HESI RN Mental Health Exit
Exam – 3 Newest Versions
Test Bank 2025/2026
Section 1: Anxiety, Stress, and Coping (Questions 1–15)
1. A client with panic disorder tells the nurse, "I feel like I'm going to die right
now." Which is the nurse's priority action?
A. Reassure the client that the feeling will pass
B. Stay with the client and use a calm, matter-of-fact approach
C. Administer the PRN alprazolam immediately
D. Teach the client deep breathing techniques
Correct Answer: B
Rationale: The priority during a panic attack is to remain with the client and
maintain a calm, nonthreatening presence. Reassurance ("it will pass") is often
ineffective because the client cannot process logic during acute panic. PRN
medication may be given but is not the first action. Teaching deep breathing is
appropriate once the acute phase subsides. Safety and presence take precedence.
2. Which client statement indicates the use of a healthy defense mechanism?
A. "I didn't get the job because the interviewer was intimidated by me."
B. "I'm upset about my diagnosis, so I'm going to the gym to burn off steam."
C. "I forgot my appointment because I really didn't want to hear bad news."
D. "I yell at my spouse when I'm stressed at work, but it's not my fault."
Correct Answer: B
Rationale: Sublimation (channeling unacceptable impulses into socially
acceptable activities) is a mature, healthy defense mechanism. Option A is
rationalization. Option C is suppression/repression. Option D is displacement with
projection. Only sublimation reflects adaptive coping.
,3. A client is experiencing a panic attack. Which assessment finding should the
nurse expect?
A. Bradycardia and hypotension
B. Decreased respiratory rate
C. Dilated pupils and increased heart rate
D. Constricted pupils and warm, dry skin
Correct Answer: C
Rationale: Panic attacks activate the sympathetic nervous system, causing
mydriasis (dilated pupils), tachycardia, tachypnea, diaphoresis, and increased
blood pressure. Options A, B, and D reflect parasympathetic or normal findings.
4. SATA: Which interventions are appropriate for a client with generalized
anxiety disorder (GAD)? Select all that apply.
A. Encourage the client to identify triggers
B. Teach relaxation techniques such as guided imagery
C. Discourage the client from discussing worries to prevent reinforcement
D. Administer buspirone as prescribed
E. Provide a structured daily routine
F. Encourage caffeine intake to increase alertness
Correct Answers: A, B, D, E
Rationale: Identifying triggers, relaxation techniques, buspirone (a non-
benzodiazepine anxiolytic), and structure all reduce anxiety. Discussing worries is
therapeutic and should not be discouraged. Caffeine is a stimulant that worsens
anxiety.
5. A nurse is caring for a client with obsessive-compulsive disorder (OCD) who
performs handwashing rituals. Which response is most therapeutic?
A. "You don't need to wash your hands again; they're clean."
B. "I'll wait with you while you wash your hands, then we'll go to lunch."
,C. "If you keep washing your hands, you'll damage your skin."
D. "Let's set a limit of two handwashes per hour."
Correct Answer: B
Rationale: The nurse should allow time for the ritual while setting a
supportive, nonjudgmental tone. Arguing or reasoning with the client increases
anxiety. Interrupting the ritual can precipitate panic. Limit-setting is appropriate
only after trust is established and is done collaboratively, not punitively.
6. Which finding indicates that a client's anxiety is at a moderate level?
A. The client is unable to focus on anything but the anxiety
B. The client's perceptual field is narrowed, but the client can follow directions
C. The client is pacing and unable to sit still
D. The client reports feeling "completely out of control"
Correct Answer: B
Rationale: Moderate anxiety narrows the perceptual field, but the client can
still follow directions with assistance. Severe anxiety markedly narrows the field
and impairs reasoning. Panic causes loss of control and inability to focus. Pacing
suggests severe anxiety.
7. A client with a phobia of flying is scheduled for a needed business trip.
Which therapy is most effective for this condition?
A. Psychoanalysis
B. Systematic desensitization
C. Electroconvulsive therapy
D. Aversion therapy
Correct Answer: B
Rationale: Systematic desensitization (a form of behavioral therapy) gradually
exposes the client to the feared stimulus while teaching relaxation, which is the
treatment of choice for specific phobias. Psychoanalysis is lengthy and not first-
line. ECT is for severe depression. Aversion therapy is used for substance use.
, 8. A nurse is assessing a client 24 hours after a traumatic event. The client
reports feeling numb and detached. Which is the nurse's best interpretation?
A. The client is in the acute stress disorder phase
B. The client is exhibiting signs of posttraumatic stress disorder (PTSD)
C. The client is in the exhaustion stage of general adaptation syndrome
D. The client is experiencing a panic attack
Correct Answer: A
Rationale: Acute stress disorder occurs within 3 days to 1 month after trauma
and includes numbing, detachment, and dissociation. PTSD is diagnosed after
symptoms persist beyond 1 month. Exhaustion stage involves depletion of
resources. Panic attack has different features.
9. SATA: A nurse is teaching a client about stress management. Which
statements indicate understanding? Select all that apply.
A. "I will practice deep breathing when I feel tense."
B. "I should avoid all stressful situations."
C. "Regular exercise can help reduce my stress."
D. "I can use guided imagery to relax."
E. "Drinking alcohol will help me relax."
F. "Journaling my thoughts may help me cope."
Correct Answers: A, C, D, F
Rationale: Deep breathing, exercise, guided imagery, and journaling are
healthy stress-management techniques. Avoiding all stress is unrealistic and not
therapeutic. Alcohol is a maladaptive coping mechanism that worsens anxiety over
time.
10. A client with panic disorder is prescribed clonazepam. Which instruction
should the nurse include?
