Updated HESI RN Mental Health 2026: 100 Practice
Questions & Answers with Rationales | NGN Clinical
Judgment Review
Section 1: Therapeutic communication and psychiatric
nursing fundamentals (1–15)
Questions 1–15
1. A client says, “I feel like nobody cares whether I live or die.” What is the nurse’s best
response?
A. “You should not think that way.” B. “Why would you say something like that?” C. “Are you
thinking about suicide?” D. “Your family cares about you.”
Answer: C.
Rationale: Directly asking about suicide helps assess immediate risk. It does not increase suicidal
thoughts. If risk is identified, assess intent, plan, access to means, and immediate safety needs.
2. A client whose spouse recently died begins crying during an interview. What should the nurse
do?
A. Change the subject. B. Sit quietly and remain present. C. Tell the client to be strong. D.
Explain the stages of grief immediately.
Answer: B.
Rationale: Therapeutic silence communicates acceptance and gives the client time to express
grief without pressure.
3. A client says, “The staff are plotting to poison my food.” Which response is most therapeutic?
A. “That is ridiculous.” B. “Yes, the staff may be doing that.” C. “I understand that you feel
unsafe. I have no evidence that your food is poisoned.” D. “Stop talking about that.”
Answer: C.
Rationale: Acknowledge the client’s feelings without agreeing with or reinforcing a delusion.
,4. Which statement demonstrates reflection?
A. “You seem worried about your diagnosis.” B. “Why are you worried?” C. “Everything will be
fine.” D. “You need to relax.”
Answer: A.
Rationale: Reflection identifies and returns the apparent feeling to the client, encouraging further
exploration.
5. A client remains silent after being asked about a traumatic experience. What should the nurse
do?
A. Ask several questions rapidly. B. Respect the silence and offer support. C. End the therapeutic
relationship. D. Tell the client the information is required.
Answer: B.
Rationale: Silence may reflect distress, fear, or the need to organize thoughts. Allow the client
time and maintain a calm, supportive presence.
6. Which is an example of a nontherapeutic response?
A. “Tell me more about that.” B. “What concerns you most?” C. “Everything will be fine.” D.
“You seem upset.”
Answer: C.
Rationale: False reassurance minimizes uncertainty and can discourage expression of legitimate
fears.
7. A client says, “I am terrified about tomorrow’s surgery.” Which response is best?
A. “There is nothing to fear.” B. “Other clients have done well.” C. “What worries you most
about the surgery?” D. “You should trust your surgeon.”
Answer: C.
Rationale: An open-ended question explores the client’s specific fears and supports
individualized care.
8. Which nursing action best establishes a therapeutic relationship?
A. Making personal promises. B. Maintaining consistent boundaries and demonstrating empathy.
C. Sharing confidential information about other clients. D. Giving advice about every problem.
, Answer: B.
Rationale: Trust develops through empathy, reliability, confidentiality, and professional
boundaries.
9. A client says, “I failed my exam. I am a complete failure.” What is the best response?
A. “You should have studied harder.” B. “One exam does not define your entire worth. What
happened?” C. “Forget about it.” D. “You are overreacting.”
Answer: B.
Rationale: This response gently challenges an overgeneralized negative belief while inviting
exploration.
10. A client is pacing, trembling, and reporting severe anxiety. What should the nurse do first?
A. Provide lengthy education. B. Give the client a complex decision-making task. C. Remain
with the client and use short, calm statements. D. Encourage participation in a large group.
Answer: C.
Rationale: Severe anxiety reduces concentration and problem-solving ability. A calm presence,
reduced stimulation, and brief directions promote safety.
11. Which finding is subjective data?
A. Blood pressure of 150/90 mmHg. B. Visible hand tremors. C. “I feel hopeless.” D. Heart rate
of 112 beats/min.
Answer: C.
Rationale: Subjective data are symptoms or experiences reported by the client. The other options
are objectively measurable findings.
12. Which behavior is most consistent with active listening?
A. Interrupting to correct the client. B. Maintaining appropriate attention and clarifying
statements. C. Looking at the computer throughout the interview. D. Offering solutions before
hearing the problem.
Answer: B.
Rationale: Active listening involves attention, clarification, appropriate nonverbal
communication, and checking understanding.
