HESI RN 2026 MENTAL HEALTH COMPREHENSIVE EXAM
QUESTIONS COMPLETE WITH CORRECT ANSWERS AND
RATIONALES
1. A client with schizophrenia tells the nurse, "The government is
monitoring my thoughts through satellite signals." Which response by
the nurse is most therapeutic?
A. "That's not possible; satellites don't read thoughts."
B. "What makes you believe the government is monitoring you?"
C. "I understand you believe that, but I don't see any evidence of
monitoring."
D. "Let's talk about something else that's less frightening."
Answer: B. What makes you believe the government is monitoring
you?
Rationale: This response acknowledges the client's belief without
challenging it directly and gathers more information about the delusion.
It uses therapeutic communication techniques that validate the client's
experience while exploring the content of the delusion. Option A
dismisses the client's belief, C directly challenges the delusion, and D
changes the subject, which may make the client feel unheard.
,2. A client diagnosed with major depressive disorder states, "I'm
worthless and everyone would be better off without me." What is the
nurse's priority intervention?
A. Ask the client to list their positive qualities.
B. Document the client's statement in the medical record.
C. Conduct a suicide risk assessment.
D. Encourage the client to participate in group therapy.
Answer: C. Conduct a suicide risk assessment.
Rationale: The client's statement expresses feelings of worthlessness
and contains suicidal ideation. The priority intervention is to assess the
client's risk for suicide, including asking about suicidal thoughts, plans,
intent, and means. Safety is always the priority in psychiatric nursing.
Options A, B, and D are appropriate but should occur after a thorough
suicide risk assessment.
3. A client with bipolar disorder is exhibiting pressured speech, flight
of ideas, and decreased need for sleep. Which intervention should the
nurse implement first?
A. Place the client in a quiet environment with minimal stimulation.
B. Encourage the client to journal their thoughts and feelings.
C. Administer prescribed antipsychotic medication.
D. Provide high-calorie finger foods and fluids.
Answer: A. Place the client in a quiet environment with minimal
stimulation.
,Rationale: The client is experiencing manic symptoms that require
environmental management first to decrease stimulation and promote
safety. A quiet environment with minimal stimulation helps reduce
agitation and prevents escalation. While medication administration (C)
is important, environmental intervention is the priority nursing action.
Options B and D are appropriate adjunct interventions.
4. A client has been taking fluoxetine (Prozac) for 6 weeks and reports
feeling better but is experiencing sexual dysfunction. Which response
by the nurse is most appropriate?
A. "This side effect usually resolves within a few more weeks."
B. "You should stop taking the medication immediately."
C. "Let's discuss this with your healthcare provider; there are options to
manage this."
D. "This means the medication isn't working for you."
Answer: C. Let's discuss this with your healthcare provider; there are
options to manage this.
Rationale: Sexual dysfunction is a common side effect of SSRIs. The
nurse should acknowledge the client's concern and collaborate with the
healthcare provider to address the issue. Options for managing this side
effect include dosage adjustment, medication holiday, or switching to
another antidepressant. Option A provides false reassurance, B is
unsafe, and D is incorrect as the client reports feeling better.
5. A client with borderline personality disorder has just been informed
that their primary nurse is going on vacation. The client becomes
, angry and states, "You're just like everyone else - you abandon me!"
Which nursing response is most therapeutic?
A. "I understand you're upset, but the nurse needs time off."
B. "You're overreacting to this situation."
C. "I can see you're feeling abandoned. Let's talk about this change."
D. "Don't worry; another nurse will be assigned to you."
Answer: C. I can see you're feeling abandoned. Let's talk about this
change.
Rationale: This response validates the client's feelings, acknowledges
the fear of abandonment common in borderline personality disorder,
and opens the door for therapeutic discussion. Option A dismisses the
client's feelings, B invalidates them, and D provides false reassurance
without addressing the underlying emotion.
6. A client with alcohol use disorder is admitted with tremors,
diaphoresis, and tachycardia. Which medication should the nurse
anticipate administering?
A. Naltrexone (ReVia)
B. Disulfiram (Antabuse)
C. Chlordiazepoxide (Librium)
D. Acamprosate (Campral)
Answer: C. Chlordiazepoxide (Librium)
Rationale: The client is exhibiting symptoms of alcohol withdrawal.
