HESI RN MENTAL HEALTH (2026/2027) | NEWEST UPDATED EXAM SOLVED |
VERIFIED 100% GRADED A+
HESI RN Mental Health Nursing Comprehensive Examination | Core Domains: Therapeutic
Communication & Nurse-Client Relationship, Mental Health Assessment & Diagnosis, Anxiety &
Stress-Related Disorders, Mood Disorders (Depression, Bipolar), Schizophrenia Spectrum & Psychotic
Disorders, Substance Use & Addictive Disorders, Crisis Intervention & Suicide Prevention, and
Psychopharmacology & Medication Management | NCLEX-RN® Mental Health Focus | Comprehensive
Predictor Exam Format
Exam Structure
The HESI RN Mental Health Exam for the 2026/2027 academic cycle is an 80-question, multiple-choice
question (MCQ) examination.
Introduction
This HESI RN Mental Health Exam guide for the 2026/2027 cycle prepares nursing students for the
specialized assessment of psychiatric-mental health nursing principles. The content emphasizes the
application of therapeutic communication, the nursing process for major mental health disorders, safe
administration of psychotropic medications, and evidence-based interventions for crisis management and
health promotion, aligning with the HESI predictor and NCLEX-RN® test plan.
Answer Format
All correct answers and psychiatric nursing interventions must be presented in bold and green,
followed by detailed rationales that integrate DSM-6 diagnostic criteria, apply therapeutic communication
techniques, explain psychopharmacology mechanisms and side effects, prioritize safety and de-escalation
strategies, and incorporate ethical and legal standards in mental health care.
Questions (80 Total)
1. A client says, “I can’t go on anymore.” What is the nurse’s most therapeutic response?
A. “Things will get better.”
B. “Are you thinking about hurting yourself?”
C. “You have so much to live for.”
D. “Let’s talk about something happier.”
Rationale: Directly asking about suicidal ideation does not increase risk—it opens dialogue and allows
for immediate safety assessment. Minimizing (“things will get better”) or changing the subject
invalidates feelings. Per suicide prevention best practices, assess intent, plan, means, and history.
2. A client with schizophrenia is prescribed haloperidol. Which side effect should the nurse monitor for?
A. Hypertension
B. Acute dystonia
,C. Diarrhea
D. Hyperglycemia
Rationale: Haloperidol, a first-generation antipsychotic, commonly causes extrapyramidal symptoms
(EPS), including acute dystonia (involuntary muscle spasms, often neck or eyes). Other EPS include
akathisia and parkinsonism. Monitor for tardive dyskinesia long-term. Second-gen antipsychotics (e.g.,
olanzapine) more commonly cause metabolic effects like hyperglycemia.
3. During a panic attack, a client hyperventilates and feels like they are “going to die.” What is the priority
nursing intervention?
A. Administer PRN lorazepam immediately
B. Stay with the client and encourage slow, deep breathing
C. Leave the room to give space
D. Tell the client to “calm down”
Rationale: Presence and grounding are key. Encourage diaphragmatic breathing to counteract
respiratory alkalosis from hyperventilation. Avoid minimizing language (“calm down”). Medication
may be used but is secondary to non-pharmacologic support. Leaving increases anxiety. Reassurance
should be calm and factual: “You’re safe; this will pass.”
4. A client with bipolar I disorder is in an acute manic episode. Which behavior is expected?
A. Social withdrawal
B. Grandiosity and decreased need for sleep
C. Excessive guilt
D. Psychomotor retardation
Rationale: Mania includes elevated mood, grandiosity, decreased sleep, pressured speech, and risky
behavior. Depression features guilt, withdrawal, and retardation. DSM-6 requires ≥1 week of mania
with functional impairment. Safety is priority due to impulsivity and poor judgment.
5. A client with alcohol use disorder begins to tremble and sweat 12 hours after last drink. What condition
is likely developing?