Questions & Answers with Rationales | NGN Clinical
Judgment Review
Section 1: Therapeutic communication and psychiatric
nursing fundamentals (1–15)
Questions 1–15
1. A client says, “I feel like nobody cares whether I live or die.” What is the nurse’s best
response?
A. “You should not think that way.” B. “Why would you say something like that?” C. “Are you
thinking about suicide?” D. “Your family cares about you.”
Answer: C.
Rationale: Directly asking about suicide helps assess immediate risk. It does not increase suicidal
thoughts. If risk is identified, assess intent, plan, access to means, and immediate safety needs.
2. A client whose spouse recently died begins crying during an interview. What should the nurse
do?
A. Change the subject. B. Sit quietly and remain present. C. Tell the client to be strong. D.
Explain the stages of grief immediately.
Answer: B.
Rationale: Therapeutic silence communicates acceptance and gives the client time to express
grief without pressure.
3. A client says, “The staff are plotting to poison my food.” Which response is most therapeutic?
A. “That is ridiculous.” B. “Yes, the staff may be doing that.” C. “I understand that you feel
unsafe. I have no evidence that your food is poisoned.” D. “Stop talking about that.”
Answer: C.
Rationale: Acknowledge the client’s feelings without agreeing with or reinforcing a delusion.
,4. Which statement demonstrates reflection?
A. “You seem worried about your diagnosis.” B. “Why are you worried?” C. “Everything will be
fine.” D. “You need to relax.”
Answer: A.
Rationale: Reflection identifies and returns the apparent feeling to the client, encouraging further
exploration.
5. A client remains silent after being asked about a traumatic experience. What should the nurse
do?
A. Ask several questions rapidly. B. Respect the silence and offer support. C. End the therapeutic
relationship. D. Tell the client the information is required.
Answer: B.
Rationale: Silence may reflect distress, fear, or the need to organize thoughts. Allow the client
time and maintain a calm, supportive presence.
6. Which is an example of a nontherapeutic response?
A. “Tell me more about that.” B. “What concerns you most?” C. “Everything will be fine.” D.
“You seem upset.”
Answer: C.
Rationale: False reassurance minimizes uncertainty and can discourage expression of legitimate
fears.
7. A client says, “I am terrified about tomorrow’s surgery.” Which response is best?
A. “There is nothing to fear.” B. “Other clients have done well.” C. “What worries you most
about the surgery?” D. “You should trust your surgeon.”
Answer: C.
Rationale: An open-ended question explores the client’s specific fears and supports
individualized care.
8. Which nursing action best establishes a therapeutic relationship?
A. Making personal promises. B. Maintaining consistent boundaries and demonstrating empathy.
C. Sharing confidential information about other clients. D. Giving advice about every problem.
, Answer: B.
Rationale: Trust develops through empathy, reliability, confidentiality, and professional
boundaries.
9. A client says, “I failed my exam. I am a complete failure.” What is the best response?
A. “You should have studied harder.” B. “One exam does not define your entire worth. What
happened?” C. “Forget about it.” D. “You are overreacting.”
Answer: B.
Rationale: This response gently challenges an overgeneralized negative belief while inviting
exploration.
10. A client is pacing, trembling, and reporting severe anxiety. What should the nurse do first?
A. Provide lengthy education. B. Give the client a complex decision-making task. C. Remain
with the client and use short, calm statements. D. Encourage participation in a large group.
Answer: C.
Rationale: Severe anxiety reduces concentration and problem-solving ability. A calm presence,
reduced stimulation, and brief directions promote safety.
11. Which finding is subjective data?
A. Blood pressure of 150/90 mmHg. B. Visible hand tremors. C. “I feel hopeless.” D. Heart rate
of 112 beats/min.
Answer: C.
Rationale: Subjective data are symptoms or experiences reported by the client. The other options
are objectively measurable findings.
12. Which behavior is most consistent with active listening?
A. Interrupting to correct the client. B. Maintaining appropriate attention and clarifying
statements. C. Looking at the computer throughout the interview. D. Offering solutions before
hearing the problem.
Answer: B.
Rationale: Active listening involves attention, clarification, appropriate nonverbal
communication, and checking understanding.
