EVOLVE HESI MENTAL HEALTH
NURSING EXAM TEST BANK 2026/2027
HIGH YIELD PRACTICE QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
Core Domains
Therapeutic Communication and the Nurse-Client Relationship
Psychiatric Assessment and Mental Status Examination
Anxiety, Trauma, and Stressor-Related Disorders
,Depressive Disorders and Suicide Risk
Bipolar and Related Disorders
Schizophrenia Spectrum and Psychotic Disorders
Personality Disorders and Impulse-Control Disorders
Substance Use Disorders and Addiction
Neurocognitive Disorders and Delirium
Child and Adolescent Mental Health
Psychopharmacology and Medication Management
Crisis Intervention, Milieu Management, and Legal-Ethical Issues
Introduction
The Evolve HESI Mental Health Nursing Examination evaluates the
nursing student's readiness for entry-level practice in psychiatric-
mental health settings and for the NCLEX-RN licensure examination.
The assessment measures clinical judgment through scenario-based
items requiring recognition and analysis of cues, prioritization of
hypotheses, generation of solutions, and evaluation of outcomes.
Content covers therapeutic communication, psychiatric assessment,
major psychiatric disorders, psychopharmacology, crisis
intervention, and legal-ethical principles. This comprehensive test
bank challenges the candidate to apply the nursing process, ensure
client safety, and implement evidence-based interventions in diverse
mental health scenarios.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client diagnosed with schizophrenia
who is experiencing auditory hallucinations. Which
therapeutic communication technique is most appropriate for
the nurse to use initially?
,A. "Tell me what the voices are saying to you."
B. "You know those voices aren't real."
C. "I don't hear any voices. Let's talk about something else."
D. "Try to ignore the voices and focus on your tasks."
A. "Tell me what the voices are saying to you."
RATIONALE: Asking the client to describe the hallucinations
assesses the content and command nature of the voices, which is
essential for safety evaluation. Directing the client to ignore or deny
the voices dismisses their experience and damages trust. This initial
assessment guides whether the client is at risk for harm to self or
others.
2. A client with major depressive disorder states, "I'm
worthless. Everyone would be better off without me." Which
nursing response is the priority?
A. "You have so much to live for."
B. "Are you thinking about killing yourself?"
C. "Let's talk about your accomplishments."
D. "You shouldn't feel that way."
B. "Are you thinking about killing yourself?"
RATIONALE: Direct, nonjudgmental questioning about suicidal
ideation is essential when a client expresses hopelessness or
worthlessness. This is the priority because it assesses immediate
safety risk and determines the level of intervention needed.
Providing reassurance or minimizing feelings discourages open
communication.
, 3. A nurse is assessing a client with generalized anxiety
disorder. Which finding should the nurse expect to observe?
A. Decreased muscle tension
B. Hypervigilance and restlessness
C. Psychomotor retardation
D. Anhedonia
B. Hypervigilance and restlessness
RATIONALE: Generalized anxiety disorder is characterized by
excessive, uncontrollable worry accompanied by hypervigilance,
restlessness, muscle tension, fatigue, and sleep disturbance.
Anhedonia and psychomotor retardation are more characteristic of
depressive disorders.
4. A client taking lithium carbonate reports a fine hand tremor
and increased thirst. Which action should the nurse take?
A. Reassure the client these are expected side effects
B. Obtain a serum lithium level
C. Withhold the next dose
D. Restrict fluid intake
B. Obtain a serum lithium level
RATIONALE: Fine hand tremor and polydipsia can be early
signs of lithium toxicity. The nurse should obtain a serum lithium
level to assess whether the client is within the therapeutic range
(0.6–1.2 mEq/L). If levels are elevated, immediate intervention is
required.
NURSING EXAM TEST BANK 2026/2027
HIGH YIELD PRACTICE QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
Core Domains
Therapeutic Communication and the Nurse-Client Relationship
Psychiatric Assessment and Mental Status Examination
Anxiety, Trauma, and Stressor-Related Disorders
,Depressive Disorders and Suicide Risk
Bipolar and Related Disorders
Schizophrenia Spectrum and Psychotic Disorders
Personality Disorders and Impulse-Control Disorders
Substance Use Disorders and Addiction
Neurocognitive Disorders and Delirium
Child and Adolescent Mental Health
Psychopharmacology and Medication Management
Crisis Intervention, Milieu Management, and Legal-Ethical Issues
Introduction
The Evolve HESI Mental Health Nursing Examination evaluates the
nursing student's readiness for entry-level practice in psychiatric-
mental health settings and for the NCLEX-RN licensure examination.
The assessment measures clinical judgment through scenario-based
items requiring recognition and analysis of cues, prioritization of
hypotheses, generation of solutions, and evaluation of outcomes.
Content covers therapeutic communication, psychiatric assessment,
major psychiatric disorders, psychopharmacology, crisis
intervention, and legal-ethical principles. This comprehensive test
bank challenges the candidate to apply the nursing process, ensure
client safety, and implement evidence-based interventions in diverse
mental health scenarios.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client diagnosed with schizophrenia
who is experiencing auditory hallucinations. Which
therapeutic communication technique is most appropriate for
the nurse to use initially?
,A. "Tell me what the voices are saying to you."
B. "You know those voices aren't real."
C. "I don't hear any voices. Let's talk about something else."
D. "Try to ignore the voices and focus on your tasks."
A. "Tell me what the voices are saying to you."
RATIONALE: Asking the client to describe the hallucinations
assesses the content and command nature of the voices, which is
essential for safety evaluation. Directing the client to ignore or deny
the voices dismisses their experience and damages trust. This initial
assessment guides whether the client is at risk for harm to self or
others.
2. A client with major depressive disorder states, "I'm
worthless. Everyone would be better off without me." Which
nursing response is the priority?
A. "You have so much to live for."
B. "Are you thinking about killing yourself?"
C. "Let's talk about your accomplishments."
D. "You shouldn't feel that way."
B. "Are you thinking about killing yourself?"
RATIONALE: Direct, nonjudgmental questioning about suicidal
ideation is essential when a client expresses hopelessness or
worthlessness. This is the priority because it assesses immediate
safety risk and determines the level of intervention needed.
Providing reassurance or minimizing feelings discourages open
communication.
, 3. A nurse is assessing a client with generalized anxiety
disorder. Which finding should the nurse expect to observe?
A. Decreased muscle tension
B. Hypervigilance and restlessness
C. Psychomotor retardation
D. Anhedonia
B. Hypervigilance and restlessness
RATIONALE: Generalized anxiety disorder is characterized by
excessive, uncontrollable worry accompanied by hypervigilance,
restlessness, muscle tension, fatigue, and sleep disturbance.
Anhedonia and psychomotor retardation are more characteristic of
depressive disorders.
4. A client taking lithium carbonate reports a fine hand tremor
and increased thirst. Which action should the nurse take?
A. Reassure the client these are expected side effects
B. Obtain a serum lithium level
C. Withhold the next dose
D. Restrict fluid intake
B. Obtain a serum lithium level
RATIONALE: Fine hand tremor and polydipsia can be early
signs of lithium toxicity. The nurse should obtain a serum lithium
level to assess whether the client is within the therapeutic range
(0.6–1.2 mEq/L). If levels are elevated, immediate intervention is
required.
