HESI RN MENTAL HEALTH EXAM – QUESTIONS
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DETAILED ANSWERS | PLUS RATIONALES |
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1. A nurse is caring for a client admitted with severe depression who states, "Everyone
would be better off without me." What is the nurse's priority action?
A. Conduct an immediate suicide risk assessment and ensure the client's safety.
B. Reassure the client that everything will improve.
C. Change the subject to reduce negative thinking.
D. Encourage the client to spend time alone.
CORRECT ANSWER: A. Conduct an immediate suicide risk assessment and ensure the
client's safety.
RATIONALE:
Statements suggesting hopelessness or self-harm require immediate assessment
for suicide risk. The nurse's priority is to ensure the client's safety through
further evaluation, close observation as indicated, and implementation of facility
protocols.
2. A client with generalized anxiety disorder reports persistent excessive worry that
interferes with daily functioning. Which nursing intervention is most appropriate initially?
A. Encourage the client to identify triggers and practice anxiety-reduction techniques.
B. Tell the client to stop worrying.
C. Avoid discussing the client's concerns.
D. Recommend complete social isolation.
CORRECT ANSWER: A. Encourage the client to identify triggers and practice anxiety-
reduction techniques.
RATIONALE:
Helping clients recognize anxiety triggers and develop coping strategies such as
deep breathing, grounding, or relaxation techniques promotes symptom
management and self-efficacy.
,3. A client diagnosed with schizophrenia states, "The television is sending me secret
messages." What is the nurse's best therapeutic response?
A. "I understand that this feels real to you, but I do not experience the television sending
messages."
B. "You're absolutely right."
C. "That's impossible. Stop thinking that way."
D. "Ignore it and it will disappear."
CORRECT ANSWER: A. "I understand that this feels real to you, but I do not experience the
television sending messages."
RATIONALE:
The nurse should acknowledge the client's feelings without reinforcing the
delusion. Presenting reality calmly while maintaining a therapeutic relationship
is the most appropriate response.
4. Which assessment finding requires immediate intervention in a client receiving lithium
therapy?
A. Severe diarrhea, vomiting, tremors, and confusion
B. Mild thirst
C. Increased appetite
D. Occasional dry mouth
CORRECT ANSWER: A. Severe diarrhea, vomiting, tremors, and confusion
RATIONALE:
These findings are consistent with possible lithium toxicity and require prompt
evaluation. Nurses should recognize toxicity early to prevent serious
complications.
5. A client experiencing a panic attack arrives in the emergency department. What is the
nurse's priority intervention?
A. Remain with the client, provide reassurance, and speak in a calm, simple manner.
B. Ask the client to complete detailed paperwork.
,C. Leave the client alone until the symptoms resolve.
D. Encourage vigorous exercise immediately.
CORRECT ANSWER: A. Remain with the client, provide reassurance, and speak in a calm,
simple manner.
RATIONALE:
During a panic attack, the nurse should remain with the client, reduce
environmental stimuli, use short, clear statements, and provide reassurance until
the acute symptoms subside.
6. A client with bipolar disorder is experiencing an acute manic episode. Which nursing
intervention is the highest priority?
A. Reduce environmental stimulation and maintain a safe environment.
B. Encourage participation in competitive group activities.
C. Provide unlimited caffeine.
D. Allow unrestricted spending.
CORRECT ANSWER: A. Reduce environmental stimulation and maintain a safe
environment.
RATIONALE:
Clients experiencing mania are at increased risk for injury due to impulsive
behavior, poor judgment, and excessive activity. Safety is the priority.
7. Which statement by a client indicates effective understanding of prescribed
antidepressant therapy?
A. "I know it may take several weeks before I notice the full benefits of this medication."
B. "I'll stop taking the medication as soon as I feel better."
C. "The medication should work completely after the first dose."
D. "I only need the medication on stressful days."
CORRECT ANSWER: A. "I know it may take several weeks before I notice the full benefits of
this medication."
RATIONALE:
, Most antidepressants require several weeks before their full therapeutic effect is
achieved. Clients should continue taking medications as prescribed unless
directed otherwise by the healthcare provider.
8. Which therapeutic communication technique is most appropriate when a client is
grieving the recent loss of a spouse?
A. Active listening with therapeutic silence when appropriate
B. Changing the subject to happier topics
C. Telling the client to "stay positive"
D. Comparing the loss to the nurse's own experiences
CORRECT ANSWER: A. Active listening with therapeutic silence when appropriate
RATIONALE:
Active listening allows the client to express emotions openly while demonstrating
empathy, acceptance, and emotional support without directing the conversation
away from the client's experience.
9. A client diagnosed with obsessive-compulsive disorder spends several hours each day
performing repetitive handwashing rituals. Which nursing goal is most appropriate
initially?
A. Reduce anxiety while gradually limiting compulsive behaviors.
B. Stop all rituals immediately.
C. Ignore the compulsive behavior completely.
D. Encourage additional rituals.
CORRECT ANSWER: A. Reduce anxiety while gradually limiting compulsive behaviors.
RATIONALE:
Compulsive behaviors often reduce anxiety temporarily. Gradual behavioral
interventions and anxiety management strategies are more therapeutic than
abruptly preventing rituals.
