HESI MENTAL HEALTH EXAM 2025–2026
LATEST ACTUAL EXAM • 300 COMPLETE QUESTIONS WITH
VERIFIED DETAILED RATIONALES (A+ GRADED)
1. During an annual physical by the occupational RN working in a corporate clinic, a
male employee tells the RN that is high-stress job is causing trouble in his personal
life. He further explains that he often gets so angry while driving to and from work
that he has considered "getting even" with other drivers. How should the RN
respond?
A. "Anger is contagious and could result in major confrontation."
B. "Try not to let your anger cause you to act impulsively."
C. "Expressing your anger to a stranger could result in an unsafe situation."
D. "It sounds as if there are many situations that make you feel angry." -
ANSWER--D
2. A client who has agoraphobia (a fear of crowds) is beginning desensitization with the
therapist, and the RN is reinforcing the process. Which intervention has the highest
priority for this client's plan of care?
A. Encourage substitution of positive thoughts and negative ones.
B. Establish trust by providing a calm, safe environment.
C. Progressively expose the client to larger crowds.
D. Encourage deep breathing when anxiety escalates in a crowd. - ANSWER—B
3. A male client is admitted to the psychiatric unit for recurrent negative symptoms of
chronic schizophrenia and medication adjustment of Risperidone (Risperdal). When
the client walks to the nurse's station in a laterally contracted position, he states that
something has made his body contort into a monster. What action should the RN
take?
A. Medicate the client with the prescribed antipsychotic thioridazine (Mellaril).
B. Offer the client a prescribed physical therapy hot pack for muscle spasms.
C. Direct client to occupational therapy to distract him from somatic complaints.
D. Administer the prescribed anticholinergic benztropine (Cogentin) for
dystonia. - ANSWER--D
4. A mental health worker is caring for a client with escalating aggressive behavior.
Which action by the MHW warrant immediate intervention by the RN?
A. Is attempting to physically restrain the patient.
B. Tells the client to go to the quiet area of the unit.
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, C. Is using a loid voice to talk to the client.
D. Remains at a distance of 4 feet from the client. - ANSWER--A
5. A client on the mental health unit is becoming more agitated, shouting at the staff,
and pacing in the hallway. When the PRN medication is offered, the client refuses the
medication and defiantly sits on the floor in the middle of the unit hallway. What
nursing intervention should the RN implement first?
A. Transport of the client to the seclusion room.
B. Quietly approach the client with additional staff members.
C. Take other clients in the area to the client lounge.
D. Administer medication to chemically restrain the patient. - ANSWER--C
6. A client is admitted to the mental health unit and reports taking extra antianxiety
medication because, "I'm so stressed out. I just want to go to sleep." The RN should
plan one-on-one observation of the client based on which statement?
A. "What should I do? Nothing seems to help."
B. "I have been so tired lately and needed to sleep."
C. "I really think that I don't need to be here."
D. "I don't want to walk. Nothing matters anymore." - ANSWER--D
7. A male hospital employee is pushed out the way by a female employee because of an
oncoming gurney. The pushed employee becomes very angry and swings at the
female employee. Both employees are referred for counseling with the staff
psychiatric RN. Which factor in the pushed employee's history is most related to the
reaction that occurred?
A. Is worried about losing his job to a woman.
B. Tortured animals as a child.
C. Was physically abused by his mother.
D. Hates to be touched by anyone. - ANSWER--C
8. The RN documents the mental status of a female client who has been hospitalized for
several days by court order. The client states, "I don't need to be here" and tells the
RN that she believes the television talks to her. The RN should document these
assessment findings in which section of the mental status exam/
A. Level of concentration.
B. Insightandjudgement.
C. Remotememory. D. Mood and affect. - ANSWER--B
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, 9. A client is admitted to the mental health unit reports shortness of breath and
dizziness. The client tells the RN, "I feel like I'm going to die". Which nursing problem
should the RN include in this client's plan of care?
A. Mood disturbance.
B. Moderate anxiety.
C. Alteredthoughts.
D. Social isolation. - ANSWER--B
10. A female client who is wearing dirty clothes and has foul body odor, comes to the
clinic reporting feeling scared because she is being stalked. What action is most
important for the RN to take?
A. Offer the client a safe place to relax before interviewing her.
B. Ask the client to describe why she is being stalked.
C. Recommend that the client talk with a social worker.
D. Assure the client that the HCP will see her today. - ANSWER--A
11. The RN leading a group session of adolescent clients gives the members a handout
about anger management. One of the male clients is fidgety, interrupts peers when
they try and talk, and talks about his pets at home. What nursing action is best for
the RN to take?
A. Explore the client's feelings about his pets and home life.
B. Encourage his peers to help involve him in the activity.
C. Give the client permission to leave and return in 10 minutes.
D. Redirect him by encouraging him to read from the handout. - ANSWER--D
12. A male adolescent was admitted to the unit two days ago for depression. When the
mental health RN tries to interview the client to establish rapport, he becomes very
irritated and sarcastic. Which action is best for the RN to take?
