EVOLVE HESI MENTAL HEALTH NURSING EXAM
TEST BANK 2026/2027 HIGH YIELD PRACTICE
QUESTIONS QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
PDF
Core Domains
Therapeutic Communication and the Nurse-Patient Relationship
Mood Disorders and Suicide Risk Assessment
Anxiety, Obsessive-Compulsive, and Related Disorders
Psychotic Disorders and Antipsychotic Pharmacology
Personality Disorders and Defense Mechanisms
Substance Use Disorders and Withdrawal Management
Legal, Ethical, and Professional Standards in Psychiatric Nursing
Crisis Intervention, Milieu Therapy, and Patient Safety
Introduction
This examination assesses the entry-level competencies required for safe and
effective mental health nursing practice. It evaluates therapeutic communication,
psychiatric assessment, psychopharmacology, crisis intervention, and legal-ethical
decision-making across diverse behavioral health settings. The multiple-choice
and scenario-based items emphasize real-world clinical judgment, patient safety,
and evidence-informed nursing interventions. Candidates must demonstrate
proficiency in recognizing psychiatric manifestations, prioritizing nursing actions,
and applying patient-centered care principles. This format reflects professional
licensure and certification expectations, promoting accountability and quality in
mental health nursing practice.
SECTION ONE: QUESTIONS 1–100
,1. A client with major depressive disorder says, "My family would be better
off without me." What is the nurse's priority response?
A. "Why do you think your family feels that way?"
B. "You should focus on the positive things in your life."
C. "Are you thinking about killing yourself?"
D. "Your family needs you."
C. "Are you thinking about killing yourself?"
RATIONALE: Directly assessing suicidal thoughts is appropriate and does not
increase suicide risk. The nurse must determine the presence of suicidal ideation,
plan, intent, and access to means .
2. Which finding is most characteristic of a manic episode?
A. Social withdrawal
B. Decreased need for sleep
C. Psychomotor retardation
D. Feelings of worthlessness
B. Decreased need for sleep
RATIONALE: Mania commonly includes elevated or irritable mood, increased
energy, pressured speech, racing thoughts, impulsivity, and a decreased need for
sleep .
3. A client taking lithium reports severe diarrhea, vomiting, and coarse hand
tremors. What should the nurse do first?
A. Administer the next lithium dose
B. Encourage increased caffeine intake
C. Hold lithium and notify the provider
D. Reassure the client that these are expected effects
, C. Hold lithium and notify the provider
RATIONALE: Severe gastrointestinal symptoms and coarse tremors can
indicate lithium toxicity. Lithium should be withheld and the provider notified
promptly .
4. Which statement by a client demonstrates understanding of lithium
therapy?
A. "I should drastically reduce my salt intake."
B. "I need to maintain consistent fluid and sodium intake."
C. "I can stop the medication when I feel better."
D. "I should double my dose if I miss one."
B. "I need to maintain consistent fluid and sodium intake."
RATIONALE: Sodium and fluid balance influence lithium levels. Consistency
helps prevent potentially dangerous fluctuations in serum lithium concentration .
5. A client experiencing auditory hallucinations says, "The voices are telling
me to hurt myself." What is the nurse's priority?
A. Ask what the voices sound like
B. Determine whether the client intends to act on the command
C. Tell the client the voices are not real
D. Encourage the client to ignore the voices
B. Determine whether the client intends to act on the command
RATIONALE: Command hallucinations involving self-harm require
immediate safety assessment, including intent, plan, means, and ability to resist the
commands .
6. Which nursing intervention is most appropriate for a client experiencing
acute psychosis?
A. Provide lengthy explanations
, B. Challenge delusional beliefs
C. Use short, clear statements
D. Encourage participation in a large group
C. Use short, clear statements
RATIONALE: Acute psychosis can impair concentration and information
processing. Simple, concise communication reduces confusion and anxiety .
7. A client with schizophrenia says, "The government implanted a tracking
device in my head." What is the best response?
A. "That is impossible."
B. "I know exactly what you mean."
C. "I don't see evidence of a tracking device, but I understand that this feels
frightening."
D. "Why would the government track you?"
C. "I don't see evidence of a tracking device, but I understand that this feels
frightening."
RATIONALE: The nurse should acknowledge the client's feelings without
validating the delusion or directly arguing about its content .
8. Which finding is most associated with negative symptoms of schizophrenia?
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
C. Flat affect
RATIONALE: Negative symptoms include diminished emotional expression,
avolition, anhedonia, social withdrawal, and reduced speech .
