HESI PSYCH Mental Health Exam Questions And Correct Verified
Answers With Rationales New Updated Version 2026
A 35-year-old male client who has been hospitalized for two weeks for chronic paranoia continues to state that
someone is trying to steal his clothing- Which action should the nurse implement?
A- Encourage the client to actively participate in assigned activities on the unit
B- Place a lock on the client's closet
C- Ignore the client's paranoid ideation to extinguish these behaviors
D- Explain to the client that his suspicions are false - ANSWER-ANSWER A
Diverting the client's attention from paranoid ideation and encouraging him to complete assignments can be helpful
in assisting him to develop a positive self-image (A)- The clients problem is not security,and (B) actually supports his
paranoid ideation- (C) is not correct because ignoring the client's symptoms may lower his self-esteem- The nurse
should not argue with the client about his delusions (D), and should not try to reason with the client regarding his
paranoid ideation
A male client with mental illness and substance dependency tells the mental health nurse that he has started
using illegal drugs again and wants to seek treatment. Since he has a dual diagnosis, which person is best for the
nurse to refer this client to first?
A. The emergency room nurse.
B. His case manager.
C. The clinic healthcare provider.
D. His support group sponsor. - ANSWER-ANSWER B
The case manager (B) is responsible for coordinating community services, and since this client has a dual diagnosis,
this is the best person to describe available treatment options. (A) is unnecessary, unless the client experiences
behaviors that threaten his safety or the safety of others. (C and D) might also be useful, but it is most important at
this time that a treatment program be coordinated to meet this client's needs.
Based on non-compliance with the medication regimen, an adult client with a medical diagnosis of substance
abuse and schizophrenia was recently switched from oral fluphenazine HCI (Prolixin) to IM fluphenazine
decanoate (Prolixin Decanoate)- What is most important to teach the client and family about this change in
medication regimen?
,A- Signs and symptoms of extrapyramidal effects (EPS)-
B- Information about substance abuse and schizophrenia-
C- The effects of alcohol and drug interaction-
D- The availability of support groups for those with dual diagnoses- - ANSWER-ANSWER C
Alcohol enhances the EPS side effects of Prolixin. The half-life of Prolixin PO is 8 hours, whereas the half-life of
the Prolixin Decanoate IM is 2 to 4 weeks- That means the side effects of drinking alcohol are far more severe
when the client drinks alcohol alter taking thelong-acting Prolixin Decanoate IM- (A, B, and D) provide valuable
information and should be included in the client/family teaching, but they do not have the priority of (C).
A 38-year-old female client is admitted wvith a diagnosis of paranoid schizophrenia- When her tray is
brought to her, she refuses to eat and tells 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'Il leave your tray here- I amn 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 wilI talk to your healthcare provider about the possibility of changing your diet-- ANSWER-ANSWER A
(A) is the best choice cited- The nurse does not argue wwith the client nor demand that she eat, but offers
support by agreeing to"be there if needed", e-g-, to warm the food- (B and C) are arguing with the client's
delusions, and (B) asks"why" which is usually not a good question for a psychotic client- (D) has nothing to do
with the actual problem; i.e.-, the problem is not the diet (she thinks any food given to her is poisoned-)
A woman arrives in the Emergency Center and tells the nurse she thinks she has been raped- The client is
sobbing and expresses disbelief that a rape could happen because the man is her best friend- After
acknowledging the client's fear and anxiety, how should the nurse respond?
A- "I would be very upset and mad if my best friend did that to me"
B- "You must feel betrayed, but maybe you might have led him on?"
C- "Rape is not limited to strangers and frequently occurs by someone who is known to the victim"
D- "This does not sound like rape- Did you change your mind about having sex after the fact?" -
ANSWER-ANSWER C
A victim of date rape or acquaintance rape is less prone to recognize what is happening because the incident
usually involves persons who know each other and the dynamics are different than rape by a
,stranger. (C) provides confrontation for the client's denial because the victim frequently knows and trusts the
perpetrator. Nurses should not express personal feelings (A) when dealing with victims-Suggesting that the client
led on the rapist (B) indicates that the sexual assault was somehow the victim's fault- (D) is judgmental and does
not display compassion or establish trust between the nurse and the client
A child is brought to the emergency room with a broken arm- Because of other injuries, the nurse suspects the
child may be a victim of abuse- When the nurse tries to give the child an injection, the child's mother becomes
′ ′
very loud and shouts, |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? The mother is
A- regressing to an earlier behavior pattern-
B- sublimating her anger-
D- suppressing her fear- - ANSWER-ANSWER C
Projection is attributing one's own thoughts, impulses, or behaviors onto another-it is the mother who is probably
harming the child and she is attributing her actions to the nurse (C)- The mother may be immature, but (A) is not the
best description of her behavior. (B) is substituting a socially acceptable feeling for an unacceptable one- These are
not socially acceptable feelings- The mother may be suppressing her fear (D) by displaying anger, but such an
interpretation cannot be concluded from the data presented
The wife of a male client recently diagnosed with schizophrenia asks the nurse, 'What exactly is schizophrenia? Is
my husband all right?" Which response is best for the nurse to provide to this family member?
