HESI RN Mental Health
Exam
Antigua College International (ACI) Preparation Edition
2026 | 55 Original Questions | Answers and Teaching Rationales
Clinical judgment • Safety • Psychopharmacology • Therapeutic care • NGN formats
Important: This is an independently created practice examination. It is not an official, recalled, leaked, or endorsed
HESI/Elsevier or ACI examination. Exam forms and school policies can change. Use current course instructions as the
controlling source.
Prepared for focused RN psychiatric-mental health review
, Exam Blueprint and Directions
Domain Approx. emphasis
Safety, suicide, violence, crisis and legal/ethical care 24%
Therapeutic communication and milieu 18%
Mood, psychotic, anxiety, trauma and personality disorders 25%
Psychopharmacology and adverse reactions 20%
Substance use, cognitive and eating disorders 13%
Suggested simulation: Complete all 55 questions in one sitting. Select the single best answer unless the item says “Select
all that apply” or requests an ordered response. Apply ABCs, safety, least restrictive care, nursing process, and
acute-versus-chronic prioritization.
Scoring: This practice test uses raw percent correct. HESI uses a proprietary scaled score, so a raw percentage cannot be
converted reliably to an HESI score. ACI’s public 2025-2026 catalog identifies 850 as a benchmark in its EOC
readmission-exemption policy; your course syllabus may set a different requirement.
Original HESI-style resource | ACI 2026 preparation Page 2
, Part I - Examination
1. A client says, 'There is no reason for me to live anymore.' Which response should the nurse make first?
A. Why would you say something like that?
B. Are you thinking about killing yourself?
C. You have many things to be grateful for.
D. Let's discuss your discharge plan.
2. A client experiencing acute anxiety is pacing and unable to follow detailed directions. Which intervention is
best?
A. Teach progressive muscle relaxation in detail.
B. Leave the client alone to decrease stimulation.
C. Use brief, simple statements and remain with the client.
D. Ask the client to identify childhood triggers.
3. Which nurse statement demonstrates therapeutic communication?
A. Everything will be fine.
B. Tell me more about what worries you most.
C. You should call your family.
D. I know exactly how you feel.
4. A client with schizophrenia says, 'The television is sending me secret instructions.' What is the nurse's best
response?
A. The television cannot communicate with you.
B. What exactly is the television ordering you to do?
C. I do not hear messages, but I understand that this feels real to you.
D. Turn off the television and forget about it.
5. A client reports command hallucinations. Which assessment is the priority?
A. How long have you heard voices?
B. What are the voices telling you to do?
C. Does anyone in your family hear voices?
D. Which medications have you tried before?
6. A client taking clozapine reports fever and a sore throat. What should the nurse instruct the client to do?
A. Take acetaminophen and continue the medication.
B. Skip one dose and restart tomorrow.
C. Contact the prescriber immediately for blood evaluation.
D. Increase oral fluids for 24 hours.
Original HESI-style resource | ACI 2026 preparation Page 3
, 7. Which finding in a client taking lithium requires immediate action?
A. Mild thirst
B. Fine hand tremor
C. Coarse tremor with vomiting and ataxia
D. Increased urination
8. Which teaching is most important for a client taking lithium?
A. Follow a low-sodium diet.
B. Maintain consistent sodium and fluid intake.
C. Avoid all physical activity.
D. Take ibuprofen daily for headaches.
9. A client taking phenelzine selects lunch. Which choice requires intervention?
A. Grilled chicken with rice
B. Fresh apple and yogurt
C. Aged cheese and cured sausage
D. Baked fish and green beans
10. A client recently started sertraline. Which statement indicates correct understanding?
A. I should stop it as soon as I feel better.
B. It may take several weeks before I notice full benefit.
C. I can combine it with St. John's wort.
D. It will relieve severe anxiety immediately.
11. Which assessment finding suggests serotonin syndrome?
A. Bradycardia, hypothermia, and constipation
B. Agitation, diaphoresis, hyperreflexia, and fever
C. Flat affect and social withdrawal
D. Jaundice and clay-colored stools
12. A client taking haloperidol develops neck stiffness and upward deviation of the eyes. Which action is
expected?
