HESI Mental Health Nursing Examination 55 Questions | Graded A+
HESI MENTAL HEALTH EXAM
With All 55 Questions and Correct Answers - Graded A+
HESI Psychiatric-Mental Health Nursing Examination Preparation | 2026/2027 Latest Format
Section 1: Therapeutic Communication and Nurse-Client Relationship (Q1-12)
Q1: A client diagnosed with major depressive disorder says to the nurse, 'I'm such a burden to my family.
They would be better off without me.' Which response by the nurse demonstrates therapeutic
communication?
A. 'You shouldn't think that way. Your family loves you very much.'
B. 'Everyone feels like a burden sometimes. It will get better.'
C. 'Can you tell me more about what makes you feel like a burden to your family?'
**[CORRECT]**
D. 'I understand how you feel. I have felt that way before too.'
Correct Answer: C
Rationale: This response uses open-ended questioning and exploration, which are core therapeutic communication
techniques that encourage the client to express feelings in greater depth. Option A offers false reassurance and dismisses the
client's feelings. Option B minimizes the client's emotional experience through universalizing. Option D shifts focus from the
client to the nurse through personal disclosure, which is a non-therapeutic barrier known as crossed boundaries.
Q2: A nurse is caring for a client with schizophrenia who states, 'The CIA is putting thoughts into my head
through the television.' Which is the most therapeutic nursing response?
A. 'That is not true. The CIA does not do that to people.'
B. 'You must be very frightened. I do not hear the same thing, but I can see you are upset.'
**[CORRECT]**
C. 'Let's turn off the television so the thoughts will stop.'
D. 'Why do you think the CIA is targeting you specifically?'
Correct Answer: B
Rationale: This response acknowledges the client's emotional experience without reinforcing the delusion, which is the
correct approach when managing psychotic symptoms. It uses the technique of 'offering self' and 'validating feelings
without validating the delusion.' Option A directly argues with the delusion, which is non-therapeutic and increases
defensiveness. Option C reinforces the delusion by implying the television is the cause. Option D challenges the delusion and
may provoke anxiety or agitation.
Q3: During a therapeutic interaction, a client with borderline personality disorder suddenly becomes angry
and shouts, 'You don't care about me at all! You're just like everyone else!' Which nursing response best
demonstrates therapeutic limit-setting?
A. 'I do care about you. Please calm down so we can talk.'
B. 'I can see you are upset, but I cannot continue our conversation when you are shouting. We can
talk again when you are ready to speak calmly.' **[CORRECT]**
C. 'You are projecting your feelings onto me. Let's explore that.'
HESI Psychiatric-Mental Health Nursing Exam Page 1
,HESI Mental Health Nursing Examination 55 Questions | Graded A+
D. 'I will come back later when you are in a better mood.'
Correct Answer: B
Rationale: This response sets a clear, respectful boundary while acknowledging the client's feelings and offering to
continue when behavior is appropriate. Therapeutic limit-setting involves stating the behavior, explaining the consequence,
and offering alternatives. Option A offers false reassurance without addressing the behavior. Option C uses a therapeutic
technique (interpretation) at an inappropriate time when the client is dysregulated. Option D is punitive and abandons the
client without explanation.
Q4: A nurse is providing care to a client who was sexually abused as a child. The client says, 'I trusted you,
and now I feel like you betrayed me by telling the doctor about my self-harm.' Which concept best describes
the client's reaction?
A. Countertransference
B. Transference **[CORRECT]**
C. Resistance
D. Splitting
Correct Answer: B
Rationale: Transference occurs when a client unconsciously redirects feelings about a significant person from the past onto
the nurse or therapist. This client is transferring feelings of betrayal from the abuser onto the nurse. Countertransference
(Option A) refers to the nurse's emotional reaction toward the client based on the nurse's own past experiences. Resistance
(Option C) is the client's unconscious attempt to block therapeutic progress. Splitting (Option D) is a defense mechanism in
which the client categorizes people as all good or all bad.