A. "Take this medication with grapefruit juice."
B. "This medication may cause drowsiness; avoid driving."
Exam – 3 Newest Versions
Test Bank 2025/2026
Section 1: Anxiety, Stress, and Coping (Questions 1–15)
1. A client with panic disorder tells the nurse, "I feel like I'm going to die right
now." Which is the nurse's priority action?
A. Reassure the client that the feeling will pass
B. Stay with the client and use a calm, matter-of-fact approach
C. Administer the PRN alprazolam immediately
D. Teach the client deep breathing techniques
Correct Answer: B
Rationale: The priority during a panic attack is to remain with the client and
maintain a calm, nonthreatening presence. Reassurance ("it will pass") is often
ineffective because the client cannot process logic during acute panic. PRN
medication may be given but is not the first action. Teaching deep breathing is
appropriate once the acute phase subsides. Safety and presence take precedence.
2. Which client statement indicates the use of a healthy defense mechanism?
A. "I didn't get the job because the interviewer was intimidated by me."
B. "I'm upset about my diagnosis, so I'm going to the gym to burn off steam."
C. "I forgot my appointment because I really didn't want to hear bad news."
D. "I yell at my spouse when I'm stressed at work, but it's not my fault."
Correct Answer: B
Rationale: Sublimation (channeling unacceptable impulses into socially
acceptable activities) is a mature, healthy defense mechanism. Option A is
rationalization. Option C is suppression/repression. Option D is displacement with
projection. Only sublimation reflects adaptive coping.
,3. A client is experiencing a panic attack. Which assessment finding should the
nurse expect?
A. Bradycardia and hypotension
B. Decreased respiratory rate
C. Dilated pupils and increased heart rate
D. Constricted pupils and warm, dry skin
Correct Answer: C
Rationale: Panic attacks activate the sympathetic nervous system, causing
mydriasis (dilated pupils), tachycardia, tachypnea, diaphoresis, and increased
blood pressure. Options A, B, and D reflect parasympathetic or normal findings.
4. SATA: Which interventions are appropriate for a client with generalized
anxiety disorder (GAD)? Select all that apply.
A. Encourage the client to identify triggers
B. Teach relaxation techniques such as guided imagery
C. Discourage the client from discussing worries to prevent reinforcement
D. Administer buspirone as prescribed
E. Provide a structured daily routine
F. Encourage caffeine intake to increase alertness
Correct Answers: A, B, D, E
Rationale: Identifying triggers, relaxation techniques, buspirone (a non-
benzodiazepine anxiolytic), and structure all reduce anxiety. Discussing worries is
therapeutic and should not be discouraged. Caffeine is a stimulant that worsens
anxiety.
5. A nurse is caring for a client with obsessive-compulsive disorder (OCD) who
performs handwashing rituals. Which response is most therapeutic?
A. "You don't need to wash your hands again; they're clean."
B. "I'll wait with you while you wash your hands, then we'll go to lunch."
,C. "If you keep washing your hands, you'll damage your skin."
D. "Let's set a limit of two handwashes per hour."
Correct Answer: B
Rationale: The nurse should allow time for the ritual while setting a
supportive, nonjudgmental tone. Arguing or reasoning with the client increases
anxiety. Interrupting the ritual can precipitate panic. Limit-setting is appropriate
only after trust is established and is done collaboratively, not punitively.
6. Which finding indicates that a client's anxiety is at a moderate level?
A. The client is unable to focus on anything but the anxiety
B. The client's perceptual field is narrowed, but the client can follow directions
C. The client is pacing and unable to sit still
D. The client reports feeling "completely out of control"
Correct Answer: B
Rationale: Moderate anxiety narrows the perceptual field, but the client can
still follow directions with assistance. Severe anxiety markedly narrows the field
and impairs reasoning. Panic causes loss of control and inability to focus. Pacing
suggests severe anxiety.
7. A client with a phobia of flying is scheduled for a needed business trip.
Which therapy is most effective for this condition?
A. Psychoanalysis
B. Systematic desensitization
C. Electroconvulsive therapy
D. Aversion therapy
Correct Answer: B
Rationale: Systematic desensitization (a form of behavioral therapy) gradually
exposes the client to the feared stimulus while teaching relaxation, which is the
treatment of choice for specific phobias. Psychoanalysis is lengthy and not first-
line. ECT is for severe depression. Aversion therapy is used for substance use.
, 8. A nurse is assessing a client 24 hours after a traumatic event. The client
reports feeling numb and detached. Which is the nurse's best interpretation?
A. The client is in the acute stress disorder phase
B. The client is exhibiting signs of posttraumatic stress disorder (PTSD)
C. The client is in the exhaustion stage of general adaptation syndrome
D. The client is experiencing a panic attack
Correct Answer: A
Rationale: Acute stress disorder occurs within 3 days to 1 month after trauma
and includes numbing, detachment, and dissociation. PTSD is diagnosed after
symptoms persist beyond 1 month. Exhaustion stage involves depletion of
resources. Panic attack has different features.
9. SATA: A nurse is teaching a client about stress management. Which
statements indicate understanding? Select all that apply.
A. "I will practice deep breathing when I feel tense."
B. "I should avoid all stressful situations."
C. "Regular exercise can help reduce my stress."
D. "I can use guided imagery to relax."
E. "Drinking alcohol will help me relax."
F. "Journaling my thoughts may help me cope."
Correct Answers: A, C, D, F
Rationale: Deep breathing, exercise, guided imagery, and journaling are
healthy stress-management techniques. Avoiding all stress is unrealistic and not
therapeutic. Alcohol is a maladaptive coping mechanism that worsens anxiety over
time.
10. A client with panic disorder is prescribed clonazepam. Which instruction
should the nurse include?
A. "Take this medication with grapefruit juice."
B. "This medication may cause drowsiness; avoid driving."