A. Opioid withdrawal
B. Alcohol withdrawal syndrome
C. Wernicke’s encephalopathy
D. Delirium tremens (DTs)
, Rationale: Early alcohol withdrawal (6–24 hrs) includes tremor, anxiety, nausea, and diaphoresis.
DTs (hallucinations, fever, confusion) peak at 48–72 hrs and are life-threatening. CIWA-Ar scale guides
benzodiazepine treatment. Thiamine must be given before glucose to prevent Wernicke’s.
6. Which statement by a nurse demonstrates therapeutic communication?
A. “I know exactly how you feel.”
B. “You seem upset. Would you like to talk about it?”
C. “Cheer up—tomorrow is another day.”
D. “My cousin had the same problem and she’s fine now.”
Rationale: This response validates emotion without assumption, uses an open-ended invitation, and
centers the client. “I know how you feel” is false reassurance. Giving advice or personal anecdotes shifts
focus away from the client. Therapeutic communication builds trust through empathy and active
listening.
7. A client taking lithium reports nausea, blurred vision, and muscle twitching. What action should the
nurse take?
A. Administer antiemetic as ordered
B. Hold the dose and notify the provider immediately
C. Encourage increased fluid intake
D. Document as expected side effects
Rationale: These are signs of lithium toxicity (therapeutic range: 0.6–1.2 mEq/L). Toxicity can cause
seizures, coma, or death. Hold dose, check serum level, and notify provider. Hydration helps but is not
primary. Never ignore neurologic symptoms with lithium.
8. In crisis intervention, the nurse’s primary goal is to:
A. Explore childhood trauma
B. Restore the client to pre-crisis functioning
C. Initiate long-term psychotherapy
D. Diagnose personality disorder
Rationale: Crisis intervention is time-limited (4–6 weeks) and focuses on stabilization, safety, and
return to baseline. It is not for deep analysis. Techniques include problem-solving, support systems, and
coping skills. Immediate risk (e.g., suicide) must be addressed first.
9. A client with major depressive disorder has a nursing diagnosis of “Risk for Suicide.” Which
intervention is priority?
VERIFIED 100% GRADED A+
HESI RN Mental Health Nursing Comprehensive Examination | Core Domains: Therapeutic
Communication & Nurse-Client Relationship, Mental Health Assessment & Diagnosis, Anxiety &
Stress-Related Disorders, Mood Disorders (Depression, Bipolar), Schizophrenia Spectrum & Psychotic
Disorders, Substance Use & Addictive Disorders, Crisis Intervention & Suicide Prevention, and
Psychopharmacology & Medication Management | NCLEX-RN® Mental Health Focus | Comprehensive
Predictor Exam Format
Exam Structure
The HESI RN Mental Health Exam for the 2026/2027 academic cycle is an 80-question, multiple-choice
question (MCQ) examination.
Introduction
This HESI RN Mental Health Exam guide for the 2026/2027 cycle prepares nursing students for the
specialized assessment of psychiatric-mental health nursing principles. The content emphasizes the
application of therapeutic communication, the nursing process for major mental health disorders, safe
administration of psychotropic medications, and evidence-based interventions for crisis management and
health promotion, aligning with the HESI predictor and NCLEX-RN® test plan.
Answer Format
All correct answers and psychiatric nursing interventions must be presented in bold and green,
followed by detailed rationales that integrate DSM-6 diagnostic criteria, apply therapeutic communication
techniques, explain psychopharmacology mechanisms and side effects, prioritize safety and de-escalation
strategies, and incorporate ethical and legal standards in mental health care.
Questions (80 Total)
1. A client says, “I can’t go on anymore.” What is the nurse’s most therapeutic response?
A. “Things will get better.”
B. “Are you thinking about hurting yourself?”
C. “You have so much to live for.”
D. “Let’s talk about something happier.”
Rationale: Directly asking about suicidal ideation does not increase risk—it opens dialogue and allows
for immediate safety assessment. Minimizing (“things will get better”) or changing the subject
invalidates feelings. Per suicide prevention best practices, assess intent, plan, means, and history.