TEST BANK 2026/2027 HIGH YIELD PRACTICE
QUESTIONS QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
Core Domains
Therapeutic Communication and the Nurse-Patient Relationship
Mood Disorders and Suicide Risk Assessment
Anxiety, Obsessive-Compulsive, and Related Disorders
Psychotic Disorders and Antipsychotic Pharmacology
Personality Disorders and Defense Mechanisms
Substance Use Disorders and Withdrawal Management
Legal, Ethical, and Professional Standards in Psychiatric Nursing
Crisis Intervention, Milieu Therapy, and Patient Safety
Introduction
This examination assesses the entry-level competencies required for safe and
effective mental health nursing practice. It evaluates therapeutic communication,
psychiatric assessment, psychopharmacology, crisis intervention, and legal-ethical
decision-making across diverse behavioral health settings. The multiple-choice
and scenario-based items emphasize real-world clinical judgment, patient safety,
and evidence-informed nursing interventions. Candidates must demonstrate
proficiency in recognizing psychiatric manifestations, prioritizing nursing actions,
and applying patient-centered care principles. This format reflects professional
licensure and certification expectations, promoting accountability and quality in
mental health nursing practice.
SECTION ONE: QUESTIONS 1–100
,1. A client with major depressive disorder says, "My family would be better
off without me." What is the nurse's priority response?
A. "Why do you think your family feels that way?"
B. "You should focus on the positive things in your life."
C. "Are you thinking about killing yourself?"
D. "Your family needs you."
C. "Are you thinking about killing yourself?"
RATIONALE: Directly assessing suicidal thoughts is appropriate and does not
increase suicide risk. The nurse must determine the presence of suicidal ideation,
plan, intent, and access to means .
2. Which finding is most characteristic of a manic episode?
A. Social withdrawal
B. Decreased need for sleep
C. Psychomotor retardation
D. Feelings of worthlessness
B. Decreased need for sleep
RATIONALE: Mania commonly includes elevated or irritable mood, increased
energy, pressured speech, racing thoughts, impulsivity, and a decreased need for
sleep .
3. A client taking lithium reports severe diarrhea, vomiting, and coarse hand
tremors. What should the nurse do first?
A. Administer the next lithium dose
B. Encourage increased caffeine intake
C. Hold lithium and notify the provider
D. Reassure the client that these are expected effects
, C. Hold lithium and notify the provider
RATIONALE: Severe gastrointestinal symptoms and coarse tremors can
indicate lithium toxicity. Lithium should be withheld and the provider notified
promptly .
4. Which statement by a client demonstrates understanding of lithium
therapy?
A. "I should drastically reduce my salt intake."
B. "I need to maintain consistent fluid and sodium intake."
C. "I can stop the medication when I feel better."
D. "I should double my dose if I miss one."
B. "I need to maintain consistent fluid and sodium intake."
RATIONALE: Sodium and fluid balance influence lithium levels. Consistency
helps prevent potentially dangerous fluctuations in serum lithium concentration .
5. A client experiencing auditory hallucinations says, "The voices are telling
me to hurt myself." What is the nurse's priority?
A. Ask what the voices sound like
B. Determine whether the client intends to act on the command
C. Tell the client the voices are not real
D. Encourage the client to ignore the voices
B. Determine whether the client intends to act on the command
RATIONALE: Command hallucinations involving self-harm require
immediate safety assessment, including intent, plan, means, and ability to resist the
commands .
6. Which nursing intervention is most appropriate for a client experiencing
acute psychosis?
A. Provide lengthy explanations
, B. Challenge delusional beliefs
C. Use short, clear statements
D. Encourage participation in a large group
C. Use short, clear statements
RATIONALE: Acute psychosis can impair concentration and information
processing. Simple, concise communication reduces confusion and anxiety .
7. A client with schizophrenia says, "The government implanted a tracking
device in my head." What is the best response?
A. "That is impossible."
B. "I know exactly what you mean."
C. "I don't see evidence of a tracking device, but I understand that this feels
frightening."
D. "Why would the government track you?"
C. "I don't see evidence of a tracking device, but I understand that this feels
frightening."
RATIONALE: The nurse should acknowledge the client's feelings without
validating the delusion or directly arguing about its content .
8. Which finding is most associated with negative symptoms of schizophrenia?
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
C. Flat affect
RATIONALE: Negative symptoms include diminished emotional expression,
avolition, anhedonia, social withdrawal, and reduced speech .
