HESI RN MENTAL HEALTH EXAM
2026 WITH 1-100 EXAM QUESTIONS
AND CORRECT ANSWERS AND
RATIONALE GRADED A+ || REAL RN
MENTAL HEALTH EXAM .
Questions 1-10
1. Safety Plan for Intimate Partner Violence
• Question: The RN is providing education about strategies for a safety plan for a
female client who is a victim of intimate partner violence. Which strategies should
be included in the safety plan? (Select all that apply.)
• Correct Answers: Establish a code with family and friends to signify violence;
Have a bag ready that has extra clothes for self and children; Plan an escape
route to use if the abuser blocks the main exit.
• Rationale: A safety plan focuses on preparing for a rapid, safe exit during a
violent episode. This includes establishing a code word for help, preparing an
escape bag with essentials, and planning alternative routes out of the home to
avoid being trapped by the abuser .
2. Initial Intervention for Depression and Sleep Deprivation
• Question: A homeless client who reports feeling sad and depressed tells the
mental health nurse that in the past 2 days she has only had 4 hours of sleep.
Which action is most important for the RN to implement within the first 24 hours
after treatment is initiated?
• Correct Answer: Allow the client to rest and sleep.
• Rationale: For a client who is severely sleep-deprived, addressing the basic
physiological need for rest is the immediate priority. Sleep restoration is
foundational before the client can effectively engage in therapy, groups, or
discharge planning .
3. Disulfiram (Antabuse) Teaching
, • Question: A RN is teaching a client about initiation of a prescribed abstinence
therapy using Disulfiram (Antabuse). What information should the client
acknowledge understanding?
• Correct Answer: Remain alcohol free for 12 hours prior to first dose.
• Rationale: Disulfiram causes a severe adverse reaction when combined with
alcohol. The client must be alcohol-free for at least 12 hours before taking the
first dose to prevent a reaction. They must also avoid all alcohol-containing
products while on the medication .
4. Defense Mechanism: Projection
• Question: Which client statement suggests to the RN that the client is using a
defense mechanism of projection to deal with anxiety related to admission to a
psychiatric unit?
• Correct Answer: "I am here because the police thought I was doing something
wrong."
• Rationale: Projection involves attributing one's own unacceptable thoughts or
feelings to another person. By stating the police thought he was doing
something wrong, the client is externalizing the reason for his admission,
avoiding personal responsibility for his actions. This is a classic example of the
projection defense mechanism .
5. Mental Status Exam: Documentation
• Question: The RN documents the mental status of a female client who has been
hospitalized for several days by court order. The client states, "I don't need to be
here," and tells the RN that she believes that the T.V. talks to her. The RN should
document these assessment statements in which section of the mental status
exam?
• Correct Answer: Insight and judgement.
• Rationale: "Insight and judgement" assesses the client's awareness of their own
condition and their ability to make sound decisions. The client's statement, "I
don't need to be here," indicates a lack of insight into the need for
hospitalization, which falls under this specific section of the exam .
6. Intervention for Depression and Social Withdrawal
• Question: The RN on the day shift receives report about a client with depression
who was in bed most of the weekend. The RN walks into the client's room in the
morning and finds the client in bed. What intervention is best for the RN to
implement?
, • Correct Answer: Assist the client to get out of bed and involved in an activity.
• Rationale: For clients with depression, the most therapeutic intervention is to
provide structure and encourage participation in activities to break the cycle of
withdrawal and social isolation. Direct assistance with getting out of bed is a
proactive measure .
7. New Admission: Prioritizing Confusion
• Question: A male who was found sitting in the middle of a busy street is brought
to the emergency department. Confused and has difficulty answering questions.
After ruling out a physiological etiology for the client's behavior, when admitting
the client to the unit, which action is most important for the nurse to take?
• Correct Answer: Perform a mental status exam.
• Rationale: A mental status exam is the priority assessment for a client presenting
with confusion. It establishes a baseline of cognitive function, which is crucial for
diagnosing a mental health condition and monitoring the client's progress
throughout their stay .
8. Adolescent Anger: Pre-Visit Assessment
• Question: An adolescent male client is hospitalized after he threatened a teacher
at school. He admits feeling angry because his mother tricked him and brought
him to the hospital. The client states that when his mother visits, he plans to get
his belongings from her, but he is not going to talk to her. Which activity is most
important for the nurse to complete before the mother arrives?
• Correct Answer: Assess...
• Rationale: [Content not fully available in source, but assessment is the
appropriate first action] .
9. Lithium Carbonate: Serious Side Effect
• Question: The RN is admitting a male client who takes lithium carbonate
(Eskalith) twice a day. Which information should the RN report to the HCP
immediately?
• Correct Answer: Nausea and vomiting.
• Rationale: While lithium has many side effects, nausea and vomiting can be a
sign of lithium toxicity. This is a significant concern that requires immediate
reporting and further assessment (such as a serum lithium level) .