2. A client with schizophrenia is prescribed haloperidol. Which side effect should the nurse monitor for?
A. Hypertension
B. Acute dystonia
,C. Diarrhea
D. Hyperglycemia
Rationale: Haloperidol, a first-generation antipsychotic, commonly causes extrapyramidal symptoms
(EPS), including acute dystonia (involuntary muscle spasms, often neck or eyes). Other EPS include
akathisia and parkinsonism. Monitor for tardive dyskinesia long-term. Second-gen antipsychotics (e.g.,
olanzapine) more commonly cause metabolic effects like hyperglycemia.
3. During a panic attack, a client hyperventilates and feels like they are “going to die.” What is the priority
nursing intervention?
A. Administer PRN lorazepam immediately
B. Stay with the client and encourage slow, deep breathing
C. Leave the room to give space
D. Tell the client to “calm down”
Rationale: Presence and grounding are key. Encourage diaphragmatic breathing to counteract
respiratory alkalosis from hyperventilation. Avoid minimizing language (“calm down”). Medication
may be used but is secondary to non-pharmacologic support. Leaving increases anxiety. Reassurance
should be calm and factual: “You’re safe; this will pass.”
4. A client with bipolar I disorder is in an acute manic episode. Which behavior is expected?
A. Social withdrawal
B. Grandiosity and decreased need for sleep
C. Excessive guilt
D. Psychomotor retardation
Rationale: Mania includes elevated mood, grandiosity, decreased sleep, pressured speech, and risky
behavior. Depression features guilt, withdrawal, and retardation. DSM-6 requires ≥1 week of mania
with functional impairment. Safety is priority due to impulsivity and poor judgment.
5. A client with alcohol use disorder begins to tremble and sweat 12 hours after last drink. What condition
is likely developing?
A. Opioid withdrawal
B. Alcohol withdrawal syndrome
C. Wernicke’s encephalopathy
D. Delirium tremens (DTs)
, Rationale: Early alcohol withdrawal (6–24 hrs) includes tremor, anxiety, nausea, and diaphoresis.
DTs (hallucinations, fever, confusion) peak at 48–72 hrs and are life-threatening. CIWA-Ar scale guides
benzodiazepine treatment. Thiamine must be given before glucose to prevent Wernicke’s.
6. Which statement by a nurse demonstrates therapeutic communication?
A. “I know exactly how you feel.”
B. “You seem upset. Would you like to talk about it?”
C. “Cheer up—tomorrow is another day.”
D. “My cousin had the same problem and she’s fine now.”
Rationale: This response validates emotion without assumption, uses an open-ended invitation, and
centers the client. “I know how you feel” is false reassurance. Giving advice or personal anecdotes shifts
focus away from the client. Therapeutic communication builds trust through empathy and active
listening.
7. A client taking lithium reports nausea, blurred vision, and muscle twitching. What action should the
nurse take?
A. Administer antiemetic as ordered
B. Hold the dose and notify the provider immediately
C. Encourage increased fluid intake
D. Document as expected side effects
Rationale: These are signs of lithium toxicity (therapeutic range: 0.6–1.2 mEq/L). Toxicity can cause
seizures, coma, or death. Hold dose, check serum level, and notify provider. Hydration helps but is not
primary. Never ignore neurologic symptoms with lithium.
8. In crisis intervention, the nurse’s primary goal is to:
A. Explore childhood trauma
B. Restore the client to pre-crisis functioning
C. Initiate long-term psychotherapy
D. Diagnose personality disorder
Rationale: Crisis intervention is time-limited (4–6 weeks) and focuses on stabilization, safety, and
return to baseline. It is not for deep analysis. Techniques include problem-solving, support systems, and
coping skills. Immediate risk (e.g., suicide) must be addressed first.
9. A client with major depressive disorder has a nursing diagnosis of “Risk for Suicide.” Which
intervention is priority?
