HESI MENTAL HEALTH NGN EXAM 200 ACTUAL QUESTIONS
AND CORRECT ANSWERS WITH RATIONALE ALREADY
GRADED A+
The HESI Mental Health NGN Exam is a standardized assessment designed to
evaluate nursing students' clinical judgment and readiness for the NCLEX-RN in
psychiatric-mental health nursing. The exam utilizes Next Generation NCLEX
(NGN) format, featuring unfolding case studies, multiple-choice questions, and
innovative item types like bow-tie and drag-and-drop. Key content areas include
therapeutic communication, psychiatric disorders (schizophrenia, depression,
bipolar disorder, anxiety, personality disorders), psychopharmacology, crisis
intervention, legal and ethical issues, and safety considerations. The exam
emphasizes priority setting, delegation, and evidence-based interventions,
preparing students to provide safe, holistic care to clients across the mental health
continuum. Performance on this exam is highly predictive of NCLEX success and
nursing program progression.
1. A nurse is caring for a client with antisocial personality disorder who is
manipulative and demanding. Which intervention should the nurse implement to
maintain therapeutic boundaries?
A) Grant all reasonable requests to avoid conflict with the client
B) Set clear, consistent limits on behavior and enforce consequences for violations
C) Engage in power struggles to demonstrate authority
D) Allow the client to make all decisions regarding their care plan
Answer: B
Rationale: Setting clear, consistent limits and enforcing consequences are essential
when caring for clients with antisocial personality disorder. This approach prevents
manipulation and maintains safety.
,2. A client is admitted with a diagnosis of bipolar disorder, manic episode. Which
assessment finding is most consistent with this diagnosis?
A) Flat affect and social withdrawal
B) Grandiose delusions and psychomotor agitation
C) Anhedonia and hypersomnia
D) Guilt and feelings of worthlessness
Answer: B
Rationale: Grandiose delusions, increased energy, psychomotor agitation, and
decreased need for sleep are hallmark symptoms of a manic episode. Flat affect,
withdrawal, and anhedonia are associated with depression.
3. A nurse is providing education to a client prescribed lorazepam for anxiety.
Which statement by the client indicates a need for further teaching?
A) "I should not drink alcohol while taking this medication."
B) "I can take this medication daily without risk of dependence."
C) "I should not stop taking this medication abruptly."
D) "This medication may cause drowsiness."
Answer: B
Rationale: Benzodiazepines like lorazepam have a potential for dependence and
tolerance. Clients should be informed that long-term daily use carries a risk of
dependence and should only be used as prescribed.
4. A client with obsessive-compulsive disorder (OCD) spends hours each day
checking and rechecking that the doors are locked. Which nursing intervention is
most therapeutic?
A) Allow the client unlimited time to complete the checking rituals
B) Set a time limit for checking and gradually decrease the time allowed
C) Physically prevent the client from checking the locks
D) Tell the client that the behavior is irrational and should stop
Answer: B
Rationale: Gradually decreasing the time allowed for compulsions (response
prevention) is a therapeutic intervention that helps the client gain control over the
behavior. Unlimited time reinforces the compulsion, and physical prevention or
confrontation is not therapeutic.
5. A nurse is assessing a client with a diagnosis of major depressive disorder.
Which statement by the client requires immediate intervention?
A) "I feel really sad and tired all the time."
B) "I have a plan to harm myself using pills I have at home."
C) "I don't enjoy spending time with my friends anymore."
,D) "I have difficulty sleeping and don't feel like eating."
Answer: B
Rationale: Any statement indicating a specific plan to harm oneself requires
immediate intervention to ensure safety. The nurse must take this seriously and
implement suicide precautions immediately.
6. A client with paranoid schizophrenia refuses to take medication, stating that the
pills are poisoned. Which nursing response is most appropriate?
A) "The pills are not poisoned, and you must take them."
B) "I understand you are afraid. Let me stay with you while you take the
medication."
C) "If you don't take your medication, I will have to give you a shot."
D) "You are being irrational, the hospital would not give you poisoned pills."
Answer: B
Rationale: Acknowledging the client's fear without agreeing with the delusion is
therapeutic. Offering to stay with the client builds trust and may facilitate
medication adherence.
7. A nurse is preparing to discharge a client with a history of alcohol use disorder.
Which referral is most appropriate to support long-term recovery?
A) Al-Anon family groups
B) Alcoholics Anonymous (AA)
C) Narcotics Anonymous (NA)
D) Gamblers Anonymous
Answer: B
Rationale: Alcoholics Anonymous is a peer support group specifically for
individuals with alcohol use disorder. Al-Anon is for family members, NA is for
drug addiction, and Gamblers Anonymous is for gambling addiction.
