1
NGN Mental Health HESI Exams 2025
(Version A & B) with Actual Exam
Questions and Correct Answers with
Rationales | Graded A+
NGN Mental Health HESI Exam 2025–
Version A
Therapeutic Communication (20 Questions)
Question 1
A client with major depressive disorder states, “I don’t see the point in living anymore.” What is
the nurse’s priority response?
a. “You have so much to live for.”
b. “That sounds really heavy. Are you thinking of harming yourself?”
c. “Things will get better soon.”
d. “Let’s talk about something positive.”
Rationale: Statements indicating hopelessness require immediate assessment for suicidal
ideation to ensure client safety.
Question 2
NGN Case Study: A client with generalized anxiety disorder is pacing and appears restless.
Select all that apply: Which interventions are appropriate?
a. Use a calm, reassuring tone
b. Tell the client to stop pacing
c. Offer to guide deep breathing exercises
d. Leave the client alone
e. Stay with the client
Rationale: A calm tone, deep breathing, and presence reduce anxiety and promote trust.
Question 3
A client with schizophrenia reports, “The voices are telling me to run away.” What is the nurse’s
best response?
, 2
a. “Those voices aren’t real.”
b. “I don’t hear them, but I know they’re real to you. What are they saying?”
c. “Ignore them and they’ll stop.”
d. “Let’s focus on something else.”
Rationale: Acknowledging the client’s perception without reinforcing hallucinations builds trust
and encourages communication.
Question 4
Bow-Tie Question: A client with bipolar disorder is in a manic phase. Drag and drop
assessments and interventions.
Left Side (Assessments): Monitor behavior, Assess safety risks
Right Side (Interventions): Reduce stimuli, Set clear limits
Center (Condition): Mania
Rationale: Monitoring behavior and safety risks guides interventions like reducing stimuli and
setting limits to manage mania.
Question 5
A client with PTSD says, “I can’t stop thinking about the accident.” What should the nurse say?
a. “You need to move on.”
b. “That must be really tough. Can you share more about what you’re feeling?”
c. “It’s just a memory.”
d. “Try to think about something else.”
Rationale: Validating feelings and encouraging expression promotes therapeutic communication
for PTSD.
Question 6
Scenario: A client with obsessive-compulsive disorder (OCD) is performing rituals. What
should the nurse do?
a. Interrupt the rituals immediately
b. Allow limited time for rituals while setting boundaries
c. Ignore the behavior
d. Administer a sedative
Rationale: Allowing limited ritual time reduces anxiety while maintaining structure.
Question 7
A client with borderline personality disorder says, “You’re the only one who understands me.”
What is the nurse’s best response?
a. “I’m glad you think so.”
b. “I’m here to help. Let’s talk about what’s been going on.”
c. “You don’t really mean that.”
d. “Others care about you too.”
, 3
Rationale: Redirecting to therapeutic discussion maintains professional boundaries without
reinforcing dependency.
Question 8
NGN Trend Question: A client with depression has decreasing verbalization over 3 days: Day
1: talkative, Day 2: minimal speech, Day 3: mute. What should the nurse do?
a. Continue monitoring
b. Notify the healthcare provider
c. Encourage group activities
d. Ignore the behavior
Rationale: Worsening withdrawal may indicate deepening depression, requiring provider
intervention.
Question 9
A client with anxiety asks, “Will I ever feel normal again?” What is the nurse’s best response?
a. “You’ll be fine soon.”
b. “It sounds like you’re feeling overwhelmed. Can we talk about what’s worrying you?”
c. “Everyone feels anxious sometimes.”
d. “You need to relax.”
Rationale: Reflecting feelings encourages exploration of emotions, promoting therapeutic
dialogue.
Question 10
Which response is nontherapeutic for a client with depression?
a. “I’m here to listen.”
b. “Why are you so sad?”
c. “Can you tell me more about how you’re feeling?”
d. “Let’s try some relaxation techniques.”
Rationale: “Why” questions can feel judgmental and increase client distress.