A. Report the behavior to the next shift.
B. Offer to play a game of cards with the client.
C. Document the behavior in the chart.
D. Plan to talk with the client the next day. - ANSWER--B
13. A male adult is admitted because of an acetaminophen (Tylenol) overdose. After
transfer to the mental health unit, the client is told he has liver damage. Which
information is most important for the nurse to include in the client's discharge plan?
A. Do not take any over the counter meds.
B. Eat a high carb, low fat, low protein diet.
C. Call the crisis hotline if feeling lonely.
D. Avoid exposure to large crowds. - ANSWER--A
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, 14. After receiving treatment for anorexia, a student asks the school RN for permission to
work in the school cafeteria as part of the school's work study program. What action
should the RN take?
A. Refer the student to a psychiatrist for further discussion.
B. Recommend assignment to the receptionist's office.
C. Suggest that student work in the athletic department.
D. Determine the parent's opinion of the work assignment. - ANSWER--B
15. The Rn accepts a transfer to the metal health unit and understands that the client is
distractible and is exhibiting a decreased ability to concentrate. The RN only has 15
minutes to talk to the client. To develop treatment plan for this client, which
assessment is most important for the RN to obtain?
A. Motivation of treatment.
B. History of substance use.
C. Medicationcompliance.
D. Mental status examination. - ANSWER--D
16. A male client who recently lost a loved one arrives at the mental health center and
tells the RN he is no longer interested is his usual activities and has not slept for
several days. Which priority nursing problem should the RN include in the client's
plan of care?
A. Risk for suicide.
B. Sleepdeprivation.
C. Situational low self-esteem.
D. Social isolation. - ANSWER--B
17. A male client with long history of alcohol dependency arrives in the emergency
department describing the feelings of bugs crawling on his body. His blood pressure
is 170/102, his pulse rate is 110 bpm, and is blood alcohol level is 0mg/dL. Which
prescription should the RN administer?
A. Haloperidol (Haldol).
B. Thiamine (Vitamin B1).
C. Diphenhydramine(Benadryl).
D. Lorazepam (Ativan). - ANSWER--D
18. A client who refuses antipsychotic medications disrupts group activities, talks with
nonsensical words and wanders into client's rooms. The RN decides that the client
needs constant observation based on which of these assessment findings?
4|Page
LATEST ACTUAL EXAM • 300 COMPLETE QUESTIONS WITH
VERIFIED DETAILED RATIONALES (A+ GRADED)
1. During an annual physical by the occupational RN working in a corporate clinic, a
male employee tells the RN that is high-stress job is causing trouble in his personal
life. He further explains that he often gets so angry while driving to and from work
that he has considered "getting even" with other drivers. How should the RN
respond?
A. "Anger is contagious and could result in major confrontation."
B. "Try not to let your anger cause you to act impulsively."
C. "Expressing your anger to a stranger could result in an unsafe situation."
D. "It sounds as if there are many situations that make you feel angry." -
ANSWER--D
2. A client who has agoraphobia (a fear of crowds) is beginning desensitization with the
therapist, and the RN is reinforcing the process. Which intervention has the highest
priority for this client's plan of care?
A. Encourage substitution of positive thoughts and negative ones.
B. Establish trust by providing a calm, safe environment.
C. Progressively expose the client to larger crowds.
D. Encourage deep breathing when anxiety escalates in a crowd. - ANSWER—B
3. A male client is admitted to the psychiatric unit for recurrent negative symptoms of
chronic schizophrenia and medication adjustment of Risperidone (Risperdal). When
the client walks to the nurse's station in a laterally contracted position, he states that
something has made his body contort into a monster. What action should the RN
take?
A. Medicate the client with the prescribed antipsychotic thioridazine (Mellaril).
B. Offer the client a prescribed physical therapy hot pack for muscle spasms.
C. Direct client to occupational therapy to distract him from somatic complaints.
D. Administer the prescribed anticholinergic benztropine (Cogentin) for
dystonia. - ANSWER--D
4. A mental health worker is caring for a client with escalating aggressive behavior.
Which action by the MHW warrant immediate intervention by the RN?
A. Is attempting to physically restrain the patient.
B. Tells the client to go to the quiet area of the unit.
1|Page
, C. Is using a loid voice to talk to the client.
D. Remains at a distance of 4 feet from the client. - ANSWER--A
5. A client on the mental health unit is becoming more agitated, shouting at the staff,
and pacing in the hallway. When the PRN medication is offered, the client refuses the
medication and defiantly sits on the floor in the middle of the unit hallway. What
nursing intervention should the RN implement first?
