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HESI MENTAL HEALTH/PSYCHIATRIC NURSING
EXAM LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
HESI MENTAL HEALTH/PSYCHIATRIC NURSING EXAM
250 Practice Questions with Rationales
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-CLIENT RELATIONSHIP
(Questions 1-38)
1. A nurse is caring for a client who is in the acute phase of a psychotic episode.
Which communication technique is most effective for the nurse to use?
A. Using abstract language and metaphors to help the client express feelings
B. Giving lengthy explanations and providing a lot of detailed information
C. Speaking in a firm, calm voice and using simple, concrete sentences
D. Asking open-ended questions to encourage the client to explore their delusions
Correct Answer: C
Rationale: During acute psychosis, the client has difficulty processing complex stimuli.
Speaking in a calm, firm manner with simple, concrete sentences helps the client feel
safe and understand the nurse. Abstract language (A), lengthy explanations (B), and
exploring delusions (D) can be overwhelming and increase agitation.
2. A nurse is admitting a client who states, "I am worthless and I can't do anything
right." This statement should alert the nurse to assess the client for which
condition?
A. Bipolar disorder
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B. Depression
C. Antisocial personality disorder
D. Generalized anxiety disorder
Correct Answer: B
Rationale: Feelings of worthlessness, hopelessness, and guilt are hallmark cognitive
symptoms of major depressive disorder. While these can be present in other conditions,
they are most classic for depression.
3. A nurse is caring for a client who is experiencing a panic attack. What is the
priority nursing intervention?
A. Encouraging the client to express their feelings and explore the cause of the panic
B. Giving the client a sedative medication to immediately reduce their anxiety
C. Staying with the client and providing reassurance in a quiet, calm environment
D. Leaving the client alone to give them space to regain their composure
Correct Answer: C
Rationale: The priority is to provide a safe, calm presence. The client should not be left
alone (D). While medication (B) may be needed, the immediate nursing action is to stay
with the client and use a calm demeanor to help de-escalate the panic.
4. A client who is grieving the death of a spouse tells the nurse, "I can't believe this
happened. I should have done more to make sure they were safe." Which stage of
grief, according to Kübler-Ross, is this client exhibiting?
A. Denial
B. Anger
C. Bargaining
D. Depression
Correct Answer: C
Rationale: The client is expressing guilt and trying to imagine how they could have
prevented the death, which is characteristic of the bargaining stage. Denial is a refusal
to accept reality (A), anger is rage and resentment (B), and depression is deep sadness
and hopelessness (D).
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5. A nurse is caring for a client who is refusing to take their medication. The client
says, "You're all trying to poison me." What is the nurse's most appropriate
response?
A. "That is a paranoid thought. No one is trying to poison you."
B. "I understand you feel that way. It must be frightening to think that."
C. "If you don't take it, you will have to have it as an injection."
D. "Let's discuss why you believe that we are trying to harm you."
Correct Answer: B
Rationale: This response validates the client's feelings without challenging the
delusion. It acknowledges their emotion and builds trust. Arguing (A) or threatening (C)
is not therapeutic. Exploring the delusion (D) can reinforce it.
6. A nurse is assessing a client's use of defense mechanisms. The client says, "I
don't have a drinking problem, I just like to have a few drinks to unwind." This is an
example of which defense mechanism?
A. Denial
B. Projection
C. Rationalization
D. Repression
Correct Answer: C
Rationale: The client is rationalizing their drinking behavior by providing a socially
acceptable reason (unwinding) to justify their alcohol use. Denial (A) would be outright
refusal to admit there is a problem. Projection (B) involves attributing one's own feelings
to others. Repression (D) involves unconsciously blocking unacceptable thoughts.
7. A nurse is caring for a client who is demonstrating severe anxiety and is
hyperventilating. Which intervention should the nurse implement first?
A. Encourage the client to take slow, deep breaths
B. Provide a quiet environment and speak in a calm tone
C. Have the client breathe into a paper bag
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D. Administer a prescribed antianxiety medication
Correct Answer: B
Rationale: A quiet environment and a calm demeanor are the initial steps to reduce
overstimulation and help the client regain control. Instructing the client to breathe with
the nurse (A) is the next step. Paper bags (C) are no longer recommended. Medication
(D) is not the first intervention.
8. A nurse is reviewing the history of a client diagnosed with borderline personality
disorder. Which behavior is the nurse most likely to find documented?
A. Grandiose sense of self-importance and a need for admiration
B. Instability in interpersonal relationships, self-image, and affect
C. Detachment from social relationships and restricted emotional expression
D. Disregard for and violation of the rights of others
Correct Answer: B
Rationale: Borderline personality disorder is characterized by a pervasive pattern of
instability in relationships, self-image, and emotions, along with significant impulsivity.
Grandiosity (A) is characteristic of narcissistic personality disorder, detachment (C) of
schizoid, and disregard for others (D) of antisocial.
9. A nurse is caring for a client who has a terminal illness. The client says, "I'm
going to die anyway, so what's the point?" Which of the following is the most
therapeutic response?
A. "You shouldn't feel that way. You have so much to live for."
B. "I understand you're feeling hopeless. Tell me more about what you're thinking."
C. "Let me call the chaplain to come and talk to you."
D. "You need to stay positive for your family."
Correct Answer: B
Rationale: This response validates the client's feelings and encourages them to express
their emotions, which is therapeutic. Dismissing the client's feelings (A, D) and
premature problem-solving (C) are not therapeutic.
