NGN Mental Health HESI Examination Versions A & B Question
Bank (Latest 2026/2027 Edition) – 100% Correct Questions,
Answers & Detailed Rationales
Total Questions: 70 (Version A: 35, Version B: 35)
Time Allowed: 90 Minutes
Passing Score: 850+
Instructions: Select the BEST answer for each question based on psychiatric-mental
health nursing principles, DSM-5-TR criteria, and evidence-based practice. For SATA
questions, select all that apply. NGN-style case scenarios require clinical judgment and
prioritization.
VERSION A (Questions 1-35)
SECTION 1: PSYCHIATRIC ASSESSMENT & THERAPEUTIC COMMUNICATION
Questions 1-6
Question 1
A 34-year-old patient with major depressive disorder states, "I don't think my family
cares about me anymore. They never call." Which therapeutic communication response
by the nurse is MOST appropriate?
A. "Why do you think your family doesn't care about you?"
B. "Your family does care about you. I'm sure they are just busy."
C. "It sounds like you feel isolated from your family. Tell me more about that."
D. "You should call them instead of waiting for them to call you."
Correct Answer: C
,Rationale: Option C demonstrates reflection, a core therapeutic communication
technique that validates the patient's feelings and encourages further expression.
Option A is non-therapeutic because asking "why" puts the patient on the defensive.
Option B provides false reassurance, which minimizes the patient's feelings. Option D
gives advice, which is non-therapeutic and may increase the patient's feelings of
helplessness. Reflection helps build trust and promotes the therapeutic relationship.
Question 2
A nurse is conducting a mental status examination (MSE) on a patient newly admitted
to the psychiatric unit. Which assessment finding indicates the patient is experiencing
thought process abnormalities?
A. The patient maintains consistent eye contact throughout the interview.
B. The patient jumps from topic to topic without logical connections between ideas.
C. The patient describes mood as "sad and hopeless."
D. The patient is oriented to person, place, and time.
Correct Answer: B
Rationale: Flight of ideas or loose associations, demonstrated by jumping between
unrelated topics, represents a thought process abnormality. Option A reflects
appropriate behavior. Option C describes mood/affect, not thought process. Option D
indicates intact orientation and cognition. Thought process abnormalities are critical to
identify as they may indicate psychosis, mania, or cognitive impairment requiring
immediate intervention.
Question 3 (SATA)
A nurse is completing a suicide risk assessment on a 28-year-old patient who was
recently diagnosed with bipolar disorder. Which factors should the nurse identify as
increasing this patient's suicide risk? Select all that apply.
A. Male gender
B. Recent diagnosis of a mood disorder
,C. Strong religious beliefs
D. Access to firearms
E. History of previous suicide attempts
Correct Answers: A, B, D, E
Rationale: Male gender is a demographic risk factor for completed suicide. Recent
diagnosis of a mood disorder increases risk due to adjustment difficulties and potential
untreated symptoms. Access to firearms significantly increases lethality risk and is a
major modifiable risk factor. History of previous attempts is one of the strongest
predictors of future suicidal behavior. Strong religious beliefs (Option C) are generally
considered a protective factor against suicide, not a risk factor. The nurse must
document these risk factors and implement appropriate safety precautions.
Question 4
A nurse is assessing a patient from a Southeast Asian cultural background who
presents with symptoms of anxiety. The patient describes experiencing "wind illness"
and believes their symptoms are caused by an imbalance of hot and cold forces. Which
is the MOST appropriate nursing action?
A. Explain to the patient that their cultural beliefs are incorrect and anxiety is caused by
neurotransmitter imbalances.
B. Incorporate the patient's cultural understanding into the assessment while applying
evidence-based psychiatric nursing interventions.
C. Refer the patient to a traditional healer instead of providing Western psychiatric care.
D. Document that the patient lacks insight into their mental illness due to cultural
beliefs.
Correct Answer: B
Rationale: Culturally responsive care requires respecting the patient's explanatory model
of illness while delivering evidence-based interventions. Option A dismisses the
patient's cultural framework and damages therapeutic rapport. Option C abandons the
nurse's professional responsibility to provide care. Option D pathologizes cultural
, beliefs, which is ethnocentric and inaccurate. The nurse should use cultural formulation
to understand the patient's perspective and integrate it with psychiatric treatment
planning.
Question 5
During a therapeutic interaction, a patient with borderline personality disorder becomes
angry and states, "You are the worst nurse I've ever had. You don't care about me at all."
Which response demonstrates the MOST appropriate use of limit setting?
A. "I understand you're upset, but I will not tolerate being spoken to disrespectfully. Let's
discuss your concerns calmly."
B. "I'm sorry you feel that way. I'll assign you to a different nurse."
C. "You know that's not true. I've been very attentive to your needs."
D. "Why would you say something like that when I've been helping you?"
Correct Answer: A
Rationale: Limit setting involves clearly stating boundaries while maintaining
therapeutic engagement. Option A establishes behavioral expectations without
abandoning the patient or becoming defensive. Option B reinforces splitting and avoids
addressing the behavior. Option C becomes defensive, which escalates conflict. Option
D asks "why," which is non-therapeutic and puts the patient on the defensive. Patients
with borderline personality disorder benefit from consistent, calm limit setting that
maintains the therapeutic relationship.
Question 6
A nurse administers the PHQ-9 (Patient Health Questionnaire-9) to a patient during a
routine psychiatric assessment. The patient scores 18 out of 27. Which interpretation
and action by the nurse is MOST appropriate?
A. The score indicates mild depression; schedule follow-up in 3 months.
B. The score indicates moderate depression; consider initiating antidepressant therapy
and psychotherapy.
