HESI MENTAL HEALTH EXAM 2026-2027 Practice
Questions with Detailed Explanations
FORMATTING LEGEND:
• Bold Italic = Correct Answer
• Italic = Rationale/Explanation
QUESTION 1
A nurse is conducting an admission interview with a client who is anxious and speaks
rapidly. The client states, "I can't stop thinking about all the bad things that might
happen." Which therapeutic communication technique should the nurse use initially?
A) Restating
B) Exploring
C) Focusing
D) Broad openings
CORRECT ANSWER: C) Focusing
Rationale: Focusing directs the conversation to a specific topic or issue. The client is
expressing generalized anxiety, so focusing helps narrow the discussion to the client's
specific concerns. Restating repeats the client's words, exploring encourages broader
discussion, and broad openings invite general conversation.
QUESTION 2
A nurse is caring for a client who is experiencing auditory hallucinations. The client
states, "The voices are telling me to hurt myself." Which action should the nurse take
first?
,A) Place the client on one-to-one observation
B) Ask the client if they plan to act on the voices
C) Administer prescribed antipsychotic medication
D) Notify the healthcare provider
CORRECT ANSWER: B) Ask the client if they plan to act on the voices
Rationale: When a client reports command hallucinations (voices telling them to hurt
themselves), the nurse must first assess the client's intent and plan. This determines the
level of intervention needed. One-to-one observation, medication administration, and
provider notification are important but follow the initial safety assessment.
QUESTION 3
A client with depression tells the nurse, "I don't feel like eating. Food just doesn't taste
good anymore." Which response by the nurse is most therapeutic?
A) "You need to eat to keep your strength up."
B) "I understand. Sometimes I lose my appetite too."
C) "Tell me more about how food tastes different to you."
D) "You'll feel better if you eat something."
CORRECT ANSWER: C) "Tell me more about how food tastes different to you."
Rationale: This response uses the therapeutic technique of exploring and encourages the
client to verbalize their feelings. It validates the client's experience without offering false
reassurance or advice. Options A and D are prescriptive, and Option B is inappropriate
self-disclosure.
,QUESTION 4
The nurse is caring for a client who has been diagnosed with a terminal illness. The client
states, "I don't want any more treatment. I just want to die in peace." Which action
should the nurse take?
A) Respect the client's wishes and provide comfort care
B) Encourage the client to continue treatment
C) Notify the family and ask for their opinion
D) Tell the client that they will change their mind
CORRECT ANSWER: A) Respect the client's wishes and provide comfort care
Rationale: Competent clients have the right to refuse treatment, including life-sustaining
treatment. The nurse should respect the client's wishes, provide comfort care, and ensure
the client's advance directives are followed. The family's opinion does not override the
client's decision.
QUESTION 5
A client is sitting alone in the dayroom, staring out the window. Which action should the
nurse take to promote interaction?
A) Sit quietly with the client and observe the view
B) Ask the client why they are sitting alone
C) Invite the client to join a group activity
D) Leave the client alone to respect privacy
CORRECT ANSWER: A) Sit quietly with the client and observe the view
Rationale: Sitting with the client in silence demonstrates acceptance and availability
without pressure. It allows the client to initiate communication when ready and can be less
threatening than asking questions or inviting the client to join a group.
, SECTION 2: PSYCHOPHARMACOLOGY & MEDICATION
MANAGEMENT
QUESTION 6
A client prescribed lithium carbonate for bipolar disorder reports persistent nausea and
vomiting. Which action should the nurse take first?
A) Administer an antiemetic as prescribed
B) Hold the next dose of lithium and notify the provider
C) Encourage the client to take lithium with food
D) Obtain a stat serum lithium level
CORRECT ANSWER: D) Obtain a stat serum lithium level
Rationale: Persistent nausea and vomiting are early signs of lithium toxicity. The nurse
should first obtain a stat serum lithium level to assess for toxicity. Holding the dose and
notifying the provider are important but should follow the lab draw to guide treatment
decisions.
QUESTION 7
A client prescribed fluoxetine for depression tells the nurse, "I've been feeling much
better, so I stopped taking my medication three days ago." Which response by the nurse
is most appropriate?
A) "It's good that you're feeling better. You can restart if symptoms return."
B) "Stopping abruptly can cause withdrawal symptoms. Let's talk about this."
C) "You should never stop taking your medication without consulting your provider."