Q5: A nursing student asks the instructor, 'What is the primary difference between therapeutic and
non-therapeutic communication?' Which response by the instructor is most accurate?
A. 'Therapeutic communication uses only open-ended questions, while non-therapeutic communication uses
only closed-ended questions.'
B. 'Therapeutic communication focuses on the client's needs and feelings, while non-therapeutic
communication focuses on the nurse's perspective or agenda.' **[CORRECT]**
C. 'Therapeutic communication is only used in psychiatric settings, while non-therapeutic communication is
used in medical-surgical settings.'
D. 'Therapeutic communication always results in client improvement, while non-therapeutic communication
does not.'
Correct Answer: B
Rationale: Therapeutic communication is client-centered, meaning it prioritizes the client's thoughts, feelings, and needs
above the nurse's own agenda. The hallmark is active listening, empathy, and facilitating the client's expression. Option A is
incorrect because therapeutic communication can include both open-ended and closed-ended questions depending on the
clinical context. Option C is false because therapeutic communication is applicable in all nursing settings. Option D is
incorrect because outcomes depend on many factors beyond communication alone.
Q6: A client diagnosed with generalized anxiety disorder (GAD) is pacing the hallway and appears visibly
anxious. The nurse says, 'I notice you seem restless right now.' Which therapeutic technique is the nurse
using?
A. Restating
B. Reflecting
HESI Psychiatric-Mental Health Nursing Exam Page 2
, HESI Mental Health Nursing Examination 55 Questions | Graded A+
C. Making observations **[CORRECT]**
D. Clarifying
Correct Answer: C
Rationale: Making observations involves verbalizing what the nurse perceives about the client's behavior, mood, or affect
without making judgments. The nurse is describing observable behavior (pacing, restlessness) rather than interpreting its
meaning. Restating (Option A) involves repeating the client's main idea. Reflecting (Option B) involves directing feelings
back to the client. Clarifying (Option D) involves asking the client to explain ambiguous statements.
Q7: A psychiatric nurse has been working with a client who has a history of childhood emotional neglect.
The nurse finds herself going out of her way to bring the client extra snacks and spending more time with this
client than others. Which phenomenon is the nurse most likely experiencing?
A. Transference
B. Countertransference **[CORRECT]**
C. Empathy
D. Boundary violation
Correct Answer: B
Rationale: Countertransference occurs when the nurse unconsciously projects her own emotional needs or unresolved
feelings onto the client. The nurse's overcompensation (extra snacks, extra time) suggests she may be responding to her own
unresolved feelings about neglect rather than the client's actual therapeutic needs. Transference (Option A) is the client's
projection onto the nurse. Empathy (Option C) is understanding the client's feelings without losing objectivity, which differs
from over-involvement. While this behavior could lead to a boundary violation (Option D), the underlying phenomenon is
countertransference.
Q8: A nurse says to a client with depression, 'Why did you stop taking your medication? You know how
important it is for your recovery.' Which non-therapeutic communication technique is the nurse using?
A. Defensiveness
B. Probing
C. Challenging **[CORRECT]**
D. Giving advice
Correct Answer: C
Rationale: The nurse is challenging the client by questioning their judgment in a confrontational manner, which implies the
client made a poor decision. This creates defensiveness and undermines the therapeutic relationship. Defensiveness (Option
A) occurs when the nurse protects herself from criticism. Probing (Option B) involves pushing for information the client is
not ready to share. Giving advice (Option D) involves telling the client what to do, which is not present here. The key is that
the nurse is questioning 'why' in an accusatory way.
Q9: During an admission assessment, a client with bipolar disorder is talking rapidly and jumping between
topics. The nurse states, 'You seem to have a lot on your mind today. Let's focus on one thing at a time.'
Which therapeutic technique does this demonstrate?