8. A client is experiencing a manic episode and is pacing rapidly in the hallway.
Which intervention should the nurse implement to provide a safe environment?
A) Place the client in seclusion until pacing stops
B) Provide high-calorie finger foods and fluids to maintain nutrition and hydration
C) Encourage the client to rest in a dark room
D) Assign the client to a private room away from other clients
Answer: B
Rationale: Clients in a manic episode often have increased activity and may not sit
for meals. Providing high-calorie finger foods that can be eaten while moving
helps maintain nutrition and hydration.
, 9. A nurse is assessing a client with Alzheimer's disease who is experiencing
sundowning. Which finding is characteristic of sundowning?
A) Increased confusion and agitation in the late afternoon and evening
B) Improved cognitive function in the morning
C) Decreased physical activity at night
D) Increased appetite during the evening hours
Answer: A
Rationale: Sundowning is characterized by increased confusion, agitation, and
restlessness in the late afternoon and evening hours. This is a common pattern in
Alzheimer's disease and other dementias.
10. A client with post-traumatic stress disorder (PTSD) reports recurrent
nightmares and avoidance of reminders of the traumatic event. Which class of
medication is most commonly prescribed for PTSD?
A) Antipsychotics
B) SSRIs (Selective Serotonin Reuptake Inhibitors)
C) Benzodiazepines
D) Mood stabilizers
Answer: B
Rationale: SSRIs, such as sertraline and paroxetine, are the first-line
pharmacologic treatment for PTSD. They help reduce core symptoms including
nightmares, hyperarousal, and avoidance.
11. A nurse is caring for a client with conversion disorder who is experiencing
paralysis of the lower extremities with no organic cause. Which nursing approach
is most appropriate?
A) Confront the client about the lack of physical findings
B) Assist the client with activities of daily living while allowing them to express
feelings
C) Encourage the client to try harder to walk
D) Ignore the symptom and focus on other issues
Answer: B
Rationale: Assisting the client with ADLs while providing emotional support is
therapeutic. Confrontation, encouragement to "try harder," or ignoring the
symptom are not therapeutic and may increase anxiety.
12. A client with a diagnosis of schizophrenia is prescribed clozapine. Which
laboratory test must be monitored regularly due to a serious adverse effect of this
medication?
A) Serum creatinine and BUN
AND CORRECT ANSWERS WITH RATIONALE ALREADY
GRADED A+
The HESI Mental Health NGN Exam is a standardized assessment designed to
evaluate nursing students' clinical judgment and readiness for the NCLEX-RN in
psychiatric-mental health nursing. The exam utilizes Next Generation NCLEX
(NGN) format, featuring unfolding case studies, multiple-choice questions, and
innovative item types like bow-tie and drag-and-drop. Key content areas include
therapeutic communication, psychiatric disorders (schizophrenia, depression,
bipolar disorder, anxiety, personality disorders), psychopharmacology, crisis
intervention, legal and ethical issues, and safety considerations. The exam
emphasizes priority setting, delegation, and evidence-based interventions,
preparing students to provide safe, holistic care to clients across the mental health
continuum. Performance on this exam is highly predictive of NCLEX success and
nursing program progression.
1. A nurse is caring for a client with antisocial personality disorder who is
manipulative and demanding. Which intervention should the nurse implement to
maintain therapeutic boundaries?
A) Grant all reasonable requests to avoid conflict with the client
B) Set clear, consistent limits on behavior and enforce consequences for violations
C) Engage in power struggles to demonstrate authority
D) Allow the client to make all decisions regarding their care plan
Answer: B
Rationale: Setting clear, consistent limits and enforcing consequences are essential
when caring for clients with antisocial personality disorder. This approach prevents
manipulation and maintains safety.
,2. A client is admitted with a diagnosis of bipolar disorder, manic episode. Which
assessment finding is most consistent with this diagnosis?
A) Flat affect and social withdrawal
B) Grandiose delusions and psychomotor agitation
C) Anhedonia and hypersomnia
D) Guilt and feelings of worthlessness
Answer: B
Rationale: Grandiose delusions, increased energy, psychomotor agitation, and
decreased need for sleep are hallmark symptoms of a manic episode. Flat affect,
withdrawal, and anhedonia are associated with depression.
3. A nurse is providing education to a client prescribed lorazepam for anxiety.
Which statement by the client indicates a need for further teaching?
A) "I should not drink alcohol while taking this medication."
B) "I can take this medication daily without risk of dependence."
C) "I should not stop taking this medication abruptly."
D) "This medication may cause drowsiness."
