NGN Mental Health HESI Exams 2025/2026 (Version A & B) with Actual Exam Questions and Correct Answers with Rationales | Graded A+

NGN Mental Health HESI Exams
2025/2026 (Version A & B) with Actual
Exam Questions and Correct Answers
with Rationales | Graded A+

Question 1 A client diagnosed with major depressive disorder has been in bed for 3 days and
refuses to eat or participate in activities. Which nursing diagnosis has the highest priority? A.
Hopelessness B. Social Isolation C. Imbalanced Nutrition: Less Than Body Requirements D.
Ineffective Coping Answer: C. Imbalanced Nutrition: Less Than Body Requirements
Rationale: Physiological needs (nutrition/fluids) take priority over psychosocial needs per
Maslow’s hierarchy. Severe refusal to eat can quickly lead to life-threatening dehydration,
electrolyte imbalance, and refeeding syndrome.

Question 2 A client angrily states, “My roommate is the most selfish, angry person I’ve ever
met. If he loses it one more time, I’m going to punch him out!” This is an example of which
defense mechanism? A. Denial B. Projection C. Displacement D. Rationalization Answer: B.
Projection Rationale: The client is attributing his own unacceptable feelings (anger/aggression)
to the roommate.

Question 3 A client who was sexually assaulted last night is calm, quiet, and shows no emotion.
This behavior most likely reflects: A. Acceptance B. Denial C. Intellectualization D. Regression
Answer: B. Denial Rationale: Denial is a common initial defense mechanism after acute
trauma, allowing temporary emotional protection.

Question 4 When assessing a client with schizophrenia who reports auditory hallucinations, the
most important question is: A. “How do the voices make you feel?” B. “Do the voices tell you to
hurt yourself or anyone else?” C. “When did you first hear the voices?” D. “Are the voices male
or female?” Answer: B. “Do the voices tell you to hurt yourself or anyone else?” Rationale:
Command hallucinations pose the highest immediate safety risk and must be assessed first.

Question 5 A client on lithium carbonate reports nausea, vomiting, and coarse hand tremor. The
nurse’s priority action is: A. Administer an antiemetic B. Check serum lithium level C.
Encourage increased oral fluids D. Hold the next dose and notify the provider Answer: B.
Check serum lithium level Rationale: These are classic early signs of lithium toxicity
(therapeutic range 0.6–1.2 mEq/L). Serum level must be obtained immediately.

Question 6 A mental health worker is de-escalating an aggressive client and maintains constant
direct eye contact. The RN should intervene because: A. It is the most therapeutic approach B.
Prolonged eye contact can be perceived as threatening C. It shows genuine concern D. It helps

, the client maintain focus Answer: B. Prolonged eye contact can be perceived as threatening
Rationale: In de-escalation, minimal eye contact is preferred to avoid escalation of agitation.

Question 7 A dying client states, “I’m going to die soon and I’m angry my family keeps hoping
for a cure.” The most therapeutic response is: A. “Anger is a normal part of dying.” B. “Have
you shared these feelings with your family?” C. “You need to accept the inevitable.” D. “Why
are you angry at your family?” Answer: B. “Have you shared these feelings with your
family?” Rationale: This promotes open communication and problem-solving between client
and family.

Question 8 A client presents to the ED 12 hours after sexual assault. The most important
question for evidence collection is: A. “Did you know the attacker?” B. “Have you showered,
douched, or changed clothes?” C. “Do you feel safe at home?” D. “Did you fight back?”
Answer: B. “Have you showered, douched, or changed clothes?” Rationale: These actions
destroy DNA evidence critical for forensic examination.

Question 9 Which behavior best indicates effective coping in a client grieving the loss of a
spouse? A. Sleeping 12 hours per day B. Avoiding discussion of the deceased C. Attending a
bereavement support group D. Refusing antidepressant medication Answer: C. Attending a
bereavement support group Rationale: Active participation in support demonstrates adaptive
coping and social reconnection.

Question 10 A client with borderline personality disorder threatens to cut herself during group
therapy. The nurse’s priority action is: A. Administer PRN lorazepam B. Place the client in
seclusion C. Assess lethality and current intent D. Instruct the client to sit quietly Answer: C.
Assess lethality and current intent Rationale: Safety assessment drives all subsequent
interventions.

Question 11 A client with schizophrenia reports command hallucinations telling him to harm
others. The nurse’s immediate action is: A. Administer PRN antipsychotic B. Encourage
journaling C. Implement one-to-one observation D. Teach distraction techniques Answer: C.
Implement one-to-one observation Rationale: Command hallucinations pose imminent
danger; constant monitoring is required until de-escalated or medicated.

Question 12 During the working phase of the nurse-client relationship, the nurse primarily
focuses on: A. Establishing trust B. Identifying feelings that block adaptive coping C.
Termination planning D. Assessing functional ability Answer: B. Identifying feelings that
block adaptive coping Rationale: The working phase centers on problem-solving and exploring
barriers to growth.

Question 13 An SSRI is preferred over a tricyclic antidepressant for depression because: A.
SSRIs are more effective B. Tricyclics have more dangerous side effects and overdose risk C.
SSRIs require weekly blood monitoring D. Tricyclics are less expensive Answer: B. Tricyclics
have more dangerous side effects and overdose risk Rationale: TCAs have significant
anticholinergic and cardiotoxic effects and are lethal in overdose.