D) "Why did you stop taking your medication without telling anyone?"
Questions with Detailed Explanations
FORMATTING LEGEND:
• Bold Italic = Correct Answer
• Italic = Rationale/Explanation
QUESTION 1
A nurse is conducting an admission interview with a client who is anxious and speaks
rapidly. The client states, "I can't stop thinking about all the bad things that might
happen." Which therapeutic communication technique should the nurse use initially?
A) Restating
B) Exploring
C) Focusing
D) Broad openings
CORRECT ANSWER: C) Focusing
Rationale: Focusing directs the conversation to a specific topic or issue. The client is
expressing generalized anxiety, so focusing helps narrow the discussion to the client's
specific concerns. Restating repeats the client's words, exploring encourages broader
discussion, and broad openings invite general conversation.
QUESTION 2
A nurse is caring for a client who is experiencing auditory hallucinations. The client
states, "The voices are telling me to hurt myself." Which action should the nurse take
first?
,A) Place the client on one-to-one observation
B) Ask the client if they plan to act on the voices
C) Administer prescribed antipsychotic medication
D) Notify the healthcare provider
CORRECT ANSWER: B) Ask the client if they plan to act on the voices
Rationale: When a client reports command hallucinations (voices telling them to hurt
themselves), the nurse must first assess the client's intent and plan. This determines the
level of intervention needed. One-to-one observation, medication administration, and
provider notification are important but follow the initial safety assessment.
QUESTION 3
A client with depression tells the nurse, "I don't feel like eating. Food just doesn't taste
good anymore." Which response by the nurse is most therapeutic?
A) "You need to eat to keep your strength up."
B) "I understand. Sometimes I lose my appetite too."
C) "Tell me more about how food tastes different to you."
D) "You'll feel better if you eat something."
CORRECT ANSWER: C) "Tell me more about how food tastes different to you."
Rationale: This response uses the therapeutic technique of exploring and encourages the
client to verbalize their feelings. It validates the client's experience without offering false
reassurance or advice. Options A and D are prescriptive, and Option B is inappropriate
self-disclosure.
,QUESTION 4
The nurse is caring for a client who has been diagnosed with a terminal illness. The client
states, "I don't want any more treatment. I just want to die in peace." Which action
should the nurse take?
A) Respect the client's wishes and provide comfort care
B) Encourage the client to continue treatment
C) Notify the family and ask for their opinion
D) Tell the client that they will change their mind
CORRECT ANSWER: A) Respect the client's wishes and provide comfort care
Rationale: Competent clients have the right to refuse treatment, including life-sustaining
treatment. The nurse should respect the client's wishes, provide comfort care, and ensure
the client's advance directives are followed. The family's opinion does not override the
client's decision.
QUESTION 5
A client is sitting alone in the dayroom, staring out the window. Which action should the
nurse take to promote interaction?
A) Sit quietly with the client and observe the view
B) Ask the client why they are sitting alone
C) Invite the client to join a group activity
D) Leave the client alone to respect privacy
CORRECT ANSWER: A) Sit quietly with the client and observe the view
Rationale: Sitting with the client in silence demonstrates acceptance and availability
without pressure. It allows the client to initiate communication when ready and can be less
threatening than asking questions or inviting the client to join a group.
, SECTION 2: PSYCHOPHARMACOLOGY & MEDICATION
MANAGEMENT
QUESTION 6
A client prescribed lithium carbonate for bipolar disorder reports persistent nausea and
vomiting. Which action should the nurse take first?
A) Administer an antiemetic as prescribed
B) Hold the next dose of lithium and notify the provider
C) Encourage the client to take lithium with food
D) Obtain a stat serum lithium level
CORRECT ANSWER: D) Obtain a stat serum lithium level
Rationale: Persistent nausea and vomiting are early signs of lithium toxicity. The nurse
should first obtain a stat serum lithium level to assess for toxicity. Holding the dose and
notifying the provider are important but should follow the lab draw to guide treatment
decisions.
QUESTION 7
A client prescribed fluoxetine for depression tells the nurse, "I've been feeling much
better, so I stopped taking my medication three days ago." Which response by the nurse
is most appropriate?
A) "It's good that you're feeling better. You can restart if symptoms return."
B) "Stopping abruptly can cause withdrawal symptoms. Let's talk about this."
C) "You should never stop taking your medication without consulting your provider."
D) "Why did you stop taking your medication without telling anyone?"
