HESI MODULE 4: PSYCHOSOCIAL ALTERATIONS
COMPREHENSIVE PRACTICE EXAM | CURRENTLY TESTING EXAM
QUESTIONS WITH DETAILED VERIFIED ANSWERS (100% CORRECT
ANSWERS AND RATIONALES) ALREADY GRADED A+
SECTION 1: THERAPEUTIC COMMUNICATION (Questions 1–30)
1. A client tells the nurse, "I feel like I'm going crazy. Nothing makes sense
anymore." Which response by the nurse demonstrates therapeutic
communication?
A. "You're not going crazy. You're just stressed."
B. "Tell me more about what feels like it doesn't make sense."
C. "Everyone feels that way sometimes. You'll be fine."
D. "Why do you think you're going crazy?"
Answer: B
Rationale: This open-ended response encourages the client to elaborate on their
feelings and promotes further exploration. Option A offers false reassurance.
Option C minimizes the client's feelings. Option D uses "why," which can feel
accusatory.
2. A client with depression tells the nurse, "There's no point in going on.
Everyone would be better off without me." What is the nurse's priority
response?
A. "You have so much to live for. Think about your family."
B. "Are you thinking about harming yourself?"
C. "I understand how you feel. I've been there too."
D. "Let's focus on the positive things in your life."
Answer: B
Rationale: This statement indicates possible suicidal ideation. The nurse must
directly assess for suicidal thoughts, plans, and intent. Safety is the
priority. Option A offers false reassurance. Option C is inappropriate self-
1
, disclosure. Option D dismisses the client's feelings.
3. A client with schizophrenia tells the nurse, "The voices are telling me to do
bad things." Which response is most therapeutic?
A. "I don't hear any voices. You're imagining things."
B. "That must be frightening for you. Are the voices telling you to hurt
yourself?"
C. "Try to ignore the voices. They're not real."
D. "If you pray, the voices will go away."
Answer: B
Rationale: This response validates the client's feelings without agreeing with
the hallucination and assesses for safety. Option A denies the client's
reality. Option C dismisses the experience. Option D introduces religious
advice without assessment.
4. A client who is withdrawn and silent sits alone in the dayroom. The nurse
approaches and says:
A. "You seem upset. Would you like to talk?"
B. "I'll sit with you for a while if that's okay."
C. "You need to participate in group activities."
D. "Why are you sitting here all alone?"
Answer: B
Rationale: Sitting with a withdrawn client without demanding conversation
provides presence and support without pressure. Option A may feel intrusive.
Option C is prescriptive. Option D uses "why" and may feel accusatory.
5. A client states, "I'm a terrible mother. I can't do anything right." Which
response reflects therapeutic communication?
A. "You're a wonderful mother. Your children love you."
B. "What makes you say you're a terrible mother?"
C. "Everyone makes mistakes. Don't be so hard on yourself."
2
, D. "I'm sure you're doing the best you can."
Answer: B
Rationale: This open-ended question encourages the client to explore the basis
of their feelings and promotes self-reflection. Option A offers false
reassurance. Option C minimizes feelings. Option D is a platitude.
6. A client experiencing anxiety states, "I can't breathe. I think I'm dying."
What is the nurse's best initial action?
A. Administer a PRN anxiolytic immediately.
B. Stay with the client and use a calm, soothing voice.
C. Tell the client to take deep breaths and calm down.
D. Leave the client to gather personal space.
Answer: B
Rationale: Staying with the client and using a calm voice provides安全感 and
grounding during panic. Option A may be premature without assessment.
Option C
may increase anxiety. Option D abandons the client.
7. A client with bipolar disorder in a manic episode says, "I'm going to be a
millionaire and buy this whole hospital!" Which response is most appropriate?
A. "That's a wonderful goal. Let's discuss how to achieve it."
B. "You seem to have a lot of energy today."
C. "You can't buy a hospital. That's unrealistic."
D. "Why do you think you can buy a hospital?"
Answer: B
Rationale: This response acknowledges the client's energy without reinforcing
grandiose delusions. Option A reinforces the delusion. Option C is
confrontational. Option D uses "why" and challenges the client.
8. A client tells the nurse, "My family would be better off if I were dead."
3
, Which is the nurse's priority assessment?
A. "Tell me more about your family."
B. "Are you planning to kill yourself?"
C. "You have a lot to live for."
D. "Have you been feeling depressed?"
Answer: B
Rationale: Direct assessment of suicidal ideation, plan, and intent is the
priority when a client expresses suicidal thoughts. Safety supersedes all other
concerns.
9. A client with post-traumatic stress disorder (PTSD) has difficulty discussing
a traumatic event. The nurse's best response is:
A. "You need to talk about it to get better."
B. "We don't have to talk about that now. What would you like to discuss?"
C. "I understand exactly what you went through."
D. "If you don't talk about it, you'll never heal."
Answer: B
Rationale: This response respects the client's boundaries and allows the client
to control the pace of therapy. Option A is prescriptive. Option C is
inappropriate self-disclosure. Option D is threatening.
10. The nurse is caring for a client who is crying and states, "I just feel so
alone." Which response is most therapeutic?