A- It sounds like you're worried about your husband- Let's sit down and talk
B- It is a chemical imbalance in the brain that causes disorganized thinking
C- Your husband will be just fine if he takes his medications regularly
D-I think you should talk to your husband's psychologist about this question - ANSWER-ANSWER B
The nurse should answer the client's question with factuaI information and explain that schizophrenia is a chemical
imbalance in the brain (B)
(A) is a therapeutic response but does not answer the question, and may be an appropriate response after the nurse
answers the question asked Although (C) is likely true to some degree, it is also true that some clients continue to
have disorganized thinking even with antipsychotic medications- Referring the spouse to the psychologist (D) is
avoiding the issue; the nurse can and should answer the question
, A 40-year-old male client diagnosed with schizophrenia and alcohol dependence has not had any visitors or
phone calls since admission. He reports he has no family that cares about him and was living on the streets prior
to this admission. According to Erikson's theory of psychosocial development, which stage is the client in at this
time?
A. Isolation.
B. Stagnation.
C. Despair.
D. Role confusion. - ANSWER-ANSWER B
The client is in Erikson's "Generativity vs- Stagnation" stage (age 24 to 45), and meeting the task includes
maintaining intimate relationships and moving toward developing a family (B)- (A) occurs in young adulthood
(age 18 to 25), (C) occurs in maturity (age 45 to death), and (D) occurs in adolescence (age 12to 20)- These are
all stages that occur if individuals are not successfully coping with their psychosocial developmental stage
The community health nurse talks to a male client who has bipolar disorder. The client explains that he sleeps
4 to 5 hours a night and is working with his partner to start two new businesses and build an empire. The
client stopped taking his medications several days ago. What nursing problem has the highest priority?
A. Excessive work activity.
B. Decreased need for sleep.
C..Medication management
D. Inflated self-esteem. - ANSWER-ANSWER C
The most important nursing problem is medication management (C) because compliance with the medication
regimen will help prevent hospitalization. The client is also exhibitingsigns of (A, B, and C);however, these
problems do not have the priority of medication management.
The nurse is assessing a client's intelligence- Which factor should the nurse remember during this part of the
mental status exam?
A- Acute psychiatric illnesses impair intelligence-
B- Intelligence is influenced by social andd cultural beliefs-
C- Poor concentration skills suggests limited intelligence-
D- The inability to think abstractly indicates limited intelligence- - ANSWER-ANSWER B
Social and cultural beliefs (B) have significant impact on intelligence- Chronic psychiatric illness may impair
intelligence (A), especially if it remains untreated- Limited concentration does not suggest limited
Answers With Rationales New Updated Version 2026
A 35-year-old male client who has been hospitalized for two weeks for chronic paranoia continues to state that
someone is trying to steal his clothing- Which action should the nurse implement?
A- Encourage the client to actively participate in assigned activities on the unit
B- Place a lock on the client's closet
C- Ignore the client's paranoid ideation to extinguish these behaviors
D- Explain to the client that his suspicions are false - ANSWER-ANSWER A
Diverting the client's attention from paranoid ideation and encouraging him to complete assignments can be helpful
in assisting him to develop a positive self-image (A)- The clients problem is not security,and (B) actually supports his
paranoid ideation- (C) is not correct because ignoring the client's symptoms may lower his self-esteem- The nurse
should not argue with the client about his delusions (D), and should not try to reason with the client regarding his
paranoid ideation
A male client with mental illness and substance dependency tells the mental health nurse that he has started
using illegal drugs again and wants to seek treatment. Since he has a dual diagnosis, which person is best for the
nurse to refer this client to first?
A. The emergency room nurse.
B. His case manager.
C. The clinic healthcare provider.
D. His support group sponsor. - ANSWER-ANSWER B
The case manager (B) is responsible for coordinating community services, and since this client has a dual diagnosis,
this is the best person to describe available treatment options. (A) is unnecessary, unless the client experiences
behaviors that threaten his safety or the safety of others. (C and D) might also be useful, but it is most important at
this time that a treatment program be coordinated to meet this client's needs.
Based on non-compliance with the medication regimen, an adult client with a medical diagnosis of substance
abuse and schizophrenia was recently switched from oral fluphenazine HCI (Prolixin) to IM fluphenazine
decanoate (Prolixin Decanoate)- What is most important to teach the client and family about this change in
medication regimen?
,A- Signs and symptoms of extrapyramidal effects (EPS)-
B- Information about substance abuse and schizophrenia-
C- The effects of alcohol and drug interaction-
D- The availability of support groups for those with dual diagnoses- - ANSWER-ANSWER C
Alcohol enhances the EPS side effects of Prolixin. The half-life of Prolixin PO is 8 hours, whereas the half-life of
the Prolixin Decanoate IM is 2 to 4 weeks- That means the side effects of drinking alcohol are far more severe
when the client drinks alcohol alter taking thelong-acting Prolixin Decanoate IM- (A, B, and D) provide valuable
information and should be included in the client/family teaching, but they do not have the priority of (C).