A. Focusing **[CORRECT]**
B. Redirecting
C. Summarizing
D. Broadening
Correct Answer: A
HESI Psychiatric-Mental Health Nursing Exam Page 3
HESI MENTAL HEALTH EXAM
With All 55 Questions and Correct Answers - Graded A+
HESI Psychiatric-Mental Health Nursing Examination Preparation | 2026/2027 Latest Format
Section 1: Therapeutic Communication and Nurse-Client Relationship (Q1-12)
Q1: A client diagnosed with major depressive disorder says to the nurse, 'I'm such a burden to my family.
They would be better off without me.' Which response by the nurse demonstrates therapeutic
communication?
A. 'You shouldn't think that way. Your family loves you very much.'
B. 'Everyone feels like a burden sometimes. It will get better.'
C. 'Can you tell me more about what makes you feel like a burden to your family?'
**[CORRECT]**
D. 'I understand how you feel. I have felt that way before too.'
Correct Answer: C
Rationale: This response uses open-ended questioning and exploration, which are core therapeutic communication
techniques that encourage the client to express feelings in greater depth. Option A offers false reassurance and dismisses the
client's feelings. Option B minimizes the client's emotional experience through universalizing. Option D shifts focus from the
client to the nurse through personal disclosure, which is a non-therapeutic barrier known as crossed boundaries.
Q2: A nurse is caring for a client with schizophrenia who states, 'The CIA is putting thoughts into my head
through the television.' Which is the most therapeutic nursing response?
A. 'That is not true. The CIA does not do that to people.'
B. 'You must be very frightened. I do not hear the same thing, but I can see you are upset.'
**[CORRECT]**
C. 'Let's turn off the television so the thoughts will stop.'
D. 'Why do you think the CIA is targeting you specifically?'
Correct Answer: B
Rationale: This response acknowledges the client's emotional experience without reinforcing the delusion, which is the
correct approach when managing psychotic symptoms. It uses the technique of 'offering self' and 'validating feelings
without validating the delusion.' Option A directly argues with the delusion, which is non-therapeutic and increases
defensiveness. Option C reinforces the delusion by implying the television is the cause. Option D challenges the delusion and
may provoke anxiety or agitation.
Q3: During a therapeutic interaction, a client with borderline personality disorder suddenly becomes angry
and shouts, 'You don't care about me at all! You're just like everyone else!' Which nursing response best
demonstrates therapeutic limit-setting?
A. 'I do care about you. Please calm down so we can talk.'
B. 'I can see you are upset, but I cannot continue our conversation when you are shouting. We can
talk again when you are ready to speak calmly.' **[CORRECT]**
C. 'You are projecting your feelings onto me. Let's explore that.'
HESI Psychiatric-Mental Health Nursing Exam Page 1
,HESI Mental Health Nursing Examination 55 Questions | Graded A+
D. 'I will come back later when you are in a better mood.'
Correct Answer: B
Rationale: This response sets a clear, respectful boundary while acknowledging the client's feelings and offering to
continue when behavior is appropriate. Therapeutic limit-setting involves stating the behavior, explaining the consequence,
and offering alternatives. Option A offers false reassurance without addressing the behavior. Option C uses a therapeutic
technique (interpretation) at an inappropriate time when the client is dysregulated. Option D is punitive and abandons the
client without explanation.
Q4: A nurse is providing care to a client who was sexually abused as a child. The client says, 'I trusted you,
and now I feel like you betrayed me by telling the doctor about my self-harm.' Which concept best describes
the client's reaction?
A. Countertransference
B. Transference **[CORRECT]**
C. Resistance
D. Splitting
Correct Answer: B
Rationale: Transference occurs when a client unconsciously redirects feelings about a significant person from the past onto
the nurse or therapist. This client is transferring feelings of betrayal from the abuser onto the nurse. Countertransference
(Option A) refers to the nurse's emotional reaction toward the client based on the nurse's own past experiences. Resistance
(Option C) is the client's unconscious attempt to block therapeutic progress. Splitting (Option D) is a defense mechanism in
which the client categorizes people as all good or all bad.