A. Transport of the client to the seclusion room.
B. Quietly approach the client with additional staff members.
C. Take other clients in the area to the client lounge.
D. Administer medication to chemically restrain the patient. - ANSWER--C
6. A client is admitted to the mental health unit and reports taking extra antianxiety
medication because, "I'm so stressed out. I just want to go to sleep." The RN should
plan one-on-one observation of the client based on which statement?
A. "What should I do? Nothing seems to help."
B. "I have been so tired lately and needed to sleep."
C. "I really think that I don't need to be here."
D. "I don't want to walk. Nothing matters anymore." - ANSWER--D
7. A male hospital employee is pushed out the way by a female employee because of an
oncoming gurney. The pushed employee becomes very angry and swings at the
female employee. Both employees are referred for counseling with the staff
psychiatric RN. Which factor in the pushed employee's history is most related to the
reaction that occurred?
A. Is worried about losing his job to a woman.
B. Tortured animals as a child.
C. Was physically abused by his mother.
D. Hates to be touched by anyone. - ANSWER--C
8. The RN documents the mental status of a female client who has been hospitalized for
several days by court order. The client states, "I don't need to be here" and tells the
RN that she believes the television talks to her. The RN should document these
assessment findings in which section of the mental status exam/
A. Level of concentration.
B. Insightandjudgement.
C. Remotememory. D. Mood and affect. - ANSWER--B
2|Page
, 9. A client is admitted to the mental health unit reports shortness of breath and
dizziness. The client tells the RN, "I feel like I'm going to die". Which nursing problem
should the RN include in this client's plan of care?
A. Mood disturbance.
B. Moderate anxiety.
C. Alteredthoughts.
D. Social isolation. - ANSWER--B
10. A female client who is wearing dirty clothes and has foul body odor, comes to the
clinic reporting feeling scared because she is being stalked. What action is most
important for the RN to take?
A. Offer the client a safe place to relax before interviewing her.
B. Ask the client to describe why she is being stalked.
C. Recommend that the client talk with a social worker.
D. Assure the client that the HCP will see her today. - ANSWER--A
11. The RN leading a group session of adolescent clients gives the members a handout
about anger management. One of the male clients is fidgety, interrupts peers when
they try and talk, and talks about his pets at home. What nursing action is best for
the RN to take?
A. Explore the client's feelings about his pets and home life.
B. Encourage his peers to help involve him in the activity.
C. Give the client permission to leave and return in 10 minutes.
D. Redirect him by encouraging him to read from the handout. - ANSWER--D
12. A male adolescent was admitted to the unit two days ago for depression. When the
mental health RN tries to interview the client to establish rapport, he becomes very
irritated and sarcastic. Which action is best for the RN to take?
A. Report the behavior to the next shift.
B. Offer to play a game of cards with the client.
C. Document the behavior in the chart.
D. Plan to talk with the client the next day. - ANSWER--B
13. A male adult is admitted because of an acetaminophen (Tylenol) overdose. After
transfer to the mental health unit, the client is told he has liver damage. Which
information is most important for the nurse to include in the client's discharge plan?
A. Do not take any over the counter meds.
B. Eat a high carb, low fat, low protein diet.
C. Call the crisis hotline if feeling lonely.
D. Avoid exposure to large crowds. - ANSWER--A
3|Page
, 14. After receiving treatment for anorexia, a student asks the school RN for permission to
work in the school cafeteria as part of the school's work study program. What action
should the RN take?
A. Refer the student to a psychiatrist for further discussion.
B. Recommend assignment to the receptionist's office.
C. Suggest that student work in the athletic department.
D. Determine the parent's opinion of the work assignment. - ANSWER--B
15. The Rn accepts a transfer to the metal health unit and understands that the client is
distractible and is exhibiting a decreased ability to concentrate. The RN only has 15
minutes to talk to the client. To develop treatment plan for this client, which
assessment is most important for the RN to obtain?
A. Motivation of treatment.
B. History of substance use.
C. Medicationcompliance.
D. Mental status examination. - ANSWER--D
16. A male client who recently lost a loved one arrives at the mental health center and
tells the RN he is no longer interested is his usual activities and has not slept for
several days. Which priority nursing problem should the RN include in the client's
plan of care?
A. Risk for suicide.
B. Sleepdeprivation.
C. Situational low self-esteem.
D. Social isolation. - ANSWER--B
17. A male client with long history of alcohol dependency arrives in the emergency
department describing the feelings of bugs crawling on his body. His blood pressure
is 170/102, his pulse rate is 110 bpm, and is blood alcohol level is 0mg/dL. Which
prescription should the RN administer?
A. Haloperidol (Haldol).
B. Thiamine (Vitamin B1).
C. Diphenhydramine(Benadryl).
D. Lorazepam (Ativan). - ANSWER--D
18. A client who refuses antipsychotic medications disrupts group activities, talks with
nonsensical words and wanders into client's rooms. The RN decides that the client
needs constant observation based on which of these assessment findings?
4|Page
