Mental Health HESI Comprehensive Exam Questions and
Answers |Fall 2026/2027 Update | 100% Correct Latest
QUESTION 1
A nurse is caring for a client experiencing auditory hallucinations who is observed talking to an
empty chair. Which response by the nurse is most therapeutic?
A. “Tell me what the voices are saying to you.”
B. “You must stop talking to those voices.”
C. “I don’t hear anyone speaking; are you feeling frightened?”
D. “Let’s change the subject.”
CORRECT ANSWER: C
RATIONALE: The nurse presents reality while acknowledging the client’s emotional experience.
This approach fosters trust without validating the hallucination.
QUESTION 2
A client with major depressive disorder states, “My family would be better off without me.”
What is the nurse’s priority action?
A. Notify the mental health team immediately.
B. Offer reassurance that things will get better.
C. Provide distraction with an activity.
D. Document the statement only.
CORRECT ANSWER: A
RATIONALE: The client expresses suicidal ideation; immediate safety measures and
multidisciplinary notification are critical.
QUESTION 3
A nurse is providing discharge teaching to a client newly prescribed lithium carbonate. Which
client statement indicates the need for further teaching?
A. “I will drink 2 to 3 liters of water each day.”
B. “I will notify my provider if I have diarrhea or vomiting.”
C. “It’s fine to skip a few doses on weekends.”
D. “I’ll keep my follow-up appointments for blood tests.”
,CORRECT ANSWER: C
RATIONALE: Lithium must be taken consistently; missed doses can destabilize levels and mood.
QUESTION 4
Which finding in a client taking clozapine requires immediate intervention?
A. Mild sedation
B. Sore throat and fever
C. Constipation
D. Weight gain
CORRECT ANSWER: B
RATIONALE: Fever and sore throat may indicate agranulocytosis, a serious adverse effect
requiring prompt evaluation.
QUESTION 5
During an admission interview, a client repeatedly shifts topics and uses invented words. The
nurse documents this as:
A. Flight of ideas
B. Neologisms
C. Clang associations
D. Word salad
CORRECT ANSWER: B
RATIONALE: Neologisms are made-up words created by clients with thought disorders, often
seen in schizophrenia.
QUESTION 6
A client with panic disorder is hyperventilating and trembling. Which intervention should the
nurse implement first?
A. Encourage slow, deep breathing with the nurse.
B. Explore triggers for the panic attack.
C. Administer prescribed benzodiazepine.
D. Provide education about relaxation techniques.
,CORRECT ANSWER: A
RATIONALE: Immediate physiological control through guided breathing reduces hyperventilation
before exploring triggers.
QUESTION 7
A nurse overhears staff discussing a client’s diagnosis in an elevator. What ethical principle has
been violated?
A. Veracity
B. Fidelity
C. Beneficence
D. Confidentiality
CORRECT ANSWER: D
RATIONALE: Confidentiality requires that client information not be shared publicly or with
unauthorized persons.
QUESTION 8
A client is prescribed sertraline. The nurse should instruct the client that therapeutic effects may
begin in:
A. 24 hours
B. 1 week
C. 2 to 4 weeks
D. Immediately after dosing
CORRECT ANSWER: C
RATIONALE: SSRIs require several weeks for mood improvement due to delayed neurochemical
adaptation.
QUESTION 9
A client with schizophrenia says, “The government implanted a chip in my body.” What is the
nurse’s best response?
A. “That’s not true.”
B. “I understand this is frightening. I don’t have that information.”
, C. “You should stop talking like that.”
D. “Why do you believe that?”
CORRECT ANSWER: B
RATIONALE: Acknowledges the emotion, avoids arguing, and presents limited reality to maintain
trust.
QUESTION 10
Which statement indicates that a client with obsessive–compulsive disorder understands
discharge instructions?
A. “If I stop my ritual, my anxiety will worsen.”
B. “Medication can help reduce how often I feel the urge to perform rituals.”
C. “The rituals are my choice and not related to anxiety.”
D. “I will try to suppress every compulsion immediately.”
CORRECT ANSWER: B
RATIONALE: SSRIs and behavioral therapy reduce obsessive behaviors. Gradual control is
expected, not immediate cessation.
QUESTION 11
A manic client states, “I’m the smartest person alive!” Which defense mechanism is most
evident?
A. Projection
B. Compensation
C. Denial
D. Grandiosity
CORRECT ANSWER: D
RATIONALE: Exaggerated self-importance and superiority are hallmark features of manic
grandiosity.
QUESTION 12
A nurse plans care for a client newly admitted with alcohol withdrawal. Which medication
should the nurse anticipate administering?