A. "You shouldn't feel alone. You have family."
B. "I can see that you're feeling very alone right now."
C. "Let's find something to distract you."
D. "Everyone feels alone sometimes."
Answer: B
Rationale: This response validates the client's feelings through reflection
4
COMPREHENSIVE PRACTICE EXAM | CURRENTLY TESTING EXAM
QUESTIONS WITH DETAILED VERIFIED ANSWERS (100% CORRECT
ANSWERS AND RATIONALES) ALREADY GRADED A+
SECTION 1: THERAPEUTIC COMMUNICATION (Questions 1–30)
1. A client tells the nurse, "I feel like I'm going crazy. Nothing makes sense
anymore." Which response by the nurse demonstrates therapeutic
communication?
A. "You're not going crazy. You're just stressed."
B. "Tell me more about what feels like it doesn't make sense."
C. "Everyone feels that way sometimes. You'll be fine."
D. "Why do you think you're going crazy?"
Answer: B
Rationale: This open-ended response encourages the client to elaborate on their
feelings and promotes further exploration. Option A offers false reassurance.
Option C minimizes the client's feelings. Option D uses "why," which can feel
accusatory.
2. A client with depression tells the nurse, "There's no point in going on.
Everyone would be better off without me." What is the nurse's priority
response?
A. "You have so much to live for. Think about your family."
B. "Are you thinking about harming yourself?"
C. "I understand how you feel. I've been there too."
D. "Let's focus on the positive things in your life."
Answer: B
Rationale: This statement indicates possible suicidal ideation. The nurse must
directly assess for suicidal thoughts, plans, and intent. Safety is the
priority. Option A offers false reassurance. Option C is inappropriate self-
1
, disclosure. Option D dismisses the client's feelings.
3. A client with schizophrenia tells the nurse, "The voices are telling me to do
bad things." Which response is most therapeutic?
A. "I don't hear any voices. You're imagining things."
B. "That must be frightening for you. Are the voices telling you to hurt
yourself?"
C. "Try to ignore the voices. They're not real."
D. "If you pray, the voices will go away."
Answer: B
Rationale: This response validates the client's feelings without agreeing with
the hallucination and assesses for safety. Option A denies the client's
reality. Option C dismisses the experience. Option D introduces religious
advice without assessment.
4. A client who is withdrawn and silent sits alone in the dayroom. The nurse
approaches and says:
A. "You seem upset. Would you like to talk?"
B. "I'll sit with you for a while if that's okay."
C. "You need to participate in group activities."
D. "Why are you sitting here all alone?"
Answer: B
Rationale: Sitting with a withdrawn client without demanding conversation
provides presence and support without pressure. Option A may feel intrusive.
Option C is prescriptive. Option D uses "why" and may feel accusatory.
5. A client states, "I'm a terrible mother. I can't do anything right." Which
response reflects therapeutic communication?
A. "You're a wonderful mother. Your children love you."
B. "What makes you say you're a terrible mother?"
C. "Everyone makes mistakes. Don't be so hard on yourself."
2
, D. "I'm sure you're doing the best you can."
Answer: B
Rationale: This open-ended question encourages the client to explore the basis
of their feelings and promotes self-reflection. Option A offers false
reassurance. Option C minimizes feelings. Option D is a platitude.
6. A client experiencing anxiety states, "I can't breathe. I think I'm dying."
What is the nurse's best initial action?
A. Administer a PRN anxiolytic immediately.
B. Stay with the client and use a calm, soothing voice.
C. Tell the client to take deep breaths and calm down.
D. Leave the client to gather personal space.
Answer: B
Rationale: Staying with the client and using a calm voice provides安全感 and
grounding during panic. Option A may be premature without assessment.
Option C
may increase anxiety. Option D abandons the client.
7. A client with bipolar disorder in a manic episode says, "I'm going to be a
millionaire and buy this whole hospital!" Which response is most appropriate?
A. "That's a wonderful goal. Let's discuss how to achieve it."
B. "You seem to have a lot of energy today."
C. "You can't buy a hospital. That's unrealistic."
D. "Why do you think you can buy a hospital?"
Answer: B
Rationale: This response acknowledges the client's energy without reinforcing
grandiose delusions. Option A reinforces the delusion. Option C is
confrontational. Option D uses "why" and challenges the client.
8. A client tells the nurse, "My family would be better off if I were dead."
3
, Which is the nurse's priority assessment?
A. "Tell me more about your family."
B. "Are you planning to kill yourself?"
C. "You have a lot to live for."
D. "Have you been feeling depressed?"
Answer: B
Rationale: Direct assessment of suicidal ideation, plan, and intent is the
priority when a client expresses suicidal thoughts. Safety supersedes all other
concerns.
9. A client with post-traumatic stress disorder (PTSD) has difficulty discussing
a traumatic event. The nurse's best response is:
A. "You need to talk about it to get better."
B. "We don't have to talk about that now. What would you like to discuss?"
C. "I understand exactly what you went through."
D. "If you don't talk about it, you'll never heal."
Answer: B
Rationale: This response respects the client's boundaries and allows the client
to control the pace of therapy. Option A is prescriptive. Option C is
inappropriate self-disclosure. Option D is threatening.
10. The nurse is caring for a client who is crying and states, "I just feel so
alone." Which response is most therapeutic?
A. "You shouldn't feel alone. You have family."
B. "I can see that you're feeling very alone right now."
C. "Let's find something to distract you."
D. "Everyone feels alone sometimes."
Answer: B
Rationale: This response validates the client's feelings through reflection
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