calm, and vital signs are T 36.8 C, HR 82, RR 16, BP 118/72, SpO2 98% RA. Which response is therapeutic?

   • A.I do not hear a message, but I can see this feels important to you.
   • B.That is impossible; televisions cannot send messages to you.
   • C.What do you think you did to make the television send messages?
   • D.You should stop watching television if it is upsetting you.

   Rationale: The response acknowledges the client's experience and presents the nurse's reality without agreeing with the delusion. Arguing or questioning the client's responsibility can increase distress, while giving advice does not assess the client's feelings. The exam takeaway is to validate emotion, not the delusional belief.

2. 2.During a home visit, a 31-year-old client with schizophrenia reports hearing a voice. The client is alert, with T 37.0 C, HR 90, RR 18, BP 124/78, SpO2 97% RA. Which questions are most important to assess immediate risk? Select all that apply.

   • A.Can you tell me what you ate for breakfast?
   • B.Have you thought about acting on what the voice says?
   • C.Do you have access to anything you could use to hurt yourself or someone else?
   • D.Does the voice tell you to hurt yourself or someone else?
   • E.What is the voice saying to you?

   Rationale: Asking what the voice says, whether it gives harmful commands, whether the client may obey, and access to means clarifies immediate danger. Asking about breakfast does not assess command-hallucination risk. Take threats seriously and implement safety measures based on the answers.

3. 3.At change of shift on an inpatient psychiatric unit, a 42-year-old client with schizophrenia is pacing and says, "The walls are melting." T 37.1 C, HR 104, RR 22, BP 138/84, SpO2 97% RA. Which action should the nurse take first?

   • A.Explain that the walls are solid and the client's perception is incorrect.
   • B.Ask what the client is experiencing and whether the client feels in danger.
   • C.Invite the client to join a crowded group activity.
   • D.Ask the client to write down the experience for later discussion.

   Rationale: The report may describe an illusion or hallucination, so the nurse first assesses the experience and immediate safety. Flatly contradicting the client may impair trust, and a crowded activity or delayed discussion may worsen distress. Calm assessment and reality-based support are appropriate initial responses.

4. 4.Which statement by a 19-year-old client in a first-episode psychosis clinic is an example of a neologism? Vital signs are T 36.7 C, HR 78, RR 16, BP 110/68, SpO2 99% RA.

   • A.I feel sad because my friend moved away.
   • B.Yesterday I went to the store and bought some bread.
   • C.I need to take my flinderpax before the moon eats lunch.
   • D.The blue car is fast, and the window is open.

   Answer and rationale are in the full material.

5. 5.In a long-term care residence, a 76-year-old client with schizophrenia says, "The nurse is poisoning my food." The client has not eaten lunch; T 36.9 C, HR 86, RR 17, BP 130/76, SpO2 96% RA. Which response is best?

   • A.You are being unreasonable, and the food is perfectly safe.
   • B.If you do not eat, you will need a feeding tube.
   • C.I agree that the food may be poisoned, so I will throw it away.
   • D.I understand you are worried. I do not believe the food is poisoned; we can look at it together.

   Answer and rationale are in the full material.