10. Therapeutic Milieu: Environmental Setting
2026 WITH 1-100 EXAM QUESTIONS
AND CORRECT ANSWERS AND
RATIONALE GRADED A+ || REAL RN
MENTAL HEALTH EXAM .
Questions 1-10
1. Safety Plan for Intimate Partner Violence
• Question: The RN is providing education about strategies for a safety plan for a
female client who is a victim of intimate partner violence. Which strategies should
be included in the safety plan? (Select all that apply.)
• Correct Answers: Establish a code with family and friends to signify violence;
Have a bag ready that has extra clothes for self and children; Plan an escape
route to use if the abuser blocks the main exit.
• Rationale: A safety plan focuses on preparing for a rapid, safe exit during a
violent episode. This includes establishing a code word for help, preparing an
escape bag with essentials, and planning alternative routes out of the home to
avoid being trapped by the abuser .
2. Initial Intervention for Depression and Sleep Deprivation
• Question: A homeless client who reports feeling sad and depressed tells the
mental health nurse that in the past 2 days she has only had 4 hours of sleep.
Which action is most important for the RN to implement within the first 24 hours
after treatment is initiated?
• Correct Answer: Allow the client to rest and sleep.
• Rationale: For a client who is severely sleep-deprived, addressing the basic
physiological need for rest is the immediate priority. Sleep restoration is
foundational before the client can effectively engage in therapy, groups, or
discharge planning .
3. Disulfiram (Antabuse) Teaching
, • Question: A RN is teaching a client about initiation of a prescribed abstinence
therapy using Disulfiram (Antabuse). What information should the client
acknowledge understanding?
• Correct Answer: Remain alcohol free for 12 hours prior to first dose.
• Rationale: Disulfiram causes a severe adverse reaction when combined with
alcohol. The client must be alcohol-free for at least 12 hours before taking the
first dose to prevent a reaction. They must also avoid all alcohol-containing
products while on the medication .
4. Defense Mechanism: Projection
• Question: Which client statement suggests to the RN that the client is using a
defense mechanism of projection to deal with anxiety related to admission to a
psychiatric unit?
• Correct Answer: "I am here because the police thought I was doing something
wrong."
• Rationale: Projection involves attributing one's own unacceptable thoughts or
feelings to another person. By stating the police thought he was doing
something wrong, the client is externalizing the reason for his admission,
avoiding personal responsibility for his actions. This is a classic example of the
projection defense mechanism .
5. Mental Status Exam: Documentation
• Question: The RN documents the mental status of a female client who has been
hospitalized for several days by court order. The client states, "I don't need to be
here," and tells the RN that she believes that the T.V. talks to her. The RN should
document these assessment statements in which section of the mental status
exam?
• Correct Answer: Insight and judgement.
• Rationale: "Insight and judgement" assesses the client's awareness of their own
condition and their ability to make sound decisions. The client's statement, "I
don't need to be here," indicates a lack of insight into the need for
hospitalization, which falls under this specific section of the exam .
6. Intervention for Depression and Social Withdrawal
• Question: The RN on the day shift receives report about a client with depression
who was in bed most of the weekend. The RN walks into the client's room in the
morning and finds the client in bed. What intervention is best for the RN to
implement?
, • Correct Answer: Assist the client to get out of bed and involved in an activity.
• Rationale: For clients with depression, the most therapeutic intervention is to
provide structure and encourage participation in activities to break the cycle of
withdrawal and social isolation. Direct assistance with getting out of bed is a
proactive measure .
7. New Admission: Prioritizing Confusion
• Question: A male who was found sitting in the middle of a busy street is brought
to the emergency department. Confused and has difficulty answering questions.
After ruling out a physiological etiology for the client's behavior, when admitting
the client to the unit, which action is most important for the nurse to take?
• Correct Answer: Perform a mental status exam.
• Rationale: A mental status exam is the priority assessment for a client presenting
with confusion. It establishes a baseline of cognitive function, which is crucial for
diagnosing a mental health condition and monitoring the client's progress
throughout their stay .
8. Adolescent Anger: Pre-Visit Assessment
• Question: An adolescent male client is hospitalized after he threatened a teacher
at school. He admits feeling angry because his mother tricked him and brought
him to the hospital. The client states that when his mother visits, he plans to get
his belongings from her, but he is not going to talk to her. Which activity is most
important for the nurse to complete before the mother arrives?
• Correct Answer: Assess...
• Rationale: [Content not fully available in source, but assessment is the
appropriate first action] .
9. Lithium Carbonate: Serious Side Effect
• Question: The RN is admitting a male client who takes lithium carbonate
(Eskalith) twice a day. Which information should the RN report to the HCP
immediately?
• Correct Answer: Nausea and vomiting.
• Rationale: While lithium has many side effects, nausea and vomiting can be a
sign of lithium toxicity. This is a significant concern that requires immediate
reporting and further assessment (such as a serum lithium level) .
10. Therapeutic Milieu: Environmental Setting
