HESI Psychiatric Mental Health Nursing
2026/2027
100 Comprehensive Practice Questions & Detailed Rationales
1. A client with schizophrenia is experiencing auditory hallucinations and tells the
nurse, 'The voices are telling me to hurt myself.' What is the nurse's priority
action?
A. Tell the client the voices aren't real.
B. Place the client on one-to-one suicide precautions.
C. Administer an as-needed (PRN) antipsychotic.
D. Encourage the client to listen to music to drown out the voices.
Correct Answer: B
Rationale: Safety is the priority. Command hallucinations that involve self-harm require
immediate, constant supervision to ensure client safety.
2. A client is admitted to the psychiatric unit with a diagnosis of Major Depressive
Disorder. Which statement by the client requires immediate intervention?
A. 'I don't have the energy to get out of bed today.'
B. 'I've finally found a solution to all my problems.'
C. 'I don't feel like eating anything right now.'
D. 'I feel so guilty about things I did years ago.'
Correct Answer: B
Rationale: A sudden improvement in mood or a statement about 'finding a solution' often
indicates that a client has made a definitive plan for suicide and feels relief.
,3. A nurse is caring for a client with Bipolar Disorder in the manic phase. Which
meal choice is most appropriate?
A. Spaghetti and meatballs with a side salad
B. Beef and vegetable stew with a roll
C. Chicken fingers and a banana
D. Soup and a sandwich
Correct Answer: C
Rationale: Clients in a manic state are hyperactive and often unable to sit down for a full
meal. 'Finger foods' allow them to eat on the move and maintain caloric intake.
4. The nurse is preparing to administer Lithium Carbonate to a client. Which lab
value should the nurse check before administration?
A. Blood Glucose
B. Serum Creatinine
C. Hemoglobin A1C
D. Liver Enzymes
Correct Answer: B
Rationale: Lithium is excreted by the kidneys. Impaired renal function can lead to lithium
toxicity; therefore, creatinine and BUN must be monitored.
5. A client with obsessive-compulsive disorder (OCD) is late for group therapy
because they are ritualistically arranging their shoes. What is the nurse's best
response?
A. 'You must stop that immediately and come to group.'
B. 'I will wait for you to finish and then we will go together.'
C. 'Why do you feel the need to do that every morning?'
D. 'If you don't come now, you will lose your phone privileges.'
Correct Answer: B
Rationale: Rituals are a mechanism to manage anxiety. Stopping a ritual abruptly can cause
panic. In early treatment, the nurse should allow time for the ritual while gradually
implementing a schedule.
,6. Which defense mechanism is a client using when they yell at their spouse
because they are angry with their boss?
A. Denial
B. Displacement
C. Projection
D. Rationalization
Correct Answer: B
Rationale: Displacement involves transferring emotions from the original source of stress to a
less threatening target.
7. A client is experiencing Alcohol Withdrawal Delirium. Which medication should
the nurse anticipate administering?
A. Disulfiram
B. Methadone
C. Lorazepam
D. Naloxone
Correct Answer: C
Rationale: Benzodiazepines like Lorazepam are the gold standard for managing alcohol
withdrawal symptoms and preventing seizures/delirium tremens.
8. A client with Anorexia Nervosa has a BMI of 15 and is being admitted. What is
the priority nursing diagnosis?
A. Disturbed Body Image
B. Imbalanced Nutrition: Less than body requirements
C. Chronic Low Self-Esteem
D. Ineffective Coping
Correct Answer: B
Rationale: Physiological needs (nutrition) take priority over psychosocial needs in an acutely
ill client with a dangerously low BMI.
, 9. A nurse is teaching a client about a new prescription for Phenelzine (an MAOI).
Which food choice indicates a need for further teaching?
A. Grilled chicken and broccoli
B. Fresh apples and grapes
C. Pepperoni pizza and aged cheese
D. Scrambled eggs and toast
Correct Answer: C
Rationale: MAOIs interact with tyramine-rich foods (aged cheese, cured meats, wine),
potentially causing a hypertensive crisis.
10. A client with Post-Traumatic Stress Disorder (PTSD) is experiencing a
flashback. What is the nurse's priority action?
A. Touch the client to ground them.
B. Ask the client to describe the trauma in detail.
C. Remain with the client and offer reassurance of safety.
D. Leave the room to give the client privacy.
Correct Answer: C
Rationale: During a flashback, the client is reliving the trauma. The nurse must stay with the
client to provide safety and 'ground' them using calm, verbal cues. Do not touch without
permission.
11. Psychiatric Nursing Q11: Signs of Opioid Withdrawal?
A. Rhinorrhea / Dilated pupils / Yawning
B. Constricted pupils
C. Standard monitoring
D. Physician referral
Correct Answer: A
Rationale: Feels like a severe case of the flu.