HESI MENTAL HEALTH/PSYCHIATRIC NURSING
EXAM LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
HESI MENTAL HEALTH/PSYCHIATRIC NURSING EXAM
250 Practice Questions with Rationales
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-CLIENT RELATIONSHIP
(Questions 1-38)
1. A nurse is caring for a client who is in the acute phase of a psychotic episode.
Which communication technique is most effective for the nurse to use?
A. Using abstract language and metaphors to help the client express feelings
B. Giving lengthy explanations and providing a lot of detailed information
C. Speaking in a firm, calm voice and using simple, concrete sentences
D. Asking open-ended questions to encourage the client to explore their delusions
Correct Answer: C
Rationale: During acute psychosis, the client has difficulty processing complex stimuli.
Speaking in a calm, firm manner with simple, concrete sentences helps the client feel
safe and understand the nurse. Abstract language (A), lengthy explanations (B), and
exploring delusions (D) can be overwhelming and increase agitation.
2. A nurse is admitting a client who states, "I am worthless and I can't do anything
right." This statement should alert the nurse to assess the client for which
condition?
A. Bipolar disorder
, Page 2 of 95
B. Depression
C. Antisocial personality disorder
D. Generalized anxiety disorder
Correct Answer: B
Rationale: Feelings of worthlessness, hopelessness, and guilt are hallmark cognitive
symptoms of major depressive disorder. While these can be present in other conditions,
they are most classic for depression.
3. A nurse is caring for a client who is experiencing a panic attack. What is the
priority nursing intervention?
A. Encouraging the client to express their feelings and explore the cause of the panic
B. Giving the client a sedative medication to immediately reduce their anxiety
C. Staying with the client and providing reassurance in a quiet, calm environment
D. Leaving the client alone to give them space to regain their composure
Correct Answer: C
Rationale: The priority is to provide a safe, calm presence. The client should not be left
alone (D). While medication (B) may be needed, the immediate nursing action is to stay
with the client and use a calm demeanor to help de-escalate the panic.
4. A client who is grieving the death of a spouse tells the nurse, "I can't believe this
happened. I should have done more to make sure they were safe." Which stage of
grief, according to Kübler-Ross, is this client exhibiting?
A. Denial
B. Anger
C. Bargaining
D. Depression
Correct Answer: C
Rationale: The client is expressing guilt and trying to imagine how they could have
prevented the death, which is characteristic of the bargaining stage. Denial is a refusal
to accept reality (A), anger is rage and resentment (B), and depression is deep sadness
and hopelessness (D).
, Page 3 of 95
5. A nurse is caring for a client who is refusing to take their medication. The client
says, "You're all trying to poison me." What is the nurse's most appropriate
response?
A. "That is a paranoid thought. No one is trying to poison you."
B. "I understand you feel that way. It must be frightening to think that."
C. "If you don't take it, you will have to have it as an injection."
D. "Let's discuss why you believe that we are trying to harm you."
Correct Answer: B
Rationale: This response validates the client's feelings without challenging the
delusion. It acknowledges their emotion and builds trust. Arguing (A) or threatening (C)
is not therapeutic. Exploring the delusion (D) can reinforce it.
6. A nurse is assessing a client's use of defense mechanisms. The client says, "I
don't have a drinking problem, I just like to have a few drinks to unwind." This is an
example of which defense mechanism?
A. Denial
B. Projection
C. Rationalization
D. Repression
Correct Answer: C
Rationale: The client is rationalizing their drinking behavior by providing a socially
acceptable reason (unwinding) to justify their alcohol use. Denial (A) would be outright
refusal to admit there is a problem. Projection (B) involves attributing one's own feelings
to others. Repression (D) involves unconsciously blocking unacceptable thoughts.
7. A nurse is caring for a client who is demonstrating severe anxiety and is
hyperventilating. Which intervention should the nurse implement first?
A. Encourage the client to take slow, deep breaths
B. Provide a quiet environment and speak in a calm tone
C. Have the client breathe into a paper bag
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D. Administer a prescribed antianxiety medication
Correct Answer: B
Rationale: A quiet environment and a calm demeanor are the initial steps to reduce
overstimulation and help the client regain control. Instructing the client to breathe with
the nurse (A) is the next step. Paper bags (C) are no longer recommended. Medication
(D) is not the first intervention.
8. A nurse is reviewing the history of a client diagnosed with borderline personality
disorder. Which behavior is the nurse most likely to find documented?
A. Grandiose sense of self-importance and a need for admiration
B. Instability in interpersonal relationships, self-image, and affect
C. Detachment from social relationships and restricted emotional expression
D. Disregard for and violation of the rights of others
Correct Answer: B
Rationale: Borderline personality disorder is characterized by a pervasive pattern of
instability in relationships, self-image, and emotions, along with significant impulsivity.
Grandiosity (A) is characteristic of narcissistic personality disorder, detachment (C) of
schizoid, and disregard for others (D) of antisocial.
9. A nurse is caring for a client who has a terminal illness. The client says, "I'm
going to die anyway, so what's the point?" Which of the following is the most
therapeutic response?
A. "You shouldn't feel that way. You have so much to live for."
B. "I understand you're feeling hopeless. Tell me more about what you're thinking."
C. "Let me call the chaplain to come and talk to you."
D. "You need to stay positive for your family."
Correct Answer: B
Rationale: This response validates the client's feelings and encourages them to express
their emotions, which is therapeutic. Dismissing the client's feelings (A, D) and
premature problem-solving (C) are not therapeutic.
