HCA Cognitive and Mental Health 3 — Questions and Answers
Question 1: An elderly client who was previously social now refuses to eat, sleeps most of the day, and says 'nothing matters anymore.' The HCA should FIRST:
- Assume this is normal aging and document nothing
- Report these signs of possible depression to the supervisor immediately (Correct answer)
- Encourage the client to 'cheer up' and think positive
- Increase the client's physical activity without consulting the care team
Correct answer: Report these signs of possible depression to the supervisor immediately
These are classic warning signs of depression in older adults and must be reported promptly so the care team can assess and intervene appropriately.
Question 2: Which of the following is an example of a visual hallucination?
- Believing the government is monitoring you
- Hearing voices when no one is present
- Seeing insects crawling on the walls that are not there (Correct answer)
- Feeling that one's thoughts are being broadcast to others
Correct answer: Seeing insects crawling on the walls that are not there
A visual hallucination is a false sensory perception involving sight, such as seeing objects or people that do not exist.
Question 3: Sundowning in dementia refers to:
- A client's refusal to eat at dinnertime
- Increased confusion and agitation occurring in the late afternoon or evening (Correct answer)
- A side effect of sunlight exposure in dementia patients
- A sleep disorder caused by dementia medication
Correct answer: Increased confusion and agitation occurring in the late afternoon or evening
Sundowning describes a pattern of increased confusion, agitation, and behavioral changes that typically worsen in the late afternoon and evening hours.
Question 4: A client with bipolar disorder is currently in a manic episode. Which behavior would the HCA MOST likely observe?
- Excessive sleeping and loss of interest in activities
- Decreased appetite with weight loss and crying spells
- Rapid speech, grandiose thinking, and decreased need for sleep (Correct answer)
- Flat affect, social withdrawal, and poverty of speech
Correct answer: Rapid speech, grandiose thinking, and decreased need for sleep
Mania is characterized by elevated mood, rapid speech, grandiosity, impulsivity, and a markedly reduced need for sleep.
Question 5: When using therapeutic communication with a client experiencing mental health challenges, the HCA should avoid:
- Active listening and paraphrasing
- Open-ended questions
- False reassurances such as 'Everything will be fine' (Correct answer)
- Reflecting the client's feelings
Correct answer: False reassurances such as 'Everything will be fine'
False reassurances undermine trust and minimize the client's real concerns; honest, empathetic responses are more therapeutic.
Question 6: A client's care plan includes 'reality orientation' as an intervention. This technique is MOST appropriate for clients with:
- Severe anxiety disorders
- Mild to moderate cognitive impairment (Correct answer)
- Active psychosis with delusions
- Post-traumatic stress disorder
Correct answer: Mild to moderate cognitive impairment
Reality orientation — using consistent cues such as calendars, clocks, and familiar objects — is most effective for clients with mild to moderate cognitive impairment to reinforce awareness of time, place, and person.
Question 7: Which of the following actions BEST supports the dignity of a client with mental illness?
- Discussing the client's diagnosis loudly with coworkers in the hallway
- Referring to the client as 'the schizophrenic in room 4'
- Using the client's preferred name and treating them with respect (Correct answer)
- Limiting the client's choices to simplify care routines
Correct answer: Using the client's preferred name and treating them with respect
Person-first language and using preferred names upholds dignity and demonstrates respect, which is foundational to therapeutic relationships.
HCA Cognitive and Mental Health 3
An elderly client who was previously social now refuses to eat, sleeps most of the day, and says 'nothing matters anymore.' The HCA should FIRST: