EVOLVE HESI RN PSYCHIATRIC-MENTAL HEALTH EXIT
EXAM 200 ACTUAL QUESTIONS AND CORRECT ANSWERS
WITH RATIONALE LATEST 2026 ALREADY GRADED A+
This comprehensive 200-question exam bank covers the full spectrum of the
EVOLVE HESI RN Psychiatric-Mental Health Exit Examination. It includes
foundational psychiatric nursing concepts, therapeutic communication
techniques, psychotropic medication management (antipsychotics,
antidepressants, mood stabilizers, anxiolytics), and care for clients with
schizophrenia, bipolar disorder, major depression, anxiety disorders, PTSD,
eating disorders, personality disorders, dementia, and substance use
disorders. Questions address safety protocols, legal and ethical issues, crisis
intervention, suicide risk assessment, stages of change, defense mechanisms,
and nursing diagnoses. Each unique question features multiple-choice format
with correct answers and detailed rationales to reinforce clinical reasoning
and critical thinking for successful exam preparation.
1. At the first meeting of a group of older adults at a daycare center, the nurse asks
one member what she would like to do. She shrugs and says, "You tell me, you're
the leader." What is the best response for the nurse to make?
A) "Yes, I am the leader today. Would you like to be the leader tomorrow?"
B) "Yes, I will be leading this group. What would you like to accomplish during
this time?"
C) "Yes, I have been assigned to be the leader of this group. I will be here for the
next six weeks."
D) "Yes, I am the leader. You seem angry about not being the leader yourself."
Correct Answer: B) "Yes, I will be leading this group. What would you like to
accomplish during this time?"
Rationale: In the initial phase of group dynamics, members often experience
anxiety and test the leader. Option B provides information about the leader's role
and redirects the group to define its function, which is therapeutic. Option A is
manipulative, C provides information but lacks focus on the group's purpose, and
D is an interpretive challenge that is inappropriate for the initial phase .
,2. During a group session that has been meeting for several weeks, one male
participant monopolizes the group's time and interrupts others. What is the best
action for the nurse to take?
A) Talk to the client outside the group about his behavior.
B) Remind the client to allow others a chance to talk.
C) Allow the group to handle the problem.
D) Ask the client to join another group.
Correct Answer: C) Allow the group to handle the problem.
Rationale: The group is in the working phase, and members should be allowed to
determine the group's direction. Allowing the group to address the monopolizing
behavior promotes group cohesion and members' problem-solving skills. Separate
meetings with the leader (A) can be manipulative, B is dictatorial, and D avoids the
problem .
3. An 86-year-old female client with Alzheimer's disease is wandering the busy
halls and asks the nurse, "Where should I stand for the parade?" Which response is
best for the nurse to provide?
A) "Anywhere you want to stand as long as you do not get hurt by those in the
parade."
B) "You are confused because of all the activity in the hall. There is no parade."
C) "Let's go back to the activity room and see what is going on in there."
D) "Remember I told you that this is a nursing home and I am your nurse."
Correct Answer: C) "Let's go back to the activity room and see what is going on in
there."
Rationale: Redirecting the client to a safer place and familiar activities is most
helpful, as clients with Alzheimer's experience short-term memory loss. A
dismisses the client's attempt to find order, B dismisses the client and may increase
anxiety, and D scolds the client and may hurt their feelings .
4. Physical examination of a 6-year-old reveals several bite marks in various
locations on his body, and x-rays reveal healed rib fractures. The mother tells the
nurse her child is "always having accidents." Which initial response by the nurse is
most appropriate?
A) "I need to inform the healthcare provider about your child's tendency to be
accident prone."
B) "Tell me more specifically about your child's accidents."
C) "I must report these injuries to the authorities because they do not seem
accidental."
D) "Boys this age always seem to require more supervision and can be quite
accident prone."
,Correct Answer: B) "Tell me more specifically about your child's accidents."
Rationale: This open-ended, non-threatening statement seeks more information
before jumping to conclusions. A is sarcastic and avoids the situation, C is
accusatory before conclusive data is obtained, and D dismisses the seriousness of
the situation .
5. A child is brought to the emergency room with a broken arm. Because of other
injuries, the nurse suspects abuse. When the nurse tries to give the child an
injection, the mother becomes loud and shouts, "I won't leave my son! Don't you
touch him! You'll hurt my child!" What is the best interpretation of the mother's
statements?
A) Regressing to an earlier behavior pattern
B) Sublimating her anger
C) Projecting her feelings onto the nurse
D) Suppressing her fear
Correct Answer: C) Projecting her feelings onto the nurse.
Rationale: Projection is attributing one's own unacceptable thoughts, impulses, or
behaviors onto another. The mother is likely harming the child and is attributing
her actions to the nurse. She may be immature, but regression (A) is not the best
description. Sublimation (B) involves substituting a socially acceptable feeling for
an unacceptable one. Suppression (D) is a conscious denial, but the data suggests
projection .
6. A client with paranoid schizophrenia refuses to eat, telling the nurse, "I know
you are trying to poison me with that food." Which response is most appropriate
for the nurse to make?
