MENTAL HEALTH RN
Student Exam
PSYCHIATRIC NURSING
Safety - Crisis Care - Therapeutic Communication
Mood Disorders - Psychosis - Substance Use
Eating Disorders - Personality Disorders
Medication Safety - Abuse Screening
Questions, Answers, Rationales, and High-Yield Notes
Page 1
,HESI Mental Health RN Exam Questions and Answers
Table of Content
1. Safety and Crisis Intervention
2. Therapeutic Communication
3. Anxiety, Trauma, and Stressor Disorders
4. Depression and Suicide Risk
5. Bipolar Disorder
6. Psychosis and Schizophrenia
7. Substance Use and Withdrawal
8. Eating Disorders
9. Personality Disorders
10. Defense Mechanisms
11. Psychiatric Medications
12. Abuse, Violence, and Legal Issues
13. Mental Status Examination
14. Group and Milieu Therapy
15. Integrated Review
Student instructions
Choose the best answer for each question.
Review the rationale after answering.
Use the blue high-yield note for fast recall.
Focus on safety, therapeutic communication, medication risks, and prioritization.
Page 2
,HESI Mental Health RN Exam Questions and Answers
Safety and Crisis Intervention
Question 1
A client on an inpatient mental health unit becomes increasingly agitated, paces rapidly, and shouts at staff after being
redirected. Which nursing action should the RN implement first?
A. Call security immediately without speaking to the client
B. Move nearby clients to a safer area and reduce stimulation
C. Tell the client that privileges will be removed
D. Begin a detailed admission assessment
Correct Answer: B. Move nearby clients to a safer area and reduce stimulation
Rationale: The first priority is safety for the client, other clients, and staff. Removing other clients from the immediate
area and reducing stimulation helps prevent escalation while maintaining a therapeutic environment.
High-yield note: Safety is the first priority when behavior is escalating.
Question 2
A client tells the RN, "Nothing matters anymore," and refuses to participate in assessment. Which nursing response is
the priority?
A. Document the statement and reassess tomorrow
B. Ask directly about thoughts of self-harm and ensure close observation
C. Encourage the client to attend recreational therapy
D. Tell the client to think positively
Correct Answer: B. Ask directly about thoughts of self-harm and ensure close observation
Rationale: Hopeless statements require immediate suicide-risk assessment. The RN should ask directly, maintain safety,
and follow facility observation precautions.
High-yield note: Direct assessment of self-harm risk is therapeutic and necessary.
Question 3
A client in the day room picks up a chair and threatens another client. What should the nurse do first?
A. Approach alone and remove the chair
B. Obtain staff assistance and protect others from harm
C. Ask the client to write about feelings
D. Ignore the behavior until the client calms down
Correct Answer: B. Obtain staff assistance and protect others from harm
Rationale: A client threatening violence requires immediate safety measures. The nurse should obtain staff assistance,
use a calm approach, maintain distance, and protect other clients.
High-yield note: Do not attempt to manage violent behavior alone.
Page 3
, HESI Mental Health RN Exam Questions and Answers
Question 4
A client with command hallucinations states that voices are telling him to harm himself. Which intervention is most
important?
A. Ask the client to describe the voices later
B. Place the client on close observation and remove unsafe objects
C. Encourage the client to ignore the voices independently
D. Provide a complex written worksheet
Correct Answer: B. Place the client on close observation and remove unsafe objects
Rationale: Command hallucinations involving harm are high-risk. The nurse must maintain safety, provide close
observation, and reduce access to unsafe items according to policy.
High-yield note: Command hallucinations require immediate safety assessment.
Question 5
A client presents to the crisis clinic after a traumatic event and is trembling, tearful, and unable to decide what to do
next. Which nursing action is best?
A. Give multiple options and ask the client to choose quickly
B. Provide a calm environment and use simple, concrete questions
C. Confront the client about irrational behavior
D. Leave the client alone until emotions stop
Correct Answer: B. Provide a calm environment and use simple, concrete questions
Rationale: In crisis, the client may have reduced problem-solving ability. A calm setting and simple focused questions
help the client regain control.
High-yield note: Crisis intervention begins with safety, calm communication, and immediate needs.
Therapeutic Communication
Question 6
A client with schizophrenia says, "The television is sending special messages about me." Which response by the nurse is
most therapeutic?
A. That is not true, so stop saying it
B. I do not receive messages from the television, but I can see this feels real to you
C. Maybe the television really is talking to you
D. Let us ask another client if it is true
Correct Answer: B. I do not receive messages from the television, but I can see this feels real to you
Rationale: The nurse should present reality without arguing or validating the delusion. A therapeutic response
acknowledges the feeling while maintaining reality orientation.
High-yield note: Do not argue with delusions; acknowledge feelings and present reality.
