HESI MENTAL HEALTH EXAM
2026-2027 QUESTIONS AND
ANSWERS WITH
RATIONALES/GRADED A+/2026
UPDATE/100% CORRECT
/INSTANT DOWNLOAD
1. Therapeutic Communication
1. A client with anxiety says, “I feel like I’m losing my mind.” Which response by
the nurse is most therapeutic?
• a) “Don’t worry, everyone feels that way sometimes.”
• b) “Tell me more about what you are experiencing.”
• c) “You are not losing your mind; you are just anxious.”
• d) “Why do you think you feel that way?”
Rationale: Open-ended questions encourage expression of feelings. “Why”
questions can feel accusatory; false reassurance blocks communication.
2. A client states, “I want to die.” Which response demonstrates therapeutic
communication?
• a) “You have so much to live for.”
• b) “Are you thinking of hurting yourself?”
• c) “Don’t say that; you’ll feel better soon.”
• d) “Why would you say something like that?”
Rationale: Direct assessment of suicidal ideation is essential for safety. Never avoid
asking about suicide.
,3. A client with depression says, “I’m a terrible parent.” The best response is:
• a) “You are a good parent; your children love you.”
• b) “What makes you feel like a terrible parent?”
• c) “All parents make mistakes.”
• d) “Let’s talk about something positive.”
Rationale: Exploring the client’s perception validates feelings and gathers
assessment data.
2. Suicide Risk Assessment
4. Which client is at highest risk for suicide?
• a) 35-year-old with adjustment disorder
• b) 20-year-old with social anxiety
• c) 70-year-old widowed white male with depression and access to a gun
• d) 45-year-old female with OCD
Rationale: High-risk factors: older adult, male, widowed, depression, firearms access.
5. The most critical question to ask a suicidal client is:
• a) “Do you have a plan to kill yourself?”
• b) “Do you feel sad?”
• c) “How long have you felt this way?”
• d) “Have you been sleeping well?”
Rationale: Asking about intent, plan, and means is priority for safety. “Do you have a
plan?” is highest yield.
3. Neurotransmitters & Psychopharmacology
6. A client with major depression has low levels of which neurotransmitter?
• a) Dopamine
• b) Serotonin
• c) GABA
, • d) Acetylcholine
Rationale: Serotonin and norepinephrine deficiency are implicated in depression.
7. SSRIs like fluoxetine (Prozac) exert their effect by:
• a) Blocking reuptake of serotonin
• b) Increasing dopamine release
• c) Blocking acetylcholine receptors
• d) Inhibiting MAO-A
Rationale: SSRIs inhibit serotonin reuptake, increasing synaptic serotonin.
8. Which medication requires a strict low-tyramine diet?
• a) Sertraline (Zoloft)
• b) Bupropion (Wellbutrin)
• c) Phenelzine (Nardil)
• d) Duloxetine (Cymbalta)
Rationale: Phenelzine is an MAOI; tyramine (aged cheese, wine) can cause
hypertensive crisis.
9. A client on lithium reports nausea, tremors, and confusion. Next action?
• a) Give PRN antiemetic
• b) Hold lithium and draw a serum level
• c) Increase fluids
• d) Administer benztropine
Rationale: Nausea + tremors + confusion = possible lithium toxicity. Check level
immediately.
4. Defense Mechanisms
10. A man who is attracted to his coworker yells at his wife for being late.
Which defense mechanism?
• a) Sublimation
• b) Displacement
• c) Projection
• d) Reaction formation
2026-2027 QUESTIONS AND
ANSWERS WITH
RATIONALES/GRADED A+/2026
UPDATE/100% CORRECT
/INSTANT DOWNLOAD
1. Therapeutic Communication
1. A client with anxiety says, “I feel like I’m losing my mind.” Which response by
the nurse is most therapeutic?
• a) “Don’t worry, everyone feels that way sometimes.”
• b) “Tell me more about what you are experiencing.”
• c) “You are not losing your mind; you are just anxious.”
• d) “Why do you think you feel that way?”
Rationale: Open-ended questions encourage expression of feelings. “Why”
questions can feel accusatory; false reassurance blocks communication.
2. A client states, “I want to die.” Which response demonstrates therapeutic
communication?
• a) “You have so much to live for.”
• b) “Are you thinking of hurting yourself?”
• c) “Don’t say that; you’ll feel better soon.”
• d) “Why would you say something like that?”
Rationale: Direct assessment of suicidal ideation is essential for safety. Never avoid
asking about suicide.
,3. A client with depression says, “I’m a terrible parent.” The best response is:
• a) “You are a good parent; your children love you.”
• b) “What makes you feel like a terrible parent?”
• c) “All parents make mistakes.”
• d) “Let’s talk about something positive.”
Rationale: Exploring the client’s perception validates feelings and gathers
assessment data.
2. Suicide Risk Assessment
4. Which client is at highest risk for suicide?
• a) 35-year-old with adjustment disorder
• b) 20-year-old with social anxiety
• c) 70-year-old widowed white male with depression and access to a gun
• d) 45-year-old female with OCD
Rationale: High-risk factors: older adult, male, widowed, depression, firearms access.
5. The most critical question to ask a suicidal client is:
• a) “Do you have a plan to kill yourself?”
• b) “Do you feel sad?”
• c) “How long have you felt this way?”
• d) “Have you been sleeping well?”
Rationale: Asking about intent, plan, and means is priority for safety. “Do you have a
plan?” is highest yield.
3. Neurotransmitters & Psychopharmacology
6. A client with major depression has low levels of which neurotransmitter?
• a) Dopamine
• b) Serotonin
• c) GABA
, • d) Acetylcholine
Rationale: Serotonin and norepinephrine deficiency are implicated in depression.
7. SSRIs like fluoxetine (Prozac) exert their effect by:
• a) Blocking reuptake of serotonin
• b) Increasing dopamine release
• c) Blocking acetylcholine receptors
• d) Inhibiting MAO-A
Rationale: SSRIs inhibit serotonin reuptake, increasing synaptic serotonin.
8. Which medication requires a strict low-tyramine diet?
• a) Sertraline (Zoloft)
• b) Bupropion (Wellbutrin)
• c) Phenelzine (Nardil)
• d) Duloxetine (Cymbalta)
Rationale: Phenelzine is an MAOI; tyramine (aged cheese, wine) can cause
hypertensive crisis.
9. A client on lithium reports nausea, tremors, and confusion. Next action?
• a) Give PRN antiemetic
• b) Hold lithium and draw a serum level
• c) Increase fluids
• d) Administer benztropine
Rationale: Nausea + tremors + confusion = possible lithium toxicity. Check level
immediately.
4. Defense Mechanisms
10. A man who is attracted to his coworker yells at his wife for being late.
Which defense mechanism?
• a) Sublimation
• b) Displacement
• c) Projection
• d) Reaction formation
