HESI RN Psychiatric Mental Health
Exam 2025 Practice Questions
Question 1: Therapeutic Communication
A client with major depressive disorder states, “I’m useless, and my life has no purpose.” Which
response by the nurse demonstrates therapeutic communication?
A. “You’re feeling really down, aren’t you? Can you share more about what’s been happening?”
B. “Don’t say that; you have so much to live for.”
C. “Everyone feels like that sometimes; it’ll pass.”
D. “Let’s focus on something positive instead.”
Correct Answer: A
Rationale: Therapeutic communication encourages the client to express feelings and promotes
self-awareness. Option A uses restating and an open-ended question to facilitate discussion,
showing empathy and encouraging exploration of the client’s feelings. Option B offers false
reassurance, dismissing the client’s emotions. Option C minimizes the client’s feelings, which
can hinder therapeutic dialogue. Option D avoids addressing the client’s expressed emotions,
redirecting the conversation inappropriately.
Question 2: Safety Assessment
A client with schizophrenia is pacing the unit and shouting, “They’re watching me!” What is the
nurse’s priority action?
A. Administer an antipsychotic medication as prescribed.
B. Place the client in seclusion immediately.
C. Assess the client’s level of agitation and safety risk.
D. Instruct the client to sit down and be quiet.
Correct Answer: C
Rationale: The nurse’s priority is to assess the client’s level of agitation and potential for harm
to self or others to guide appropriate interventions. Option C ensures a thorough evaluation
before acting. Administering medication (A) or using seclusion (B) requires assessment first to
determine necessity and appropriateness. Instructing the client to sit (D) may escalate agitation
and is not therapeutic without prior assessment.
Question 3: Psychopharmacology
,A client with bipolar disorder on lithium reports nausea and hand tremors. What is the nurse’s
first action?
A. Administer an antiemetic as prescribed.
B. Check the client’s lithium level.
C. Encourage the client to drink more water.
D. Notify the healthcare provider immediately.
Correct Answer: B
Rationale: Nausea and tremors may indicate lithium toxicity, which requires immediate
assessment of serum lithium levels (therapeutic range: 0.6–1.2 mEq/L). Option B is the priority
to confirm toxicity before further action. Administering an antiemetic (A) or encouraging fluids
(C) may be secondary interventions after assessment. Notifying the provider (D) is appropriate
after obtaining the lithium level to guide the discussion.
Question 4: Crisis Intervention
A client with borderline personality disorder threatens to cut themselves during a group therapy
session. What is the nurse’s priority action?
A. Remove the client from the group session.
B. Ask the client to discuss their feelings in private.
C. Restrain the client to prevent self-harm.
D. Administer a PRN anxiolytic medication.
Correct Answer: B
Rationale: Addressing the client’s emotions in a private, safe setting de-escalates the situation
and promotes therapeutic communication. Option B prioritizes emotional exploration and safety.
Removing the client (A) may feel punitive and escalate distress. Restraining (C) is a last resort
and requires imminent danger. Administering medication (D) requires prior assessment of the
client’s needs.
Question 5: Therapeutic Communication (Select All That
Apply)
A client with generalized anxiety disorder expresses fear about an upcoming surgery. Which
responses by the nurse are therapeutic? (Select all that apply.)
A. “You seem really worried about this surgery.”
B. “Surgery is routine; you’ll be fine.”
C. “Can you tell me more about what’s making you afraid?”
D. “I had surgery once, and it wasn’t that bad.”
E. “It’s okay to feel scared; let’s talk about it.”
Correct Answers: A, C, E
Rationale: Therapeutic responses encourage the client to express feelings and facilitate
discussion. Option A uses restating to acknowledge the client’s anxiety. Option C uses an open-
, ended question to explore concerns. Option E validates feelings and encourages dialogue. Option
B minimizes the client’s fears, and option D shifts focus to the nurse’s experience, which is non-
therapeutic.
Question 6: Mental Health Assessment
A client reports hearing voices that tell them to harm themselves. What is the nurse’s priority
assessment?
A. The client’s medication compliance.
B. The content and intensity of the auditory hallucinations.
C. The client’s family history of mental illness.
D. The client’s recent life stressors.
Correct Answer: B
Rationale: The priority is to assess the content of auditory hallucinations, especially command
hallucinations, to determine the risk of self-harm or harm to others. Option B directly addresses
immediate safety. Medication compliance (A), family history (C), and stressors (D) are relevant
but secondary to assessing the immediate risk posed by hallucinations.
Question 7: Legal/Ethical Issues
A client with psychotic depression refuses to sign the consent for treatment. Which behavior
justifies short-term involuntary treatment?
A. Expressing sadness about recent life events.
B. Having a plan to harm themselves.
C. Refusing to eat meals provided.
D. Withdrawing from social interactions.
Correct Answer: B
Rationale: Short-term involuntary treatment is justified if the client poses a danger to themselves
or others. Option B indicates a clear risk of self-harm, meeting criteria for involuntary treatment.
Expressing sadness (A), refusing meals (C), or withdrawing (D) may require intervention but do
not inherently justify involuntary treatment without evidence of immediate danger.
Question 8: Psychopharmacology
A client with schizophrenia is prescribed risperidone. Which side effect should the nurse monitor
for?