A. Administer benztropine or diphenhydramine as prescribed.
B. Encourage ambulation.
C. Give the next haloperidol dose early.
D. Restrict oral fluids.
Original HESI-style resource | ACI 2026 preparation Page 4
Exam
Antigua College International (ACI) Preparation Edition
2026 | 55 Original Questions | Answers and Teaching Rationales
Clinical judgment • Safety • Psychopharmacology • Therapeutic care • NGN formats
Important: This is an independently created practice examination. It is not an official, recalled, leaked, or endorsed
HESI/Elsevier or ACI examination. Exam forms and school policies can change. Use current course instructions as the
controlling source.
Prepared for focused RN psychiatric-mental health review
, Exam Blueprint and Directions
Domain Approx. emphasis
Safety, suicide, violence, crisis and legal/ethical care 24%
Therapeutic communication and milieu 18%
Mood, psychotic, anxiety, trauma and personality disorders 25%
Psychopharmacology and adverse reactions 20%
Substance use, cognitive and eating disorders 13%
Suggested simulation: Complete all 55 questions in one sitting. Select the single best answer unless the item says “Select
all that apply” or requests an ordered response. Apply ABCs, safety, least restrictive care, nursing process, and
acute-versus-chronic prioritization.
Scoring: This practice test uses raw percent correct. HESI uses a proprietary scaled score, so a raw percentage cannot be
converted reliably to an HESI score. ACI’s public 2025-2026 catalog identifies 850 as a benchmark in its EOC
readmission-exemption policy; your course syllabus may set a different requirement.
Original HESI-style resource | ACI 2026 preparation Page 2
, Part I - Examination
1. A client says, 'There is no reason for me to live anymore.' Which response should the nurse make first?
A. Why would you say something like that?
B. Are you thinking about killing yourself?
C. You have many things to be grateful for.
D. Let's discuss your discharge plan.
2. A client experiencing acute anxiety is pacing and unable to follow detailed directions. Which intervention is
best?
A. Teach progressive muscle relaxation in detail.
B. Leave the client alone to decrease stimulation.
C. Use brief, simple statements and remain with the client.
D. Ask the client to identify childhood triggers.
3. Which nurse statement demonstrates therapeutic communication?
A. Everything will be fine.
B. Tell me more about what worries you most.
C. You should call your family.
D. I know exactly how you feel.
4. A client with schizophrenia says, 'The television is sending me secret instructions.' What is the nurse's best
response?
A. The television cannot communicate with you.
B. What exactly is the television ordering you to do?
C. I do not hear messages, but I understand that this feels real to you.
D. Turn off the television and forget about it.
5. A client reports command hallucinations. Which assessment is the priority?
A. How long have you heard voices?
B. What are the voices telling you to do?
C. Does anyone in your family hear voices?
D. Which medications have you tried before?
6. A client taking clozapine reports fever and a sore throat. What should the nurse instruct the client to do?
A. Take acetaminophen and continue the medication.
B. Skip one dose and restart tomorrow.
C. Contact the prescriber immediately for blood evaluation.
D. Increase oral fluids for 24 hours.
Original HESI-style resource | ACI 2026 preparation Page 3
, 7. Which finding in a client taking lithium requires immediate action?
A. Mild thirst
B. Fine hand tremor
C. Coarse tremor with vomiting and ataxia
D. Increased urination
8. Which teaching is most important for a client taking lithium?
A. Follow a low-sodium diet.
B. Maintain consistent sodium and fluid intake.
C. Avoid all physical activity.
D. Take ibuprofen daily for headaches.
9. A client taking phenelzine selects lunch. Which choice requires intervention?
A. Grilled chicken with rice
B. Fresh apple and yogurt
C. Aged cheese and cured sausage
D. Baked fish and green beans
10. A client recently started sertraline. Which statement indicates correct understanding?
A. I should stop it as soon as I feel better.
B. It may take several weeks before I notice full benefit.
C. I can combine it with St. John's wort.
D. It will relieve severe anxiety immediately.
11. Which assessment finding suggests serotonin syndrome?
A. Bradycardia, hypothermia, and constipation
B. Agitation, diaphoresis, hyperreflexia, and fever
C. Flat affect and social withdrawal
D. Jaundice and clay-colored stools
12. A client taking haloperidol develops neck stiffness and upward deviation of the eyes. Which action is
expected?
A. Administer benztropine or diphenhydramine as prescribed.
B. Encourage ambulation.
C. Give the next haloperidol dose early.
D. Restrict oral fluids.
Original HESI-style resource | ACI 2026 preparation Page 4