A 38-year-old female client is admitted wvith a diagnosis of paranoid schizophrenia- When her tray is
brought to her, she refuses to eat and tells 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'Il leave your tray here- I amn 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 wilI talk to your healthcare provider about the possibility of changing your diet-- ANSWER-ANSWER A
(A) is the best choice cited- The nurse does not argue wwith the client nor demand that she eat, but offers
support by agreeing to"be there if needed", e-g-, to warm the food- (B and C) are arguing with the client's
delusions, and (B) asks"why" which is usually not a good question for a psychotic client- (D) has nothing to do
with the actual problem; i.e.-, the problem is not the diet (she thinks any food given to her is poisoned-)
A woman arrives in the Emergency Center and tells the nurse she thinks she has been raped- The client is
sobbing and expresses disbelief that a rape could happen because the man is her best friend- After
acknowledging the client's fear and anxiety, how should the nurse respond?
A- "I would be very upset and mad if my best friend did that to me"
B- "You must feel betrayed, but maybe you might have led him on?"
C- "Rape is not limited to strangers and frequently occurs by someone who is known to the victim"
D- "This does not sound like rape- Did you change your mind about having sex after the fact?" -
ANSWER-ANSWER C
A victim of date rape or acquaintance rape is less prone to recognize what is happening because the incident
usually involves persons who know each other and the dynamics are different than rape by a
,stranger. (C) provides confrontation for the client's denial because the victim frequently knows and trusts the
perpetrator. Nurses should not express personal feelings (A) when dealing with victims-Suggesting that the client
led on the rapist (B) indicates that the sexual assault was somehow the victim's fault- (D) is judgmental and does
not display compassion or establish trust between the nurse and the client
A child is brought to the emergency room with a broken arm- Because of other injuries, the nurse suspects the
child may be a victim of abuse- When the nurse tries to give the child an injection, the child's mother becomes
′ ′
very loud and shouts, |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? The mother is
A- regressing to an earlier behavior pattern-
B- sublimating her anger-
D- suppressing her fear- - ANSWER-ANSWER C
Projection is attributing one's own thoughts, impulses, or behaviors onto another-it is the mother who is probably
harming the child and she is attributing her actions to the nurse (C)- The mother may be immature, but (A) is not the
best description of her behavior. (B) is substituting a socially acceptable feeling for an unacceptable one- These are
not socially acceptable feelings- The mother may be suppressing her fear (D) by displaying anger, but such an
interpretation cannot be concluded from the data presented
The wife of a male client recently diagnosed with schizophrenia asks the nurse, 'What exactly is schizophrenia? Is
my husband all right?" Which response is best for the nurse to provide to this family member?
A- It sounds like you're worried about your husband- Let's sit down and talk
B- It is a chemical imbalance in the brain that causes disorganized thinking
C- Your husband will be just fine if he takes his medications regularly
D-I think you should talk to your husband's psychologist about this question - ANSWER-ANSWER B
The nurse should answer the client's question with factuaI information and explain that schizophrenia is a chemical
imbalance in the brain (B)
(A) is a therapeutic response but does not answer the question, and may be an appropriate response after the nurse
answers the question asked Although (C) is likely true to some degree, it is also true that some clients continue to
have disorganized thinking even with antipsychotic medications- Referring the spouse to the psychologist (D) is
avoiding the issue; the nurse can and should answer the question
, A 40-year-old male client diagnosed with schizophrenia and alcohol dependence has not had any visitors or
phone calls since admission. He reports he has no family that cares about him and was living on the streets prior
to this admission. According to Erikson's theory of psychosocial development, which stage is the client in at this
time?
A. Isolation.
B. Stagnation.
C. Despair.
D. Role confusion. - ANSWER-ANSWER B
The client is in Erikson's "Generativity vs- Stagnation" stage (age 24 to 45), and meeting the task includes
maintaining intimate relationships and moving toward developing a family (B)- (A) occurs in young adulthood
(age 18 to 25), (C) occurs in maturity (age 45 to death), and (D) occurs in adolescence (age 12to 20)- These are
all stages that occur if individuals are not successfully coping with their psychosocial developmental stage
The community health nurse talks to a male client who has bipolar disorder. The client explains that he sleeps
4 to 5 hours a night and is working with his partner to start two new businesses and build an empire. The
client stopped taking his medications several days ago. What nursing problem has the highest priority?
A. Excessive work activity.
B. Decreased need for sleep.
C..Medication management
D. Inflated self-esteem. - ANSWER-ANSWER C
The most important nursing problem is medication management (C) because compliance with the medication
regimen will help prevent hospitalization. The client is also exhibitingsigns of (A, B, and C);however, these
problems do not have the priority of medication management.
The nurse is assessing a client's intelligence- Which factor should the nurse remember during this part of the
mental status exam?
A- Acute psychiatric illnesses impair intelligence-
B- Intelligence is influenced by social andd cultural beliefs-
C- Poor concentration skills suggests limited intelligence-
D- The inability to think abstractly indicates limited intelligence- - ANSWER-ANSWER B
Social and cultural beliefs (B) have significant impact on intelligence- Chronic psychiatric illness may impair
intelligence (A), especially if it remains untreated- Limited concentration does not suggest limited