A. Hyperglycemia.
B. Extrapyramidal symptoms (EPS).
C. Increased appetite.
Exam 2025 Practice Questions
Question 1: Therapeutic Communication
A client with major depressive disorder states, “I’m useless, and my life has no purpose.” Which
response by the nurse demonstrates therapeutic communication?
A. “You’re feeling really down, aren’t you? Can you share more about what’s been happening?”
B. “Don’t say that; you have so much to live for.”
C. “Everyone feels like that sometimes; it’ll pass.”
D. “Let’s focus on something positive instead.”
Correct Answer: A
Rationale: Therapeutic communication encourages the client to express feelings and promotes
self-awareness. Option A uses restating and an open-ended question to facilitate discussion,
showing empathy and encouraging exploration of the client’s feelings. Option B offers false
reassurance, dismissing the client’s emotions. Option C minimizes the client’s feelings, which
can hinder therapeutic dialogue. Option D avoids addressing the client’s expressed emotions,
redirecting the conversation inappropriately.
Question 2: Safety Assessment
A client with schizophrenia is pacing the unit and shouting, “They’re watching me!” What is the
nurse’s priority action?
A. Administer an antipsychotic medication as prescribed.
B. Place the client in seclusion immediately.
C. Assess the client’s level of agitation and safety risk.
D. Instruct the client to sit down and be quiet.
Correct Answer: C
Rationale: The nurse’s priority is to assess the client’s level of agitation and potential for harm
to self or others to guide appropriate interventions. Option C ensures a thorough evaluation
before acting. Administering medication (A) or using seclusion (B) requires assessment first to
determine necessity and appropriateness. Instructing the client to sit (D) may escalate agitation
and is not therapeutic without prior assessment.
Question 3: Psychopharmacology
,A client with bipolar disorder on lithium reports nausea and hand tremors. What is the nurse’s
first action?
A. Administer an antiemetic as prescribed.
B. Check the client’s lithium level.
C. Encourage the client to drink more water.
D. Notify the healthcare provider immediately.
Correct Answer: B
Rationale: Nausea and tremors may indicate lithium toxicity, which requires immediate
assessment of serum lithium levels (therapeutic range: 0.6–1.2 mEq/L). Option B is the priority
to confirm toxicity before further action. Administering an antiemetic (A) or encouraging fluids
(C) may be secondary interventions after assessment. Notifying the provider (D) is appropriate
after obtaining the lithium level to guide the discussion.
Question 4: Crisis Intervention
A client with borderline personality disorder threatens to cut themselves during a group therapy
session. What is the nurse’s priority action?
A. Remove the client from the group session.
B. Ask the client to discuss their feelings in private.
C. Restrain the client to prevent self-harm.
D. Administer a PRN anxiolytic medication.
Correct Answer: B
Rationale: Addressing the client’s emotions in a private, safe setting de-escalates the situation
and promotes therapeutic communication. Option B prioritizes emotional exploration and safety.
Removing the client (A) may feel punitive and escalate distress. Restraining (C) is a last resort
and requires imminent danger. Administering medication (D) requires prior assessment of the
client’s needs.
Question 5: Therapeutic Communication (Select All That
Apply)
A client with generalized anxiety disorder expresses fear about an upcoming surgery. Which
responses by the nurse are therapeutic? (Select all that apply.)
A. “You seem really worried about this surgery.”
B. “Surgery is routine; you’ll be fine.”
C. “Can you tell me more about what’s making you afraid?”
D. “I had surgery once, and it wasn’t that bad.”
E. “It’s okay to feel scared; let’s talk about it.”
Correct Answers: A, C, E
Rationale: Therapeutic responses encourage the client to express feelings and facilitate
discussion. Option A uses restating to acknowledge the client’s anxiety. Option C uses an open-
, ended question to explore concerns. Option E validates feelings and encourages dialogue. Option
B minimizes the client’s fears, and option D shifts focus to the nurse’s experience, which is non-
therapeutic.
Question 6: Mental Health Assessment
A client reports hearing voices that tell them to harm themselves. What is the nurse’s priority
assessment?
A. The client’s medication compliance.
B. The content and intensity of the auditory hallucinations.
C. The client’s family history of mental illness.
D. The client’s recent life stressors.
Correct Answer: B
Rationale: The priority is to assess the content of auditory hallucinations, especially command
hallucinations, to determine the risk of self-harm or harm to others. Option B directly addresses
immediate safety. Medication compliance (A), family history (C), and stressors (D) are relevant
but secondary to assessing the immediate risk posed by hallucinations.
Question 7: Legal/Ethical Issues
A client with psychotic depression refuses to sign the consent for treatment. Which behavior
justifies short-term involuntary treatment?
A. Expressing sadness about recent life events.
B. Having a plan to harm themselves.
C. Refusing to eat meals provided.
D. Withdrawing from social interactions.
Correct Answer: B
Rationale: Short-term involuntary treatment is justified if the client poses a danger to themselves
or others. Option B indicates a clear risk of self-harm, meeting criteria for involuntary treatment.
Expressing sadness (A), refusing meals (C), or withdrawing (D) may require intervention but do
not inherently justify involuntary treatment without evidence of immediate danger.
Question 8: Psychopharmacology
A client with schizophrenia is prescribed risperidone. Which side effect should the nurse monitor
for?
A. Hyperglycemia.
B. Extrapyramidal symptoms (EPS).
C. Increased appetite.