A) "I'll leave your tray here. I am available if you need anything else."
B) "You're not being poisoned. Why do you think someone is trying to poison
you?"
C) "No one on this unit has ever died from poisoning. You're safe here."
D) "I will talk to your healthcare provider about the possibility of changing your
diet."
Correct Answer: A) "I'll leave your tray here. I am available if you need anything
else."
Rationale: The nurse should not argue with the client's delusions. Option A offers
support by agreeing to "be there" without demanding the client eat. B and C are
arguing with the delusion and asking "why" is not therapeutic for a psychotic
client. D addresses diet, not the client's paranoid belief .
, 7. A 25-year-old female client is trying to leave the psychiatric unit, telling the
nurse, "Please let me go! I must leave because the secret police are after me."
Which response is best for the nurse to make?
A) "No one is after you, you're safe here."
B) "You'll feel better after you have rested."
C) "I know you must feel lonely and frightened."
D) "Come with me to your room and I will sit with you."
Correct Answer: D) "Come with me to your room and I will sit with you."
Rationale: This offers support without judgment or demands, helping to de-escalate
the situation. A argues with the client's delusion, B offers false reassurance, and C
tells the client how she feels rather than allowing her to describe her own feelings .
8. A 45-year-old male client tells the nurse that he used to believe he was Jesus
Christ, but now he knows he is not. Which response is best for the nurse to make?
A) "Did you really believe you were Jesus Christ?"
B) "I think you're getting well."
C) "Others have had similar thoughts when under stress."
D) "Why did you think you were Jesus Christ?"
Correct Answer: C) "Others have had similar thoughts when under stress."
Rationale: This normalizes the client's experience and offers support without
judgment. A is belittling, B is an inappropriate judgment, and D asks "why" which
the client cannot answer .
9. A nurse in the emergency room of a children's hospital admits a child whose
injuries could have resulted from abuse. Which statement most accurately
describes the nurse's responsibility in cases of suspected child abuse?
A) The nurse should obtain objective data such as x-rays before reporting
suspicions to the authorities.
B) The nurse should confirm any suspicions of child abuse with the healthcare
provider before reporting to the authorities.
C) The nurse should report any case of suspected child abuse to the nurse in
charge.
D) The nurse should note in the client's record any suspicions of child abuse so that
a history can be tracked.
Correct Answer: C) The nurse should report any case of suspected child abuse to
the nurse in charge.
Rationale: It is the nurse's legal responsibility to report all suspected cases of child
abuse. Notifying the charge nurse initiates the legal reporting process .
EXAM 200 ACTUAL QUESTIONS AND CORRECT ANSWERS
WITH RATIONALE LATEST 2026 ALREADY GRADED A+
This comprehensive 200-question exam bank covers the full spectrum of the
EVOLVE HESI RN Psychiatric-Mental Health Exit Examination. It includes
foundational psychiatric nursing concepts, therapeutic communication
techniques, psychotropic medication management (antipsychotics,
antidepressants, mood stabilizers, anxiolytics), and care for clients with
schizophrenia, bipolar disorder, major depression, anxiety disorders, PTSD,
eating disorders, personality disorders, dementia, and substance use
disorders. Questions address safety protocols, legal and ethical issues, crisis
intervention, suicide risk assessment, stages of change, defense mechanisms,
and nursing diagnoses. Each unique question features multiple-choice format
with correct answers and detailed rationales to reinforce clinical reasoning
and critical thinking for successful exam preparation.
1. At the first meeting of a group of older adults at a daycare center, the nurse asks
one member what she would like to do. She shrugs and says, "You tell me, you're
the leader." What is the best response for the nurse to make?
A) "Yes, I am the leader today. Would you like to be the leader tomorrow?"
B) "Yes, I will be leading this group. What would you like to accomplish during
this time?"
C) "Yes, I have been assigned to be the leader of this group. I will be here for the
next six weeks."
D) "Yes, I am the leader. You seem angry about not being the leader yourself."
Correct Answer: B) "Yes, I will be leading this group. What would you like to
accomplish during this time?"
Rationale: In the initial phase of group dynamics, members often experience
anxiety and test the leader. Option B provides information about the leader's role
and redirects the group to define its function, which is therapeutic. Option A is
manipulative, C provides information but lacks focus on the group's purpose, and
D is an interpretive challenge that is inappropriate for the initial phase .
,2. During a group session that has been meeting for several weeks, one male
participant monopolizes the group's time and interrupts others. What is the best
action for the nurse to take?
A) Talk to the client outside the group about his behavior.
B) Remind the client to allow others a chance to talk.
C) Allow the group to handle the problem.
D) Ask the client to join another group.
Correct Answer: C) Allow the group to handle the problem.
Rationale: The group is in the working phase, and members should be allowed to
determine the group's direction. Allowing the group to address the monopolizing
behavior promotes group cohesion and members' problem-solving skills. Separate
meetings with the leader (A) can be manipulative, B is dictatorial, and D avoids the
problem .