Question 11
NGN Case Study: A client with schizophrenia is agitated and pacing. Select all that apply:
Which interventions are appropriate?
a. Provide a low-stimulus environment
b. Encourage loud group activities
c. Use a calm tone
d. Ignore the agitation
e. Assess for triggers
Rationale: A low-stimulus environment, calm tone, and trigger assessment reduce agitation in
schizophrenia.
Question 12
, 4
A client with anorexia nervosa refuses meals. What should the nurse say?
a. “You have to eat something.”
b. “I notice you’re not eating. Can you share what’s going on?”
c. “You’ll feel better if you eat.”
d. “I’ll get you another tray later.”
Rationale: Open-ended questions explore reasons for refusal, fostering trust.
Question 13
A client with paranoia says, “Everyone is plotting against me.” What is the nurse’s best
response?
a. “That’s not true.”
b. “That must feel really scary. Can you tell me more?”
c. “You’re overreacting.”
d. “Let’s change the subject.”
Rationale: Validating feelings without reinforcing delusions promotes trust.
Question 14
Bow-Tie Question: A client with PTSD is triggered by loud noises. Drag and drop assessments
and interventions.
Left Side (Assessments): Assess triggers, Monitor anxiety
Right Side (Interventions): Provide a quiet environment, Teach grounding techniques
Center (Condition): Post-traumatic stress disorder
Rationale: Trigger and anxiety assessment guide interventions like a quiet environment and
grounding techniques.
Question 15
A client with bipolar disorder is grandiose. What should the nurse avoid?
a. Setting boundaries
b. Arguing with the client
c. Using clear communication
d. Monitoring behavior
Rationale: Arguing escalates grandiosity and disrupts therapeutic communication.
Question 16
Scenario: A client with social anxiety disorder avoids group therapy. What should the nurse do?
a. Force participation
b. Offer one-on-one support
c. Ignore the avoidance
d. Criticize the client
Rationale: One-on-one support reduces anxiety and builds trust for clients with social anxiety.
Question 17
NGN Mental Health HESI Exams 2025
(Version A & B) with Actual Exam
Questions and Correct Answers with
Rationales | Graded A+
NGN Mental Health HESI Exam 2025–
Version A
Therapeutic Communication (20 Questions)
Question 1
A client with major depressive disorder states, “I don’t see the point in living anymore.” What is
the nurse’s priority response?
a. “You have so much to live for.”
b. “That sounds really heavy. Are you thinking of harming yourself?”
c. “Things will get better soon.”
d. “Let’s talk about something positive.”
Rationale: Statements indicating hopelessness require immediate assessment for suicidal
ideation to ensure client safety.
Question 2
NGN Case Study: A client with generalized anxiety disorder is pacing and appears restless.
Select all that apply: Which interventions are appropriate?
a. Use a calm, reassuring tone
b. Tell the client to stop pacing
c. Offer to guide deep breathing exercises
d. Leave the client alone
e. Stay with the client
Rationale: A calm tone, deep breathing, and presence reduce anxiety and promote trust.
Question 3
A client with schizophrenia reports, “The voices are telling me to run away.” What is the nurse’s
best response?
, 2
a. “Those voices aren’t real.”
b. “I don’t hear them, but I know they’re real to you. What are they saying?”
c. “Ignore them and they’ll stop.”
d. “Let’s focus on something else.”
Rationale: Acknowledging the client’s perception without reinforcing hallucinations builds trust
and encourages communication.
Question 4
Bow-Tie Question: A client with bipolar disorder is in a manic phase. Drag and drop
assessments and interventions.
Left Side (Assessments): Monitor behavior, Assess safety risks
Right Side (Interventions): Reduce stimuli, Set clear limits
Center (Condition): Mania
Rationale: Monitoring behavior and safety risks guides interventions like reducing stimuli and
setting limits to manage mania.
Question 5
A client with PTSD says, “I can’t stop thinking about the accident.” What should the nurse say?
a. “You need to move on.”
b. “That must be really tough. Can you share more about what you’re feeling?”
c. “It’s just a memory.”
d. “Try to think about something else.”
