HESI MENTAL HEALTH UPDATED EXAM SCRIPT 2026
QUESTIONS AND SOLUTIONS GRADED A+
✔✔The practical nurse (PN) is caring for a male client who is admitted for schizophrenia
and observes that his thoughts do not flow logically and he uses invented words. How
should the PN document this behavior?
A. interacts with others using child like expressions
B. uses neologisms and tangential expressions
C. demonstrates rapid speech while anxious
D. responds with defensive language to cope with others - ✔✔B. uses neologisms and
tangential expressions
rationale:
Documentation of the client's altered thought processes reflected in speech should be
described as tangential ideas, circumstantially, loose associations, and neologisms, or
"word salad" (B). (A,C, and D) are not accurate descriptors for this client.
✔✔A male client arrives at the mental health clinic complaining of insomnia, irritability,
increased tension, and headaches. He tells the practical nurse that the symptoms
began a week ago after he lost his job, and he is concerned that he may have to
relocate his family. Which stressor is this client experiencing?
A. an anxiety reaction
B. a situational crisis
C. a maturational crisis
D. an adjustment disorder - ✔✔B. a situational crisis
rationale:
A situational crisis occurs when a life event upsets an individual's psychosocial
equilibrium. Loss of a job can give rise to a situational crisis (B). (A,C, and D) do not
depict this client's situation.
✔✔A 19 year old calls the clinic and tells the practical nurse (PN) that since bringing her
newborn infant home, she has felt apathetic, fatigued, and helpless. She states, " I don't
know what's expected of me." What action is most important for the PN to take?
A. tell the charge nurse to come to the phone and talk with the client
B. direct the client to come to the clinic for mother baby care instructions
C. ask the client if she has been experiencing any hallucinations
D. determine if the client is feeling sad and having suicidal thoughts - ✔✔A. tell the
charge nurse to come to the phone and talk with the client
rationale:
The client is exhibiting signs of a maturational crisis related to the role changes required
by the birth of the infant. Crisis intervention is indicated, so the PN should ask the
charge nurse to talk with the client (A). (B,C, and D) could be considered if (A) proves
ineffective.
,✔✔A client who is admitted for surgery seems to focus only on his immediate concerns
and asks the practical nurse (PN) to repeat everything that is said over again. The client
seems to follow directions but asks for assistance when filling out admission forms and
checklists. He apologizes to the PN often and says he did not hear all of the
instructions. This client is experiencing which level of anxiety?
A. mild
B. panic
C. severe
D. moderate - ✔✔C. severe
rationale:
Severe anxiety (C) is characterized by a greatly narrowed perceptual field, difficulty with
problem solving, selective attention (focus on one detail), and selective inattention
(block out threatening stimuli). Mild to moderate levels of anxiety on the continuum are
characterized by the client being alert, attentive, and a focused perception that
facilitates as optimal state for problem solving and learning. This client is not exhibiting
signs and symptoms of (A,B, or C).
✔✔A male client is admitted to the hospital with distorted sensory perceptions,
disordered thoughts, and an increase in non-goal directed motor activity. The client
does not respond to the practical nurse's (PN) calming efforts. What is the next
intervention the PN should initiate?
A. decrease environmental stimuli
B. ensure the environment is safe
C. respect the client's personal space
D. encourage the client to express feelings - ✔✔B. ensure the environment is safe
rationale:
Safety (B) is the highest priority for a client who is experiencing severe anxiety, which
places him at high risk for self-injury related to the increased non-goal directed motor
activity, distorted perceptions, and disordered thought. (A,C, and D) may be indicated,
but the client's safety has the highest priority.
✔✔A woman tells the practical nurse (PN) that for the past 6 months she has been
terrified of leaving home. Whenever she thinks about going outdoors her heart pounds,
she shakes and cries, and feels dizzy. Based on these findings, which nursing diagnosis
should the practical nurse (PN) consider when caring for this client?