Page 4
Student Exam
PSYCHIATRIC NURSING
Safety - Crisis Care - Therapeutic Communication
Mood Disorders - Psychosis - Substance Use
Eating Disorders - Personality Disorders
Medication Safety - Abuse Screening
Questions, Answers, Rationales, and High-Yield Notes
Page 1
,HESI Mental Health RN Exam Questions and Answers
Table of Content
1. Safety and Crisis Intervention
2. Therapeutic Communication
3. Anxiety, Trauma, and Stressor Disorders
4. Depression and Suicide Risk
5. Bipolar Disorder
6. Psychosis and Schizophrenia
7. Substance Use and Withdrawal
8. Eating Disorders
9. Personality Disorders
10. Defense Mechanisms
11. Psychiatric Medications
12. Abuse, Violence, and Legal Issues
13. Mental Status Examination
14. Group and Milieu Therapy
15. Integrated Review
Student instructions
Choose the best answer for each question.
Review the rationale after answering.
Use the blue high-yield note for fast recall.
Focus on safety, therapeutic communication, medication risks, and prioritization.
Page 2
,HESI Mental Health RN Exam Questions and Answers
Safety and Crisis Intervention
Question 1
A client on an inpatient mental health unit becomes increasingly agitated, paces rapidly, and shouts at staff after being
redirected. Which nursing action should the RN implement first?
A. Call security immediately without speaking to the client
B. Move nearby clients to a safer area and reduce stimulation
C. Tell the client that privileges will be removed
D. Begin a detailed admission assessment
Correct Answer: B. Move nearby clients to a safer area and reduce stimulation
Rationale: The first priority is safety for the client, other clients, and staff. Removing other clients from the immediate
area and reducing stimulation helps prevent escalation while maintaining a therapeutic environment.
High-yield note: Safety is the first priority when behavior is escalating.
Question 2
A client tells the RN, "Nothing matters anymore," and refuses to participate in assessment. Which nursing response is
the priority?
A. Document the statement and reassess tomorrow
B. Ask directly about thoughts of self-harm and ensure close observation
C. Encourage the client to attend recreational therapy
D. Tell the client to think positively
Correct Answer: B. Ask directly about thoughts of self-harm and ensure close observation
Rationale: Hopeless statements require immediate suicide-risk assessment. The RN should ask directly, maintain safety,
and follow facility observation precautions.
High-yield note: Direct assessment of self-harm risk is therapeutic and necessary.
Question 3
A client in the day room picks up a chair and threatens another client. What should the nurse do first?
A. Approach alone and remove the chair
B. Obtain staff assistance and protect others from harm
C. Ask the client to write about feelings
D. Ignore the behavior until the client calms down
Correct Answer: B. Obtain staff assistance and protect others from harm
Rationale: A client threatening violence requires immediate safety measures. The nurse should obtain staff assistance,
use a calm approach, maintain distance, and protect other clients.
High-yield note: Do not attempt to manage violent behavior alone.
Page 3
, HESI Mental Health RN Exam Questions and Answers
Question 4
A client with command hallucinations states that voices are telling him to harm himself. Which intervention is most
important?
A. Ask the client to describe the voices later
B. Place the client on close observation and remove unsafe objects
C. Encourage the client to ignore the voices independently
D. Provide a complex written worksheet
Correct Answer: B. Place the client on close observation and remove unsafe objects
Rationale: Command hallucinations involving harm are high-risk. The nurse must maintain safety, provide close
observation, and reduce access to unsafe items according to policy.
High-yield note: Command hallucinations require immediate safety assessment.
Question 5
A client presents to the crisis clinic after a traumatic event and is trembling, tearful, and unable to decide what to do
next. Which nursing action is best?
A. Give multiple options and ask the client to choose quickly
B. Provide a calm environment and use simple, concrete questions
C. Confront the client about irrational behavior
D. Leave the client alone until emotions stop
Correct Answer: B. Provide a calm environment and use simple, concrete questions
Rationale: In crisis, the client may have reduced problem-solving ability. A calm setting and simple focused questions
help the client regain control.
High-yield note: Crisis intervention begins with safety, calm communication, and immediate needs.
Therapeutic Communication
Question 6
A client with schizophrenia says, "The television is sending special messages about me." Which response by the nurse is
most therapeutic?
A. That is not true, so stop saying it
B. I do not receive messages from the television, but I can see this feels real to you
C. Maybe the television really is talking to you
D. Let us ask another client if it is true
Correct Answer: B. I do not receive messages from the television, but I can see this feels real to you
Rationale: The nurse should present reality without arguing or validating the delusion. A therapeutic response
acknowledges the feeling while maintaining reality orientation.
High-yield note: Do not argue with delusions; acknowledge feelings and present reality.
Page 4