3. An 86-year-old female client with Alzheimer's disease is wandering the busy
halls and asks the nurse, "Where should I stand for the parade?" Which response is
best for the nurse to provide?
A) "Anywhere you want to stand as long as you do not get hurt by those in the
parade."
B) "You are confused because of all the activity in the hall. There is no parade."
C) "Let's go back to the activity room and see what is going on in there."
D) "Remember I told you that this is a nursing home and I am your nurse."
Correct Answer: C) "Let's go back to the activity room and see what is going on in
there."
Rationale: Redirecting the client to a safer place and familiar activities is most
helpful, as clients with Alzheimer's experience short-term memory loss. A
dismisses the client's attempt to find order, B dismisses the client and may increase
anxiety, and D scolds the client and may hurt their feelings .
4. Physical examination of a 6-year-old reveals several bite marks in various
locations on his body, and x-rays reveal healed rib fractures. The mother tells the
nurse her child is "always having accidents." Which initial response by the nurse is
most appropriate?
A) "I need to inform the healthcare provider about your child's tendency to be
accident prone."
B) "Tell me more specifically about your child's accidents."
C) "I must report these injuries to the authorities because they do not seem
accidental."
D) "Boys this age always seem to require more supervision and can be quite
accident prone."
,Correct Answer: B) "Tell me more specifically about your child's accidents."
Rationale: This open-ended, non-threatening statement seeks more information
before jumping to conclusions. A is sarcastic and avoids the situation, C is
accusatory before conclusive data is obtained, and D dismisses the seriousness of
the situation .
5. A child is brought to the emergency room with a broken arm. Because of other
injuries, the nurse suspects abuse. When the nurse tries to give the child an
injection, the mother becomes loud and shouts, "I won't leave my son! Don't you
touch him! You'll hurt my child!" What is the best interpretation of the mother's
statements?
A) Regressing to an earlier behavior pattern
B) Sublimating her anger
C) Projecting her feelings onto the nurse
D) Suppressing her fear
Correct Answer: C) Projecting her feelings onto the nurse.
Rationale: Projection is attributing one's own unacceptable thoughts, impulses, or
behaviors onto another. The mother is likely harming the child and is attributing
her actions to the nurse. She may be immature, but regression (A) is not the best
description. Sublimation (B) involves substituting a socially acceptable feeling for
an unacceptable one. Suppression (D) is a conscious denial, but the data suggests
projection .
6. A client with paranoid schizophrenia refuses to eat, telling the nurse, "I know
you are trying to poison me with that food." Which response is most appropriate
for the nurse to make?
A) "I'll leave your tray here. I am available if you need anything else."
B) "You're not being poisoned. Why do you think someone is trying to poison
you?"
C) "No one on this unit has ever died from poisoning. You're safe here."
D) "I will talk to your healthcare provider about the possibility of changing your
diet."
Correct Answer: A) "I'll leave your tray here. I am available if you need anything
else."
Rationale: The nurse should not argue with the client's delusions. Option A offers
support by agreeing to "be there" without demanding the client eat. B and C are
arguing with the delusion and asking "why" is not therapeutic for a psychotic
client. D addresses diet, not the client's paranoid belief .
, 7. A 25-year-old female client is trying to leave the psychiatric unit, telling the
nurse, "Please let me go! I must leave because the secret police are after me."
Which response is best for the nurse to make?
A) "No one is after you, you're safe here."
B) "You'll feel better after you have rested."
C) "I know you must feel lonely and frightened."
D) "Come with me to your room and I will sit with you."
Correct Answer: D) "Come with me to your room and I will sit with you."
Rationale: This offers support without judgment or demands, helping to de-escalate
the situation. A argues with the client's delusion, B offers false reassurance, and C
tells the client how she feels rather than allowing her to describe her own feelings .
8. A 45-year-old male client tells the nurse that he used to believe he was Jesus
Christ, but now he knows he is not. Which response is best for the nurse to make?
A) "Did you really believe you were Jesus Christ?"
B) "I think you're getting well."
C) "Others have had similar thoughts when under stress."
D) "Why did you think you were Jesus Christ?"
Correct Answer: C) "Others have had similar thoughts when under stress."
Rationale: This normalizes the client's experience and offers support without
judgment. A is belittling, B is an inappropriate judgment, and D asks "why" which
the client cannot answer .
9. A nurse in the emergency room of a children's hospital admits a child whose
injuries could have resulted from abuse. Which statement most accurately
describes the nurse's responsibility in cases of suspected child abuse?
A) The nurse should obtain objective data such as x-rays before reporting
suspicions to the authorities.
B) The nurse should confirm any suspicions of child abuse with the healthcare
provider before reporting to the authorities.
C) The nurse should report any case of suspected child abuse to the nurse in
charge.
D) The nurse should note in the client's record any suspicions of child abuse so that
a history can be tracked.
Correct Answer: C) The nurse should report any case of suspected child abuse to
the nurse in charge.
Rationale: It is the nurse's legal responsibility to report all suspected cases of child
abuse. Notifying the charge nurse initiates the legal reporting process .