Rationale: Validating feelings and encouraging expression promotes therapeutic communication
for PTSD.
Question 6
Scenario: A client with obsessive-compulsive disorder (OCD) is performing rituals. What
should the nurse do?
a. Interrupt the rituals immediately
b. Allow limited time for rituals while setting boundaries
c. Ignore the behavior
d. Administer a sedative
Rationale: Allowing limited ritual time reduces anxiety while maintaining structure.
Question 7
A client with borderline personality disorder says, “You’re the only one who understands me.”
What is the nurse’s best response?
a. “I’m glad you think so.”
b. “I’m here to help. Let’s talk about what’s been going on.”
c. “You don’t really mean that.”
d. “Others care about you too.”
, 3
Rationale: Redirecting to therapeutic discussion maintains professional boundaries without
reinforcing dependency.
Question 8
NGN Trend Question: A client with depression has decreasing verbalization over 3 days: Day
1: talkative, Day 2: minimal speech, Day 3: mute. What should the nurse do?
a. Continue monitoring
b. Notify the healthcare provider
c. Encourage group activities
d. Ignore the behavior
Rationale: Worsening withdrawal may indicate deepening depression, requiring provider
intervention.
Question 9
A client with anxiety asks, “Will I ever feel normal again?” What is the nurse’s best response?
a. “You’ll be fine soon.”
b. “It sounds like you’re feeling overwhelmed. Can we talk about what’s worrying you?”
c. “Everyone feels anxious sometimes.”
d. “You need to relax.”
Rationale: Reflecting feelings encourages exploration of emotions, promoting therapeutic
dialogue.
Question 10
Which response is nontherapeutic for a client with depression?
a. “I’m here to listen.”
b. “Why are you so sad?”
c. “Can you tell me more about how you’re feeling?”
d. “Let’s try some relaxation techniques.”
Rationale: “Why” questions can feel judgmental and increase client distress.
Question 11
NGN Case Study: A client with schizophrenia is agitated and pacing. Select all that apply:
Which interventions are appropriate?
a. Provide a low-stimulus environment
b. Encourage loud group activities
c. Use a calm tone
d. Ignore the agitation
e. Assess for triggers
Rationale: A low-stimulus environment, calm tone, and trigger assessment reduce agitation in
schizophrenia.
Question 12
, 4
A client with anorexia nervosa refuses meals. What should the nurse say?
a. “You have to eat something.”
b. “I notice you’re not eating. Can you share what’s going on?”
c. “You’ll feel better if you eat.”
d. “I’ll get you another tray later.”
Rationale: Open-ended questions explore reasons for refusal, fostering trust.
Question 13
A client with paranoia says, “Everyone is plotting against me.” What is the nurse’s best
response?
a. “That’s not true.”
b. “That must feel really scary. Can you tell me more?”
c. “You’re overreacting.”
d. “Let’s change the subject.”
Rationale: Validating feelings without reinforcing delusions promotes trust.
Question 14
Bow-Tie Question: A client with PTSD is triggered by loud noises. Drag and drop assessments
and interventions.
Left Side (Assessments): Assess triggers, Monitor anxiety
Right Side (Interventions): Provide a quiet environment, Teach grounding techniques
Center (Condition): Post-traumatic stress disorder
Rationale: Trigger and anxiety assessment guide interventions like a quiet environment and
grounding techniques.
Question 15
A client with bipolar disorder is grandiose. What should the nurse avoid?
a. Setting boundaries
b. Arguing with the client
c. Using clear communication
d. Monitoring behavior
Rationale: Arguing escalates grandiosity and disrupts therapeutic communication.
Question 16
Scenario: A client with social anxiety disorder avoids group therapy. What should the nurse do?
a. Force participation
b. Offer one-on-one support
c. Ignore the avoidance
d. Criticize the client
Rationale: One-on-one support reduces anxiety and builds trust for clients with social anxiety.
Question 17
