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HESI RN Mental Health Exam
Bundle 2025 – Verified Questions
with 100% Correct Answers &
Psychiatric Nursing Rationales
Question 1
A client with major depressive disorder reports feeling hopeless and unable to enjoy activities.
Which nursing intervention is most appropriate?
A) Encourage the client to participate in group activities immediately
B) Establish a therapeutic relationship and assess suicide risk
C) Administer an antidepressant without further assessment
D) Instruct the client to avoid discussing negative feelings
Correct Answer: Establish a therapeutic relationship and assess suicide risk
Rationale: Hopelessness is a hallmark of major depressive disorder and a risk factor for suicide.
Establishing a therapeutic relationship fosters trust, enabling the nurse to assess suicide risk,
which is the priority to ensure client safety. Group activities may be premature, medication
requires assessment, and avoiding negative feelings is non-therapeutic.
Question 2
A client with schizophrenia reports hearing voices commanding self-harm. What is the nurse’s
priority action?
A) Distract the client with music
B) Assess the content and intensity of the hallucinations
C) Administer an antipsychotic immediately
D) Isolate the client to reduce stimuli
Correct Answer: Assess the content and intensity of the hallucinations
Rationale: Command hallucinations pose a high risk for self-harm or harm to others. Assessing
their content and intensity is the priority to determine the level of risk and plan interventions.
Distraction, medication, or isolation may be appropriate later but are not the initial action.
Question 3
A client with bipolar disorder is prescribed lithium. Which laboratory value should the nurse
monitor closely?
A) Blood urea nitrogen
, 2
B) Serum lithium levels
C) Hemoglobin A1c
D) Platelet count
Correct Answer: Serum lithium levels
Rationale: Lithium has a narrow therapeutic range (0.6–1.2 mEq/L), and monitoring serum
levels is critical to prevent toxicity or subtherapeutic effects. Symptoms of toxicity include
tremors and confusion. Other labs are not directly related to lithium therapy.
Question 4
A client with generalized anxiety disorder reports excessive worry and difficulty sleeping. Which
intervention should the nurse prioritize?
A) Encourage caffeine consumption to stay alert
B) Teach relaxation techniques such as deep breathing
C) Recommend avoiding all social interactions
D) Administer a sedative without assessment
Correct Answer: Teach relaxation techniques such as deep breathing
Rationale: Relaxation techniques like deep breathing help manage anxiety symptoms by
activating the parasympathetic nervous system. Caffeine worsens anxiety, social isolation is non-
therapeutic, and sedatives require medical evaluation.
Question 5
A client with post-traumatic stress disorder (PTSD) experiences flashbacks. Which nursing
response is most therapeutic?
A) Use grounding techniques to orient the client to the present
B) Ask the client to describe the trauma in detail
C) Leave the client alone to process the flashback
D) Administer an anxiolytic immediately
Correct Answer: Use grounding techniques to orient the client to the present
Rationale: Grounding techniques, such as focusing on sensory stimuli (e.g., touching an object),
help clients with PTSD return to the present during flashbacks. Describing trauma may
retraumatize, isolation is unsafe, and medication is not the first intervention.
Question 6
A client with obsessive-compulsive disorder (OCD) spends hours washing hands. What is the
nurse’s best response?
A) Restrict the client’s access to water
B) Encourage gradual exposure to anxiety-provoking stimuli
C) Tell the client to stop the behavior immediately
D) Ignore the behavior to avoid reinforcement
, 3
Correct Answer: Encourage gradual exposure to anxiety-provoking stimuli
Rationale: Gradual exposure, part of cognitive-behavioral therapy, helps clients with OCD
reduce compulsive behaviors by facing anxiety triggers. Restricting water is impractical,
stopping abruptly increases anxiety, and ignoring does not address the underlying issue.
Question 7
A client with anorexia nervosa refuses to eat meals. Which nursing intervention is most
appropriate?
A) Force-feed the client to ensure nutrition
B) Establish a trusting relationship and set small meal goals
C) Allow the client to skip meals indefinitely
D) Criticize the client for refusing food
Correct Answer: Establish a trusting relationship and set small meal goals
Rationale: Building trust and setting achievable meal goals encourage nutritional intake without
confrontation, which is critical in anorexia nervosa. Force-feeding is unethical, skipping meals
worsens malnutrition, and criticism is non-therapeutic.
Question 8
A client with alcohol use disorder is admitted for detoxification. Which medication is most likely
prescribed?
A) Haloperidol
B) Lorazepam
C) Fluoxetine
D) Bupropion
Correct Answer: Lorazepam
Rationale: Lorazepam, a benzodiazepine, is used during alcohol detoxification to prevent
seizures and manage withdrawal symptoms. Haloperidol treats psychosis, fluoxetine depression,
and bupropion is not indicated for withdrawal.
Question 9
A client with borderline personality disorder displays splitting behavior. Which nursing response
is most effective?
A) Ignore the behavior to avoid reinforcement
B) Set consistent boundaries and remain calm
C) Agree with the client’s perceptions to build trust
D) Isolate the client to reduce conflict
Correct Answer: Set consistent boundaries and remain calm
Rationale: Splitting involves viewing others as all good or all bad. Consistent boundaries and a
HESI RN Mental Health Exam
Bundle 2025 – Verified Questions
with 100% Correct Answers &
Psychiatric Nursing Rationales
Question 1
A client with major depressive disorder reports feeling hopeless and unable to enjoy activities.