A. fear related to physiologic responses to leaving the home
B. self-esteem disturbance related to inability to leave home
C. social isolation related to avoidance behaviors as evidenced by inability to go out of
doors
D. altered thought processes related to panic attacks when she thinks of leaving the
house - ✔✔C. social isolation related to avoidance behavior as evidenced by inability to
go out of doors
, rationale:
When caring for this client, the PN should consider the nursing diagnosis, social
isolations (C), which best describes the client's findings that are consistent with
agoraphobic or fear of leaving home or going outdoors. (A,B, and C) are less accurate
descriptions of the client's condition or symptoms.
✔✔The practical nurse (PN) assesses a client with a poor self-concept. This client is
most likely to demonstrate which behaviors?
A. effective group functioning
B. accurate, astute perceptions
C. escalation of anxiety
D. willingness to accept change - ✔✔C. escalation of anxiety
rationale:
A client's weak self-concept provides inadequate tools for coping with anxiety, which
causes anxiety to escalate quickly (C). (A,B, and D) are seen in individuals with strong
self-concepts.
✔✔A practical nurse (PN) is reinforcing the steps for a dressing change for a male client
who has a leg ulcer. When the client tries to change the dressing, he says he is
inadequate, incompetent, and feels helpless. Which problem should the PN recognize
that the client is exhibiting?
A. depersonalization
B. personality fusion
C. self-esteem disturbance
D. personal identity disturbance - ✔✔C. self-esteem disturbance
rationale:
Self-esteem disturbance (C) is expressed as having a negative self-evaluation or
negative feelings about one's self or one's capabilities. Characteristics expressed by the
client do not reflect the problems in (A,B, or D).
✔✔A female client tells the practical nurse (PN) that she wants to lead a healthier, more
balanced life style. She asks the PN how she should begin the process of self-
exploration. Which message should the PN convey?
A. If someone is a victim of circumstances, unhealthy coping is often beyond one's
control.
B. Each adult is responsible for one's own behaviors, including unhealthy behaviors.
C. Significant life-style changes are easier followed if professional guidance is sought.
D. The first step is to focus on changing attitudes and behaviors of significant others. -
✔✔B. Each adult is responsible for one's own behaviors, including unhealthy behaviors.
rationale:
A principle of mental health is supported by an adult's ability to make choices and cope
with the consequences of one's behaviors while effectively contributing to community
and personal relationships. Learning new life-styles and coping mechanisms begins
QUESTIONS AND SOLUTIONS GRADED A+
✔✔The practical nurse (PN) is caring for a male client who is admitted for schizophrenia
and observes that his thoughts do not flow logically and he uses invented words. How
should the PN document this behavior?
A. interacts with others using child like expressions
B. uses neologisms and tangential expressions
C. demonstrates rapid speech while anxious
D. responds with defensive language to cope with others - ✔✔B. uses neologisms and
tangential expressions
rationale:
Documentation of the client's altered thought processes reflected in speech should be
described as tangential ideas, circumstantially, loose associations, and neologisms, or
"word salad" (B). (A,C, and D) are not accurate descriptors for this client.
✔✔A male client arrives at the mental health clinic complaining of insomnia, irritability,
increased tension, and headaches. He tells the practical nurse that the symptoms
began a week ago after he lost his job, and he is concerned that he may have to
relocate his family. Which stressor is this client experiencing?
A. an anxiety reaction
B. a situational crisis
C. a maturational crisis
D. an adjustment disorder - ✔✔B. a situational crisis
rationale:
A situational crisis occurs when a life event upsets an individual's psychosocial
equilibrium. Loss of a job can give rise to a situational crisis (B). (A,C, and D) do not
depict this client's situation.
✔✔A 19 year old calls the clinic and tells the practical nurse (PN) that since bringing her
newborn infant home, she has felt apathetic, fatigued, and helpless. She states, " I don't
know what's expected of me." What action is most important for the PN to take?
A. tell the charge nurse to come to the phone and talk with the client
B. direct the client to come to the clinic for mother baby care instructions
C. ask the client if she has been experiencing any hallucinations
D. determine if the client is feeling sad and having suicidal thoughts - ✔✔A. tell the
charge nurse to come to the phone and talk with the client
rationale:
The client is exhibiting signs of a maturational crisis related to the role changes required
by the birth of the infant. Crisis intervention is indicated, so the PN should ask the
charge nurse to talk with the client (A). (B,C, and D) could be considered if (A) proves
ineffective.