Benzodiazepines such as chlordiazepoxide are the first-line treatment
for alcohol withdrawal to prevent progression to delirium tremens and
QUESTIONS COMPLETE WITH CORRECT ANSWERS AND
RATIONALES
1. A client with schizophrenia tells the nurse, "The government is
monitoring my thoughts through satellite signals." Which response by
the nurse is most therapeutic?
A. "That's not possible; satellites don't read thoughts."
B. "What makes you believe the government is monitoring you?"
C. "I understand you believe that, but I don't see any evidence of
monitoring."
D. "Let's talk about something else that's less frightening."
Answer: B. What makes you believe the government is monitoring
you?
Rationale: This response acknowledges the client's belief without
challenging it directly and gathers more information about the delusion.
It uses therapeutic communication techniques that validate the client's
experience while exploring the content of the delusion. Option A
dismisses the client's belief, C directly challenges the delusion, and D
changes the subject, which may make the client feel unheard.
,2. A client diagnosed with major depressive disorder states, "I'm
worthless and everyone would be better off without me." What is the
nurse's priority intervention?
A. Ask the client to list their positive qualities.
B. Document the client's statement in the medical record.
C. Conduct a suicide risk assessment.
D. Encourage the client to participate in group therapy.
Answer: C. Conduct a suicide risk assessment.
Rationale: The client's statement expresses feelings of worthlessness
and contains suicidal ideation. The priority intervention is to assess the
client's risk for suicide, including asking about suicidal thoughts, plans,
intent, and means. Safety is always the priority in psychiatric nursing.
Options A, B, and D are appropriate but should occur after a thorough
suicide risk assessment.
3. A client with bipolar disorder is exhibiting pressured speech, flight
of ideas, and decreased need for sleep. Which intervention should the
nurse implement first?
A. Place the client in a quiet environment with minimal stimulation.
B. Encourage the client to journal their thoughts and feelings.
C. Administer prescribed antipsychotic medication.
D. Provide high-calorie finger foods and fluids.
Answer: A. Place the client in a quiet environment with minimal
stimulation.
,Rationale: The client is experiencing manic symptoms that require
environmental management first to decrease stimulation and promote
safety. A quiet environment with minimal stimulation helps reduce
agitation and prevents escalation. While medication administration (C)
is important, environmental intervention is the priority nursing action.
Options B and D are appropriate adjunct interventions.
4. A client has been taking fluoxetine (Prozac) for 6 weeks and reports
feeling better but is experiencing sexual dysfunction. Which response
by the nurse is most appropriate?
A. "This side effect usually resolves within a few more weeks."
B. "You should stop taking the medication immediately."
C. "Let's discuss this with your healthcare provider; there are options to
manage this."
D. "This means the medication isn't working for you."
Answer: C. Let's discuss this with your healthcare provider; there are
options to manage this.
Rationale: Sexual dysfunction is a common side effect of SSRIs. The
nurse should acknowledge the client's concern and collaborate with the
healthcare provider to address the issue. Options for managing this side
effect include dosage adjustment, medication holiday, or switching to
another antidepressant. Option A provides false reassurance, B is
unsafe, and D is incorrect as the client reports feeling better.
5. A client with borderline personality disorder has just been informed
that their primary nurse is going on vacation. The client becomes
, angry and states, "You're just like everyone else - you abandon me!"
Which nursing response is most therapeutic?
A. "I understand you're upset, but the nurse needs time off."
B. "You're overreacting to this situation."
C. "I can see you're feeling abandoned. Let's talk about this change."
D. "Don't worry; another nurse will be assigned to you."
Answer: C. I can see you're feeling abandoned. Let's talk about this
change.
Rationale: This response validates the client's feelings, acknowledges
the fear of abandonment common in borderline personality disorder,
and opens the door for therapeutic discussion. Option A dismisses the
client's feelings, B invalidates them, and D provides false reassurance
without addressing the underlying emotion.
6. A client with alcohol use disorder is admitted with tremors,
diaphoresis, and tachycardia. Which medication should the nurse
anticipate administering?
A. Naltrexone (ReVia)
B. Disulfiram (Antabuse)
C. Chlordiazepoxide (Librium)
D. Acamprosate (Campral)
Answer: C. Chlordiazepoxide (Librium)
Rationale: The client is exhibiting symptoms of alcohol withdrawal.
Benzodiazepines such as chlordiazepoxide are the first-line treatment
for alcohol withdrawal to prevent progression to delirium tremens and