Which nursing intervention is most appropriate?
A) Encourage the client to participate in group activities immediately
B) Establish a therapeutic relationship and assess suicide risk
C) Administer an antidepressant without further assessment
D) Instruct the client to avoid discussing negative feelings
Correct Answer: Establish a therapeutic relationship and assess suicide risk
Rationale: Hopelessness is a hallmark of major depressive disorder and a risk factor for suicide.
Establishing a therapeutic relationship fosters trust, enabling the nurse to assess suicide risk,
which is the priority to ensure client safety. Group activities may be premature, medication
requires assessment, and avoiding negative feelings is non-therapeutic.
Question 2
A client with schizophrenia reports hearing voices commanding self-harm. What is the nurse’s
priority action?
A) Distract the client with music
B) Assess the content and intensity of the hallucinations
C) Administer an antipsychotic immediately
D) Isolate the client to reduce stimuli
Correct Answer: Assess the content and intensity of the hallucinations
Rationale: Command hallucinations pose a high risk for self-harm or harm to others. Assessing
their content and intensity is the priority to determine the level of risk and plan interventions.
Distraction, medication, or isolation may be appropriate later but are not the initial action.
Question 3
A client with bipolar disorder is prescribed lithium. Which laboratory value should the nurse
monitor closely?
A) Blood urea nitrogen
, 2
B) Serum lithium levels
C) Hemoglobin A1c
D) Platelet count
Correct Answer: Serum lithium levels
Rationale: Lithium has a narrow therapeutic range (0.6–1.2 mEq/L), and monitoring serum
levels is critical to prevent toxicity or subtherapeutic effects. Symptoms of toxicity include
tremors and confusion. Other labs are not directly related to lithium therapy.
Question 4
A client with generalized anxiety disorder reports excessive worry and difficulty sleeping. Which
intervention should the nurse prioritize?
A) Encourage caffeine consumption to stay alert
B) Teach relaxation techniques such as deep breathing
C) Recommend avoiding all social interactions
D) Administer a sedative without assessment
Correct Answer: Teach relaxation techniques such as deep breathing
Rationale: Relaxation techniques like deep breathing help manage anxiety symptoms by
activating the parasympathetic nervous system. Caffeine worsens anxiety, social isolation is non-
therapeutic, and sedatives require medical evaluation.
Question 5
A client with post-traumatic stress disorder (PTSD) experiences flashbacks. Which nursing
response is most therapeutic?
A) Use grounding techniques to orient the client to the present
B) Ask the client to describe the trauma in detail
C) Leave the client alone to process the flashback
D) Administer an anxiolytic immediately
Correct Answer: Use grounding techniques to orient the client to the present
Rationale: Grounding techniques, such as focusing on sensory stimuli (e.g., touching an object),
help clients with PTSD return to the present during flashbacks. Describing trauma may
retraumatize, isolation is unsafe, and medication is not the first intervention.
Question 6
A client with obsessive-compulsive disorder (OCD) spends hours washing hands. What is the
nurse’s best response?
A) Restrict the client’s access to water
B) Encourage gradual exposure to anxiety-provoking stimuli
C) Tell the client to stop the behavior immediately
D) Ignore the behavior to avoid reinforcement
, 3
Correct Answer: Encourage gradual exposure to anxiety-provoking stimuli
Rationale: Gradual exposure, part of cognitive-behavioral therapy, helps clients with OCD
reduce compulsive behaviors by facing anxiety triggers. Restricting water is impractical,
stopping abruptly increases anxiety, and ignoring does not address the underlying issue.
Question 7
A client with anorexia nervosa refuses to eat meals. Which nursing intervention is most
appropriate?
A) Force-feed the client to ensure nutrition
B) Establish a trusting relationship and set small meal goals
C) Allow the client to skip meals indefinitely
D) Criticize the client for refusing food
Correct Answer: Establish a trusting relationship and set small meal goals
Rationale: Building trust and setting achievable meal goals encourage nutritional intake without
confrontation, which is critical in anorexia nervosa. Force-feeding is unethical, skipping meals
worsens malnutrition, and criticism is non-therapeutic.
Question 8
A client with alcohol use disorder is admitted for detoxification. Which medication is most likely
prescribed?
A) Haloperidol
B) Lorazepam
C) Fluoxetine
D) Bupropion
Correct Answer: Lorazepam
Rationale: Lorazepam, a benzodiazepine, is used during alcohol detoxification to prevent
seizures and manage withdrawal symptoms. Haloperidol treats psychosis, fluoxetine depression,
and bupropion is not indicated for withdrawal.
Question 9
A client with borderline personality disorder displays splitting behavior. Which nursing response
is most effective?
A) Ignore the behavior to avoid reinforcement
B) Set consistent boundaries and remain calm
C) Agree with the client’s perceptions to build trust
D) Isolate the client to reduce conflict
Correct Answer: Set consistent boundaries and remain calm
Rationale: Splitting involves viewing others as all good or all bad. Consistent boundaries and a
