HESI RN MENTAL HEALTH
2026 NGN-STYLE PRACTICE EXAM
80 original questions | Answers | Detailed rationales
Includes therapeutic communication, safety, psychopharmacology, substance use,
and two unfolding clinical-judgment cases.
Practice clinical judgment. Identify safety priorities. Strengthen remediation.
Independent educational resource - not official or recalled exam content
Independent original nursing practice resource - educational use only Page 1
, How to Use This Practice Exam
Answer each item before reviewing the highlighted answer and rationale. Mark every miss by cause: content gap,
safety-priority error, communication error, medication knowledge, or stem misreading. Reattempt missed items after 24-48
hours and again after one week.
Practice structure
Section Questions
Therapeutic Communication and Assessment 14
Safety, Crisis Intervention, and Legal-Ethical Care 14
Mood, Anxiety, Trauma, and Personality Disorders 15
Psychopharmacology and Somatic Treatments 15
Substance Use, Eating Disorders, and Neurocognitive Care 10
NGN Unfolding Case Study 1 - Depression and Suicide Risk 6
NGN Unfolding Case Study 2 - Acute Mania 6
Important notice
This independently created practice resource is not affiliated with, sponsored by, or endorsed by Elsevier, HESI, NCSBN, ATI,
or any school. It contains no copied, recalled, leaked, or actual secure exam questions. HESI is referenced only to identify the
type of nursing assessment preparation learners may be seeking.
This resource supports study and remediation; it is not clinical guidance and does not replace faculty instruction, current
references, institutional policy, or professional judgment.
Independent original nursing practice resource - educational use only Page 2
, Therapeutic Communication and Assessment
1. A client newly diagnosed with major depressive disorder says, "Nothing will ever get better." Which response
is most therapeutic?
A. You should try to focus on the positive parts of your life.
B. Why do you think you are being so negative?
C. Everyone feels discouraged sometimes.
D. It sounds as though the future feels hopeless to you right now.
ANSWER: D - It sounds as though the future feels hopeless to you right now.
Rationale: Reflecting the feeling acknowledges the client's experience and invites further discussion without minimizing, judging, or
demanding an explanation.
2. A client begins crying after describing a recent divorce. What should the nurse do first?
A. Remain present and allow silence while offering tissues.
B. Immediately change the subject to reduce distress.
C. Tell the client that crying will not solve the problem.
D. Leave the room so the client can regain control.
ANSWER: A - Remain present and allow silence while offering tissues.
Rationale: Therapeutic presence and purposeful silence communicate acceptance and give the client time to process emotion.
3. A client experiencing mania speaks rapidly and changes topics every few seconds. Which response is best?
A. Correct every inaccurate statement immediately.
B. Use brief, clear statements and redirect to one topic at a time.
C. Ask several open-ended questions to encourage detailed expression.
D. Match the client's speaking speed to maintain attention.
ANSWER: B - Use brief, clear statements and redirect to one topic at a time.
Rationale: Mania can impair attention and concentration; short, concrete communication and gentle redirection reduce stimulation and
improve understanding.
4. A client with schizophrenia says, "The television is sending secret instructions to me." What is the best
response?
A. What exact instructions is the television sending?
B. I believe the messages are intended to help you.
C. I do not receive messages from the television, but I understand that this feels real to you.
D. That is impossible, and you need to stop believing it.
ANSWER: C - I do not receive messages from the television, but I understand that this feels real to you.
Rationale: The nurse presents reality without arguing or validating the delusion, while acknowledging the client's experience.
Independent original nursing practice resource - educational use only Page 3
2026 NGN-STYLE PRACTICE EXAM
80 original questions | Answers | Detailed rationales
Includes therapeutic communication, safety, psychopharmacology, substance use,
and two unfolding clinical-judgment cases.
Practice clinical judgment. Identify safety priorities. Strengthen remediation.
Independent educational resource - not official or recalled exam content
Independent original nursing practice resource - educational use only Page 1
, How to Use This Practice Exam
Answer each item before reviewing the highlighted answer and rationale. Mark every miss by cause: content gap,
safety-priority error, communication error, medication knowledge, or stem misreading. Reattempt missed items after 24-48
hours and again after one week.
Practice structure
Section Questions
Therapeutic Communication and Assessment 14
Safety, Crisis Intervention, and Legal-Ethical Care 14
Mood, Anxiety, Trauma, and Personality Disorders 15
Psychopharmacology and Somatic Treatments 15
Substance Use, Eating Disorders, and Neurocognitive Care 10
NGN Unfolding Case Study 1 - Depression and Suicide Risk 6
NGN Unfolding Case Study 2 - Acute Mania 6
Important notice
This independently created practice resource is not affiliated with, sponsored by, or endorsed by Elsevier, HESI, NCSBN, ATI,
or any school. It contains no copied, recalled, leaked, or actual secure exam questions. HESI is referenced only to identify the
type of nursing assessment preparation learners may be seeking.
This resource supports study and remediation; it is not clinical guidance and does not replace faculty instruction, current
references, institutional policy, or professional judgment.
Independent original nursing practice resource - educational use only Page 2
, Therapeutic Communication and Assessment
1. A client newly diagnosed with major depressive disorder says, "Nothing will ever get better." Which response
is most therapeutic?
A. You should try to focus on the positive parts of your life.
B. Why do you think you are being so negative?
C. Everyone feels discouraged sometimes.
D. It sounds as though the future feels hopeless to you right now.
ANSWER: D - It sounds as though the future feels hopeless to you right now.
Rationale: Reflecting the feeling acknowledges the client's experience and invites further discussion without minimizing, judging, or
demanding an explanation.
2. A client begins crying after describing a recent divorce. What should the nurse do first?
A. Remain present and allow silence while offering tissues.
B. Immediately change the subject to reduce distress.
C. Tell the client that crying will not solve the problem.
D. Leave the room so the client can regain control.
ANSWER: A - Remain present and allow silence while offering tissues.
Rationale: Therapeutic presence and purposeful silence communicate acceptance and give the client time to process emotion.
3. A client experiencing mania speaks rapidly and changes topics every few seconds. Which response is best?
A. Correct every inaccurate statement immediately.
B. Use brief, clear statements and redirect to one topic at a time.
C. Ask several open-ended questions to encourage detailed expression.
D. Match the client's speaking speed to maintain attention.
ANSWER: B - Use brief, clear statements and redirect to one topic at a time.
Rationale: Mania can impair attention and concentration; short, concrete communication and gentle redirection reduce stimulation and
improve understanding.
4. A client with schizophrenia says, "The television is sending secret instructions to me." What is the best
response?
A. What exact instructions is the television sending?
B. I believe the messages are intended to help you.
C. I do not receive messages from the television, but I understand that this feels real to you.
D. That is impossible, and you need to stop believing it.
ANSWER: C - I do not receive messages from the television, but I understand that this feels real to you.
Rationale: The nurse presents reality without arguing or validating the delusion, while acknowledging the client's experience.
Independent original nursing practice resource - educational use only Page 3