Q5: A nursing student asks the instructor, 'What is the primary difference between therapeutic and
non-therapeutic communication?' Which response by the instructor is most accurate?
A. 'Therapeutic communication uses only open-ended questions, while non-therapeutic communication uses
only closed-ended questions.'
B. 'Therapeutic communication focuses on the client's needs and feelings, while non-therapeutic
communication focuses on the nurse's perspective or agenda.' **[CORRECT]**
C. 'Therapeutic communication is only used in psychiatric settings, while non-therapeutic communication is
used in medical-surgical settings.'
D. 'Therapeutic communication always results in client improvement, while non-therapeutic communication
does not.'
Correct Answer: B
Rationale: Therapeutic communication is client-centered, meaning it prioritizes the client's thoughts, feelings, and needs
above the nurse's own agenda. The hallmark is active listening, empathy, and facilitating the client's expression. Option A is
incorrect because therapeutic communication can include both open-ended and closed-ended questions depending on the
clinical context. Option C is false because therapeutic communication is applicable in all nursing settings. Option D is
incorrect because outcomes depend on many factors beyond communication alone.
Q6: A client diagnosed with generalized anxiety disorder (GAD) is pacing the hallway and appears visibly
anxious. The nurse says, 'I notice you seem restless right now.' Which therapeutic technique is the nurse
using?
A. Restating
B. Reflecting
HESI Psychiatric-Mental Health Nursing Exam Page 2
, HESI Mental Health Nursing Examination 55 Questions | Graded A+
C. Making observations **[CORRECT]**
D. Clarifying
Correct Answer: C
Rationale: Making observations involves verbalizing what the nurse perceives about the client's behavior, mood, or affect
without making judgments. The nurse is describing observable behavior (pacing, restlessness) rather than interpreting its
meaning. Restating (Option A) involves repeating the client's main idea. Reflecting (Option B) involves directing feelings
back to the client. Clarifying (Option D) involves asking the client to explain ambiguous statements.
Q7: A psychiatric nurse has been working with a client who has a history of childhood emotional neglect.
The nurse finds herself going out of her way to bring the client extra snacks and spending more time with this
client than others. Which phenomenon is the nurse most likely experiencing?
A. Transference
B. Countertransference **[CORRECT]**
C. Empathy
D. Boundary violation
Correct Answer: B
Rationale: Countertransference occurs when the nurse unconsciously projects her own emotional needs or unresolved
feelings onto the client. The nurse's overcompensation (extra snacks, extra time) suggests she may be responding to her own
unresolved feelings about neglect rather than the client's actual therapeutic needs. Transference (Option A) is the client's
projection onto the nurse. Empathy (Option C) is understanding the client's feelings without losing objectivity, which differs
from over-involvement. While this behavior could lead to a boundary violation (Option D), the underlying phenomenon is
countertransference.
Q8: A nurse says to a client with depression, 'Why did you stop taking your medication? You know how
important it is for your recovery.' Which non-therapeutic communication technique is the nurse using?
A. Defensiveness
B. Probing
C. Challenging **[CORRECT]**
D. Giving advice
Correct Answer: C
Rationale: The nurse is challenging the client by questioning their judgment in a confrontational manner, which implies the
client made a poor decision. This creates defensiveness and undermines the therapeutic relationship. Defensiveness (Option
A) occurs when the nurse protects herself from criticism. Probing (Option B) involves pushing for information the client is
not ready to share. Giving advice (Option D) involves telling the client what to do, which is not present here. The key is that
the nurse is questioning 'why' in an accusatory way.
Q9: During an admission assessment, a client with bipolar disorder is talking rapidly and jumping between
topics. The nurse states, 'You seem to have a lot on your mind today. Let's focus on one thing at a time.'
Which therapeutic technique does this demonstrate?
A. Focusing **[CORRECT]**
B. Redirecting
C. Summarizing
D. Broadening
Correct Answer: A
HESI Psychiatric-Mental Health Nursing Exam Page 3