2026/2027
100 Comprehensive Practice Questions & Detailed Rationales
1. A client with schizophrenia is experiencing auditory hallucinations and tells the
nurse, 'The voices are telling me to hurt myself.' What is the nurse's priority
action?
A. Tell the client the voices aren't real.
B. Place the client on one-to-one suicide precautions.
C. Administer an as-needed (PRN) antipsychotic.
D. Encourage the client to listen to music to drown out the voices.
Correct Answer: B
Rationale: Safety is the priority. Command hallucinations that involve self-harm require
immediate, constant supervision to ensure client safety.
2. A client is admitted to the psychiatric unit with a diagnosis of Major Depressive
Disorder. Which statement by the client requires immediate intervention?
A. 'I don't have the energy to get out of bed today.'
B. 'I've finally found a solution to all my problems.'
C. 'I don't feel like eating anything right now.'
D. 'I feel so guilty about things I did years ago.'
Correct Answer: B
Rationale: A sudden improvement in mood or a statement about 'finding a solution' often
indicates that a client has made a definitive plan for suicide and feels relief.
,3. A nurse is caring for a client with Bipolar Disorder in the manic phase. Which
meal choice is most appropriate?
A. Spaghetti and meatballs with a side salad
B. Beef and vegetable stew with a roll
C. Chicken fingers and a banana
D. Soup and a sandwich
Correct Answer: C
Rationale: Clients in a manic state are hyperactive and often unable to sit down for a full
meal. 'Finger foods' allow them to eat on the move and maintain caloric intake.
4. The nurse is preparing to administer Lithium Carbonate to a client. Which lab
value should the nurse check before administration?
A. Blood Glucose
B. Serum Creatinine
C. Hemoglobin A1C
D. Liver Enzymes
Correct Answer: B
Rationale: Lithium is excreted by the kidneys. Impaired renal function can lead to lithium
toxicity; therefore, creatinine and BUN must be monitored.
5. A client with obsessive-compulsive disorder (OCD) is late for group therapy
because they are ritualistically arranging their shoes. What is the nurse's best
response?
A. 'You must stop that immediately and come to group.'
B. 'I will wait for you to finish and then we will go together.'
C. 'Why do you feel the need to do that every morning?'
D. 'If you don't come now, you will lose your phone privileges.'
Correct Answer: B
Rationale: Rituals are a mechanism to manage anxiety. Stopping a ritual abruptly can cause
panic. In early treatment, the nurse should allow time for the ritual while gradually
implementing a schedule.
,6. Which defense mechanism is a client using when they yell at their spouse
because they are angry with their boss?
A. Denial
B. Displacement
C. Projection
D. Rationalization
Correct Answer: B
Rationale: Displacement involves transferring emotions from the original source of stress to a
less threatening target.
7. A client is experiencing Alcohol Withdrawal Delirium. Which medication should
the nurse anticipate administering?
A. Disulfiram
B. Methadone
C. Lorazepam
D. Naloxone
Correct Answer: C
Rationale: Benzodiazepines like Lorazepam are the gold standard for managing alcohol
withdrawal symptoms and preventing seizures/delirium tremens.
8. A client with Anorexia Nervosa has a BMI of 15 and is being admitted. What is
the priority nursing diagnosis?
A. Disturbed Body Image
B. Imbalanced Nutrition: Less than body requirements
C. Chronic Low Self-Esteem
D. Ineffective Coping
Correct Answer: B
Rationale: Physiological needs (nutrition) take priority over psychosocial needs in an acutely
ill client with a dangerously low BMI.
, 9. A nurse is teaching a client about a new prescription for Phenelzine (an MAOI).
Which food choice indicates a need for further teaching?
A. Grilled chicken and broccoli
B. Fresh apples and grapes
C. Pepperoni pizza and aged cheese
D. Scrambled eggs and toast
Correct Answer: C
Rationale: MAOIs interact with tyramine-rich foods (aged cheese, cured meats, wine),
potentially causing a hypertensive crisis.
10. A client with Post-Traumatic Stress Disorder (PTSD) is experiencing a
flashback. What is the nurse's priority action?
A. Touch the client to ground them.
B. Ask the client to describe the trauma in detail.
C. Remain with the client and offer reassurance of safety.
D. Leave the room to give the client privacy.
Correct Answer: C
Rationale: During a flashback, the client is reliving the trauma. The nurse must stay with the
client to provide safety and 'ground' them using calm, verbal cues. Do not touch without
permission.
11. Psychiatric Nursing Q11: Signs of Opioid Withdrawal?
A. Rhinorrhea / Dilated pupils / Yawning
B. Constricted pupils
C. Standard monitoring
D. Physician referral
Correct Answer: A
Rationale: Feels like a severe case of the flu.
