HESI MENTAL HEALTH:
COMPREHENSIVE EXAMINATION
Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
SECTION A: THERAPEUTIC COMMUNICATION & NURSE-PATIENT
RELATIONSHIP (Q1–15)
1. A patient with borderline personality disorder says, “You’re the only nurse
who understands me. The others are all mean.” Which response by the nurse
is most therapeutic?
• A. “I will share your concerns with the team. Let’s focus on your
treatment goals.”
Rationale: This validates feelings without splitting or forming a special
alliance, maintaining therapeutic boundaries.
• B. “Thank you, but you shouldn’t talk badly about other nurses.”
• C. “I’m glad we have a connection. Tell me more about the others.”
• D. “You’re manipulating me by saying that.”
2. A patient with major depressive disorder tells the nurse, “There’s no point
in anything. I just want to sleep forever.” What is the nurse’s priority
response?
• A. “Things will get better with treatment.”
• B. “Everyone feels sad sometimes.”
, • C. “Are you having thoughts of harming yourself?”
Rationale: Directly assess for suicidal ideation, which is priority in
depression.
• D. “Let’s list three things you’re grateful for.”
3. During a group therapy session, a patient with paranoid schizophrenia
whispers to the nurse, “They’re poisoning the coffee.” Which action should
the nurse take first?
• A. Reassure the patient that coffee is safe.
• B. Privately ask the patient to explain the concern.
Rationale: Validate the patient’s experience without reinforcing delusion;
safety first.
• C. Announce to the group that the coffee is safe.
• D. Ignore the comment to avoid reinforcing delusions.
4. The nurse is caring for a patient with anorexia nervosa who says, “I feel so
fat and ugly.” Which response demonstrates empathy?
• A. “You are not fat; you are dangerously underweight.”
• B. “Stop criticizing yourself; you need to eat.”
• C. “It sounds like you’re feeling very distressed about your body.”
Rationale: Reflects feeling and validates experience without judgment.
• D. “Let’s look at your BMI chart together.”
5. A patient with PTSD states, “I can’t stop thinking about the accident. It’s
like a movie in my head.” The nurse should recognize this as:
• A. Hallucination
• B. Flashbulb memory
• C. Intrusive re-experiencing
Rationale: Core PTSD symptom; nurse should acknowledge without probing
trauma details initially.
• D. Dissociative fugue
, 6. A patient tells the nurse, “The voices say I’m evil.” What is the most
therapeutic initial response?
• A. “I don’t hear any voices.”
• B. “You are not evil; ignore them.”
• C. “That must be frightening. What are the voices telling you to do?”
Rationale: Assess command hallucinations (safety priority) while showing
empathy.
• D. “When did the voices start?”
7. The nurse notices a patient pacing aggressively and clenching fists. The best
action is:
• A. “You need to calm down now.”
• B. Leave the patient alone to de-escalate.
• C. “You seem upset. Can we talk in a quiet area?”
Rationale: Early de-escalation with calm, open-ended approach.
• D. Call security immediately.
8. Which statement by a patient with bipolar disorder, manic episode,
indicates a need for immediate intervention?
• A. “I feel like I can run a marathon.”
• B. “God told me to jump off the roof to prove I can fly.”
Rationale: Command hallucination with imminent danger to self.
• C. “I bought 10 cars yesterday.”
• D. “I haven’t slept in 3 days.”
9. A patient with alcohol use disorder says, “I only drink to relax after work.
It’s no big deal.” The nurse’s best response is:
• A. “Alcohol is a depressant, so that doesn’t make sense.”
• B. “Help me understand how drinking affects your life and goals.”
Rationale: Motivational interviewing – exploring discrepancy without
confrontation.
• C. “You are in denial about your addiction.”
COMPREHENSIVE EXAMINATION
Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
SECTION A: THERAPEUTIC COMMUNICATION & NURSE-PATIENT
RELATIONSHIP (Q1–15)
1. A patient with borderline personality disorder says, “You’re the only nurse
who understands me. The others are all mean.” Which response by the nurse
is most therapeutic?
• A. “I will share your concerns with the team. Let’s focus on your
treatment goals.”
Rationale: This validates feelings without splitting or forming a special
alliance, maintaining therapeutic boundaries.
• B. “Thank you, but you shouldn’t talk badly about other nurses.”
• C. “I’m glad we have a connection. Tell me more about the others.”
• D. “You’re manipulating me by saying that.”
2. A patient with major depressive disorder tells the nurse, “There’s no point
in anything. I just want to sleep forever.” What is the nurse’s priority
response?
• A. “Things will get better with treatment.”
• B. “Everyone feels sad sometimes.”
, • C. “Are you having thoughts of harming yourself?”
Rationale: Directly assess for suicidal ideation, which is priority in
depression.
• D. “Let’s list three things you’re grateful for.”
3. During a group therapy session, a patient with paranoid schizophrenia
whispers to the nurse, “They’re poisoning the coffee.” Which action should
the nurse take first?
• A. Reassure the patient that coffee is safe.
• B. Privately ask the patient to explain the concern.
Rationale: Validate the patient’s experience without reinforcing delusion;
safety first.
• C. Announce to the group that the coffee is safe.
• D. Ignore the comment to avoid reinforcing delusions.
4. The nurse is caring for a patient with anorexia nervosa who says, “I feel so
fat and ugly.” Which response demonstrates empathy?
• A. “You are not fat; you are dangerously underweight.”
• B. “Stop criticizing yourself; you need to eat.”
• C. “It sounds like you’re feeling very distressed about your body.”
Rationale: Reflects feeling and validates experience without judgment.
• D. “Let’s look at your BMI chart together.”
5. A patient with PTSD states, “I can’t stop thinking about the accident. It’s
like a movie in my head.” The nurse should recognize this as:
• A. Hallucination
• B. Flashbulb memory
• C. Intrusive re-experiencing
Rationale: Core PTSD symptom; nurse should acknowledge without probing
trauma details initially.
• D. Dissociative fugue
, 6. A patient tells the nurse, “The voices say I’m evil.” What is the most
therapeutic initial response?
• A. “I don’t hear any voices.”
• B. “You are not evil; ignore them.”
• C. “That must be frightening. What are the voices telling you to do?”
Rationale: Assess command hallucinations (safety priority) while showing
empathy.
• D. “When did the voices start?”
7. The nurse notices a patient pacing aggressively and clenching fists. The best
action is:
• A. “You need to calm down now.”
• B. Leave the patient alone to de-escalate.
• C. “You seem upset. Can we talk in a quiet area?”
Rationale: Early de-escalation with calm, open-ended approach.
• D. Call security immediately.
8. Which statement by a patient with bipolar disorder, manic episode,
indicates a need for immediate intervention?
• A. “I feel like I can run a marathon.”
• B. “God told me to jump off the roof to prove I can fly.”
Rationale: Command hallucination with imminent danger to self.
• C. “I bought 10 cars yesterday.”
• D. “I haven’t slept in 3 days.”
9. A patient with alcohol use disorder says, “I only drink to relax after work.
It’s no big deal.” The nurse’s best response is:
• A. “Alcohol is a depressant, so that doesn’t make sense.”
• B. “Help me understand how drinking affects your life and goals.”
Rationale: Motivational interviewing – exploring discrepancy without
confrontation.
• C. “You are in denial about your addiction.”