A. Haloperidol
Answers |Fall 2026/2027 Update | 100% Correct Latest
QUESTION 1
A nurse is caring for a client experiencing auditory hallucinations who is observed talking to an
empty chair. Which response by the nurse is most therapeutic?
A. “Tell me what the voices are saying to you.”
B. “You must stop talking to those voices.”
C. “I don’t hear anyone speaking; are you feeling frightened?”
D. “Let’s change the subject.”
CORRECT ANSWER: C
RATIONALE: The nurse presents reality while acknowledging the client’s emotional experience.
This approach fosters trust without validating the hallucination.
QUESTION 2
A client with major depressive disorder states, “My family would be better off without me.”
What is the nurse’s priority action?
A. Notify the mental health team immediately.
B. Offer reassurance that things will get better.
C. Provide distraction with an activity.
D. Document the statement only.
CORRECT ANSWER: A
RATIONALE: The client expresses suicidal ideation; immediate safety measures and
multidisciplinary notification are critical.
QUESTION 3
A nurse is providing discharge teaching to a client newly prescribed lithium carbonate. Which
client statement indicates the need for further teaching?
A. “I will drink 2 to 3 liters of water each day.”
B. “I will notify my provider if I have diarrhea or vomiting.”
C. “It’s fine to skip a few doses on weekends.”
D. “I’ll keep my follow-up appointments for blood tests.”
,CORRECT ANSWER: C
RATIONALE: Lithium must be taken consistently; missed doses can destabilize levels and mood.
QUESTION 4
Which finding in a client taking clozapine requires immediate intervention?
A. Mild sedation
B. Sore throat and fever
C. Constipation
D. Weight gain
CORRECT ANSWER: B
RATIONALE: Fever and sore throat may indicate agranulocytosis, a serious adverse effect
requiring prompt evaluation.
QUESTION 5
During an admission interview, a client repeatedly shifts topics and uses invented words. The
nurse documents this as:
A. Flight of ideas
B. Neologisms
C. Clang associations
D. Word salad
CORRECT ANSWER: B
RATIONALE: Neologisms are made-up words created by clients with thought disorders, often
seen in schizophrenia.
QUESTION 6
A client with panic disorder is hyperventilating and trembling. Which intervention should the
nurse implement first?
A. Encourage slow, deep breathing with the nurse.
B. Explore triggers for the panic attack.
C. Administer prescribed benzodiazepine.
D. Provide education about relaxation techniques.
,CORRECT ANSWER: A
RATIONALE: Immediate physiological control through guided breathing reduces hyperventilation
before exploring triggers.
QUESTION 7
A nurse overhears staff discussing a client’s diagnosis in an elevator. What ethical principle has
been violated?
A. Veracity
B. Fidelity
C. Beneficence
D. Confidentiality
CORRECT ANSWER: D
RATIONALE: Confidentiality requires that client information not be shared publicly or with
unauthorized persons.
QUESTION 8
A client is prescribed sertraline. The nurse should instruct the client that therapeutic effects may
begin in:
A. 24 hours
B. 1 week
C. 2 to 4 weeks
D. Immediately after dosing
CORRECT ANSWER: C
RATIONALE: SSRIs require several weeks for mood improvement due to delayed neurochemical
adaptation.
QUESTION 9
A client with schizophrenia says, “The government implanted a chip in my body.” What is the
nurse’s best response?
A. “That’s not true.”
B. “I understand this is frightening. I don’t have that information.”
, C. “You should stop talking like that.”
D. “Why do you believe that?”
CORRECT ANSWER: B
RATIONALE: Acknowledges the emotion, avoids arguing, and presents limited reality to maintain
trust.
QUESTION 10
Which statement indicates that a client with obsessive–compulsive disorder understands
discharge instructions?
A. “If I stop my ritual, my anxiety will worsen.”
B. “Medication can help reduce how often I feel the urge to perform rituals.”
C. “The rituals are my choice and not related to anxiety.”
D. “I will try to suppress every compulsion immediately.”
CORRECT ANSWER: B
RATIONALE: SSRIs and behavioral therapy reduce obsessive behaviors. Gradual control is
expected, not immediate cessation.
QUESTION 11
A manic client states, “I’m the smartest person alive!” Which defense mechanism is most
evident?
A. Projection
B. Compensation
C. Denial
D. Grandiosity
CORRECT ANSWER: D
RATIONALE: Exaggerated self-importance and superiority are hallmark features of manic
grandiosity.
QUESTION 12
A nurse plans care for a client newly admitted with alcohol withdrawal. Which medication
should the nurse anticipate administering?
A. Haloperidol