,✔✔A client who is admitted for surgery seems to focus only on his immediate concerns
and asks the practical nurse (PN) to repeat everything that is said over again. The client
seems to follow directions but asks for assistance when filling out admission forms and
checklists. He apologizes to the PN often and says he did not hear all of the
instructions. This client is experiencing which level of anxiety?
A. mild
B. panic
C. severe
D. moderate - ✔✔C. severe
rationale:
Severe anxiety (C) is characterized by a greatly narrowed perceptual field, difficulty with
problem solving, selective attention (focus on one detail), and selective inattention
(block out threatening stimuli). Mild to moderate levels of anxiety on the continuum are
characterized by the client being alert, attentive, and a focused perception that
facilitates as optimal state for problem solving and learning. This client is not exhibiting
signs and symptoms of (A,B, or C).
✔✔A male client is admitted to the hospital with distorted sensory perceptions,
disordered thoughts, and an increase in non-goal directed motor activity. The client
does not respond to the practical nurse's (PN) calming efforts. What is the next
intervention the PN should initiate?
A. decrease environmental stimuli
B. ensure the environment is safe
C. respect the client's personal space
D. encourage the client to express feelings - ✔✔B. ensure the environment is safe
rationale:
Safety (B) is the highest priority for a client who is experiencing severe anxiety, which
places him at high risk for self-injury related to the increased non-goal directed motor
activity, distorted perceptions, and disordered thought. (A,C, and D) may be indicated,
but the client's safety has the highest priority.
✔✔A woman tells the practical nurse (PN) that for the past 6 months she has been
terrified of leaving home. Whenever she thinks about going outdoors her heart pounds,
she shakes and cries, and feels dizzy. Based on these findings, which nursing diagnosis
should the practical nurse (PN) consider when caring for this client?
A. fear related to physiologic responses to leaving the home
B. self-esteem disturbance related to inability to leave home
C. social isolation related to avoidance behaviors as evidenced by inability to go out of
doors
D. altered thought processes related to panic attacks when she thinks of leaving the
house - ✔✔C. social isolation related to avoidance behavior as evidenced by inability to
go out of doors
, rationale:
When caring for this client, the PN should consider the nursing diagnosis, social
isolations (C), which best describes the client's findings that are consistent with
agoraphobic or fear of leaving home or going outdoors. (A,B, and C) are less accurate
descriptions of the client's condition or symptoms.
✔✔The practical nurse (PN) assesses a client with a poor self-concept. This client is
most likely to demonstrate which behaviors?
A. effective group functioning
B. accurate, astute perceptions
C. escalation of anxiety
D. willingness to accept change - ✔✔C. escalation of anxiety
rationale:
A client's weak self-concept provides inadequate tools for coping with anxiety, which
causes anxiety to escalate quickly (C). (A,B, and D) are seen in individuals with strong
self-concepts.
✔✔A practical nurse (PN) is reinforcing the steps for a dressing change for a male client
who has a leg ulcer. When the client tries to change the dressing, he says he is
inadequate, incompetent, and feels helpless. Which problem should the PN recognize
that the client is exhibiting?
A. depersonalization
B. personality fusion
C. self-esteem disturbance
D. personal identity disturbance - ✔✔C. self-esteem disturbance
rationale:
Self-esteem disturbance (C) is expressed as having a negative self-evaluation or
negative feelings about one's self or one's capabilities. Characteristics expressed by the
client do not reflect the problems in (A,B, or D).
✔✔A female client tells the practical nurse (PN) that she wants to lead a healthier, more
balanced life style. She asks the PN how she should begin the process of self-
exploration. Which message should the PN convey?
A. If someone is a victim of circumstances, unhealthy coping is often beyond one's
control.
B. Each adult is responsible for one's own behaviors, including unhealthy behaviors.
C. Significant life-style changes are easier followed if professional guidance is sought.
D. The first step is to focus on changing attitudes and behaviors of significant others. -
✔✔B. Each adult is responsible for one's own behaviors, including unhealthy behaviors.
rationale:
A principle of mental health is supported by an adult's ability to make choices and cope
with the consequences of one's behaviors while effectively contributing to community
and personal relationships. Learning new life-styles and coping mechanisms begins