Answer: B
Rationale: Benzodiazepines like lorazepam have a potential for dependence and
tolerance. Clients should be informed that long-term daily use carries a risk of
dependence and should only be used as prescribed.
4. A client with obsessive-compulsive disorder (OCD) spends hours each day
checking and rechecking that the doors are locked. Which nursing intervention is
most therapeutic?
A) Allow the client unlimited time to complete the checking rituals
B) Set a time limit for checking and gradually decrease the time allowed
C) Physically prevent the client from checking the locks
D) Tell the client that the behavior is irrational and should stop
Answer: B
Rationale: Gradually decreasing the time allowed for compulsions (response
prevention) is a therapeutic intervention that helps the client gain control over the
behavior. Unlimited time reinforces the compulsion, and physical prevention or
confrontation is not therapeutic.
5. A nurse is assessing a client with a diagnosis of major depressive disorder.
Which statement by the client requires immediate intervention?
A) "I feel really sad and tired all the time."
B) "I have a plan to harm myself using pills I have at home."
C) "I don't enjoy spending time with my friends anymore."
,D) "I have difficulty sleeping and don't feel like eating."
Answer: B
Rationale: Any statement indicating a specific plan to harm oneself requires
immediate intervention to ensure safety. The nurse must take this seriously and
implement suicide precautions immediately.
6. A client with paranoid schizophrenia refuses to take medication, stating that the
pills are poisoned. Which nursing response is most appropriate?
A) "The pills are not poisoned, and you must take them."
B) "I understand you are afraid. Let me stay with you while you take the
medication."
C) "If you don't take your medication, I will have to give you a shot."
D) "You are being irrational, the hospital would not give you poisoned pills."
Answer: B
Rationale: Acknowledging the client's fear without agreeing with the delusion is
therapeutic. Offering to stay with the client builds trust and may facilitate
medication adherence.
7. A nurse is preparing to discharge a client with a history of alcohol use disorder.
Which referral is most appropriate to support long-term recovery?
A) Al-Anon family groups
B) Alcoholics Anonymous (AA)
C) Narcotics Anonymous (NA)
D) Gamblers Anonymous
Answer: B
Rationale: Alcoholics Anonymous is a peer support group specifically for
individuals with alcohol use disorder. Al-Anon is for family members, NA is for
drug addiction, and Gamblers Anonymous is for gambling addiction.
8. A client is experiencing a manic episode and is pacing rapidly in the hallway.
Which intervention should the nurse implement to provide a safe environment?
A) Place the client in seclusion until pacing stops
B) Provide high-calorie finger foods and fluids to maintain nutrition and hydration
C) Encourage the client to rest in a dark room
D) Assign the client to a private room away from other clients
Answer: B
Rationale: Clients in a manic episode often have increased activity and may not sit
for meals. Providing high-calorie finger foods that can be eaten while moving
helps maintain nutrition and hydration.
, 9. A nurse is assessing a client with Alzheimer's disease who is experiencing
sundowning. Which finding is characteristic of sundowning?
A) Increased confusion and agitation in the late afternoon and evening
B) Improved cognitive function in the morning
C) Decreased physical activity at night
D) Increased appetite during the evening hours
Answer: A
Rationale: Sundowning is characterized by increased confusion, agitation, and
restlessness in the late afternoon and evening hours. This is a common pattern in
Alzheimer's disease and other dementias.
10. A client with post-traumatic stress disorder (PTSD) reports recurrent
nightmares and avoidance of reminders of the traumatic event. Which class of
medication is most commonly prescribed for PTSD?
A) Antipsychotics
B) SSRIs (Selective Serotonin Reuptake Inhibitors)
C) Benzodiazepines
D) Mood stabilizers
Answer: B
Rationale: SSRIs, such as sertraline and paroxetine, are the first-line
pharmacologic treatment for PTSD. They help reduce core symptoms including
nightmares, hyperarousal, and avoidance.
11. A nurse is caring for a client with conversion disorder who is experiencing
paralysis of the lower extremities with no organic cause. Which nursing approach
is most appropriate?
A) Confront the client about the lack of physical findings
B) Assist the client with activities of daily living while allowing them to express
feelings
C) Encourage the client to try harder to walk
D) Ignore the symptom and focus on other issues
Answer: B
Rationale: Assisting the client with ADLs while providing emotional support is
therapeutic. Confrontation, encouragement to "try harder," or ignoring the
symptom are not therapeutic and may increase anxiety.
12. A client with a diagnosis of schizophrenia is prescribed clozapine. Which
laboratory test must be monitored regularly due to a serious adverse effect of this
medication?
A) Serum creatinine and BUN