Bank (Latest 2026/2027 Edition) – 100% Correct Questions,
Answers & Detailed Rationales
Total Questions: 70 (Version A: 35, Version B: 35)
Time Allowed: 90 Minutes
Passing Score: 850+
Instructions: Select the BEST answer for each question based on psychiatric-mental
health nursing principles, DSM-5-TR criteria, and evidence-based practice. For SATA
questions, select all that apply. NGN-style case scenarios require clinical judgment and
prioritization.
VERSION A (Questions 1-35)
SECTION 1: PSYCHIATRIC ASSESSMENT & THERAPEUTIC COMMUNICATION
Questions 1-6
Question 1
A 34-year-old patient with major depressive disorder states, "I don't think my family
cares about me anymore. They never call." Which therapeutic communication response
by the nurse is MOST appropriate?
A. "Why do you think your family doesn't care about you?"
B. "Your family does care about you. I'm sure they are just busy."
C. "It sounds like you feel isolated from your family. Tell me more about that."
D. "You should call them instead of waiting for them to call you."
Correct Answer: C
,Rationale: Option C demonstrates reflection, a core therapeutic communication
technique that validates the patient's feelings and encourages further expression.
Option A is non-therapeutic because asking "why" puts the patient on the defensive.
Option B provides false reassurance, which minimizes the patient's feelings. Option D
gives advice, which is non-therapeutic and may increase the patient's feelings of
helplessness. Reflection helps build trust and promotes the therapeutic relationship.
Question 2
A nurse is conducting a mental status examination (MSE) on a patient newly admitted
to the psychiatric unit. Which assessment finding indicates the patient is experiencing
thought process abnormalities?
A. The patient maintains consistent eye contact throughout the interview.
B. The patient jumps from topic to topic without logical connections between ideas.
C. The patient describes mood as "sad and hopeless."
D. The patient is oriented to person, place, and time.
Correct Answer: B
Rationale: Flight of ideas or loose associations, demonstrated by jumping between
unrelated topics, represents a thought process abnormality. Option A reflects
appropriate behavior. Option C describes mood/affect, not thought process. Option D
indicates intact orientation and cognition. Thought process abnormalities are critical to
identify as they may indicate psychosis, mania, or cognitive impairment requiring
immediate intervention.
Question 3 (SATA)
A nurse is completing a suicide risk assessment on a 28-year-old patient who was
recently diagnosed with bipolar disorder. Which factors should the nurse identify as
increasing this patient's suicide risk? Select all that apply.
A. Male gender
B. Recent diagnosis of a mood disorder
,C. Strong religious beliefs
D. Access to firearms
E. History of previous suicide attempts
Correct Answers: A, B, D, E
Rationale: Male gender is a demographic risk factor for completed suicide. Recent
diagnosis of a mood disorder increases risk due to adjustment difficulties and potential
untreated symptoms. Access to firearms significantly increases lethality risk and is a
major modifiable risk factor. History of previous attempts is one of the strongest
predictors of future suicidal behavior. Strong religious beliefs (Option C) are generally
considered a protective factor against suicide, not a risk factor. The nurse must
document these risk factors and implement appropriate safety precautions.
Question 4
A nurse is assessing a patient from a Southeast Asian cultural background who
presents with symptoms of anxiety. The patient describes experiencing "wind illness"
and believes their symptoms are caused by an imbalance of hot and cold forces. Which
is the MOST appropriate nursing action?
A. Explain to the patient that their cultural beliefs are incorrect and anxiety is caused by
neurotransmitter imbalances.
B. Incorporate the patient's cultural understanding into the assessment while applying
evidence-based psychiatric nursing interventions.
C. Refer the patient to a traditional healer instead of providing Western psychiatric care.
D. Document that the patient lacks insight into their mental illness due to cultural
beliefs.
Correct Answer: B
Rationale: Culturally responsive care requires respecting the patient's explanatory model
of illness while delivering evidence-based interventions. Option A dismisses the
patient's cultural framework and damages therapeutic rapport. Option C abandons the
nurse's professional responsibility to provide care. Option D pathologizes cultural
, beliefs, which is ethnocentric and inaccurate. The nurse should use cultural formulation
to understand the patient's perspective and integrate it with psychiatric treatment
planning.
Question 5
During a therapeutic interaction, a patient with borderline personality disorder becomes
angry and states, "You are the worst nurse I've ever had. You don't care about me at all."
Which response demonstrates the MOST appropriate use of limit setting?
A. "I understand you're upset, but I will not tolerate being spoken to disrespectfully. Let's
discuss your concerns calmly."
B. "I'm sorry you feel that way. I'll assign you to a different nurse."
C. "You know that's not true. I've been very attentive to your needs."
D. "Why would you say something like that when I've been helping you?"
Correct Answer: A
Rationale: Limit setting involves clearly stating boundaries while maintaining
therapeutic engagement. Option A establishes behavioral expectations without
abandoning the patient or becoming defensive. Option B reinforces splitting and avoids
addressing the behavior. Option C becomes defensive, which escalates conflict. Option
D asks "why," which is non-therapeutic and puts the patient on the defensive. Patients
with borderline personality disorder benefit from consistent, calm limit setting that
maintains the therapeutic relationship.
Question 6
A nurse administers the PHQ-9 (Patient Health Questionnaire-9) to a patient during a
routine psychiatric assessment. The patient scores 18 out of 27. Which interpretation
and action by the nurse is MOST appropriate?
A. The score indicates mild depression; schedule follow-up in 3 months.
B. The score indicates moderate depression; consider initiating antidepressant therapy
and psychotherapy.