10. Which client statement most strongly suggests an increased risk for suicide?
AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE |
EXAM PREP | STUDY GUIDE | PRACTICE TEST
1. A nurse is caring for a client admitted with severe depression who states, "Everyone
would be better off without me." What is the nurse's priority action?
A. Conduct an immediate suicide risk assessment and ensure the client's safety.
B. Reassure the client that everything will improve.
C. Change the subject to reduce negative thinking.
D. Encourage the client to spend time alone.
CORRECT ANSWER: A. Conduct an immediate suicide risk assessment and ensure the
client's safety.
RATIONALE:
Statements suggesting hopelessness or self-harm require immediate assessment
for suicide risk. The nurse's priority is to ensure the client's safety through
further evaluation, close observation as indicated, and implementation of facility
protocols.
2. A client with generalized anxiety disorder reports persistent excessive worry that
interferes with daily functioning. Which nursing intervention is most appropriate initially?
A. Encourage the client to identify triggers and practice anxiety-reduction techniques.
B. Tell the client to stop worrying.
C. Avoid discussing the client's concerns.
D. Recommend complete social isolation.
CORRECT ANSWER: A. Encourage the client to identify triggers and practice anxiety-
reduction techniques.
RATIONALE:
Helping clients recognize anxiety triggers and develop coping strategies such as
deep breathing, grounding, or relaxation techniques promotes symptom
management and self-efficacy.
,3. A client diagnosed with schizophrenia states, "The television is sending me secret
messages." What is the nurse's best therapeutic response?
A. "I understand that this feels real to you, but I do not experience the television sending
messages."
B. "You're absolutely right."
C. "That's impossible. Stop thinking that way."
D. "Ignore it and it will disappear."
CORRECT ANSWER: A. "I understand that this feels real to you, but I do not experience the
television sending messages."
RATIONALE:
The nurse should acknowledge the client's feelings without reinforcing the
delusion. Presenting reality calmly while maintaining a therapeutic relationship
is the most appropriate response.
4. Which assessment finding requires immediate intervention in a client receiving lithium
therapy?
A. Severe diarrhea, vomiting, tremors, and confusion
B. Mild thirst
C. Increased appetite
D. Occasional dry mouth
CORRECT ANSWER: A. Severe diarrhea, vomiting, tremors, and confusion
RATIONALE:
These findings are consistent with possible lithium toxicity and require prompt
evaluation. Nurses should recognize toxicity early to prevent serious
complications.
5. A client experiencing a panic attack arrives in the emergency department. What is the
nurse's priority intervention?
A. Remain with the client, provide reassurance, and speak in a calm, simple manner.
B. Ask the client to complete detailed paperwork.
,C. Leave the client alone until the symptoms resolve.
D. Encourage vigorous exercise immediately.
CORRECT ANSWER: A. Remain with the client, provide reassurance, and speak in a calm,
simple manner.
RATIONALE:
During a panic attack, the nurse should remain with the client, reduce
environmental stimuli, use short, clear statements, and provide reassurance until
the acute symptoms subside.
6. A client with bipolar disorder is experiencing an acute manic episode. Which nursing
intervention is the highest priority?
A. Reduce environmental stimulation and maintain a safe environment.
B. Encourage participation in competitive group activities.
C. Provide unlimited caffeine.
D. Allow unrestricted spending.
CORRECT ANSWER: A. Reduce environmental stimulation and maintain a safe
environment.
RATIONALE:
Clients experiencing mania are at increased risk for injury due to impulsive
behavior, poor judgment, and excessive activity. Safety is the priority.
7. Which statement by a client indicates effective understanding of prescribed
antidepressant therapy?
A. "I know it may take several weeks before I notice the full benefits of this medication."
B. "I'll stop taking the medication as soon as I feel better."
C. "The medication should work completely after the first dose."
D. "I only need the medication on stressful days."
CORRECT ANSWER: A. "I know it may take several weeks before I notice the full benefits of
this medication."
RATIONALE:
, Most antidepressants require several weeks before their full therapeutic effect is
achieved. Clients should continue taking medications as prescribed unless
directed otherwise by the healthcare provider.
8. Which therapeutic communication technique is most appropriate when a client is
grieving the recent loss of a spouse?
A. Active listening with therapeutic silence when appropriate
B. Changing the subject to happier topics
C. Telling the client to "stay positive"
D. Comparing the loss to the nurse's own experiences
CORRECT ANSWER: A. Active listening with therapeutic silence when appropriate
RATIONALE:
Active listening allows the client to express emotions openly while demonstrating
empathy, acceptance, and emotional support without directing the conversation
away from the client's experience.
9. A client diagnosed with obsessive-compulsive disorder spends several hours each day
performing repetitive handwashing rituals. Which nursing goal is most appropriate
initially?
A. Reduce anxiety while gradually limiting compulsive behaviors.
B. Stop all rituals immediately.
C. Ignore the compulsive behavior completely.
D. Encourage additional rituals.
CORRECT ANSWER: A. Reduce anxiety while gradually limiting compulsive behaviors.
RATIONALE:
Compulsive behaviors often reduce anxiety temporarily. Gradual behavioral
interventions and anxiety management strategies are more therapeutic than
abruptly preventing rituals.
10. Which client statement most strongly suggests an increased risk for suicide?
