HESI Mental Health RN Exit Exam with NGN – Complete Questions and
Answers with Rationales 2026/2027
1. A client with major depressive disorder says, “My family would be
better off without me.” What is the nurse’s priority response?
A. “Your family needs you.”
B. “Are you thinking about killing yourself?”
C. “Why do you feel that way?”
D. “Try to think about positive things.”
Answer: B
Rationale: Directly assessing suicidal thoughts is therapeutic and helps
determine immediate safety needs. Asking about suicide does not
cause suicidal behavior.
2. A client experiencing a panic attack is pacing rapidly and
hyperventilating. Which intervention is best initially?
A. Leave the client alone to decrease stimulation.
B. Encourage detailed discussion of the trigger.
C. Stay with the client and use short, simple statements.
D. Ask the client to participate in group therapy.
Answer: C
Rationale: During severe anxiety or panic, concentration and
information processing are impaired. Remaining with the client and
providing simple directions promotes safety and decreases stimulation.
3. A client taking lithium reports diarrhea, vomiting, coarse tremors,
and difficulty walking. What should the nurse do?
A. Administer the next dose with food.
B. Encourage increased exercise.
,C. Hold lithium and notify the provider.
D. Reassure the client that these effects are expected.
Answer: C
Rationale: Gastrointestinal symptoms, coarse tremor, and ataxia can
indicate lithium toxicity. The medication should be withheld and the
provider notified promptly.
4. Which finding in a client taking clozapine requires immediate follow-
up?
A. Mild drowsiness
B. Increased appetite
C. Sore throat and fever
D. Dry mouth
Answer: C
Rationale: Clozapine can cause severe neutropenia/agranulocytosis.
Fever and sore throat may indicate infection associated with a
dangerously low white blood cell count.
5. A client says, “The voices are telling me that I am worthless.” Which
response is most therapeutic?
A. “The voices aren't real.”
B. “I don't hear the voices, but I understand that you hear them.”
C. “You should ignore them.”
D. “What did you do to make them angry?”
Answer: B
Rationale: The nurse acknowledges the client’s experience without
validating the hallucination as reality.
,6. A client with schizophrenia suddenly becomes agitated and begins
shouting. What should the nurse do first?
A. Challenge the client's behavior.
B. Ask several questions about the hallucinations.
C. Reduce environmental stimulation and maintain a safe distance.
D. Immediately place the client in restraints.
Answer: C
Rationale: Early de-escalation includes reducing stimulation,
maintaining personal space, using calm communication, and assessing
safety.
7. Which statement by a client taking an SSRI indicates a need for
further teaching?
A. “I may not notice improvement immediately.”
B. “I should not stop the medication suddenly.”
C. “I will call if I develop suicidal thoughts.”
D. “I can take extra doses when I feel especially depressed.”
Answer: D
Rationale: Antidepressants should be taken exactly as prescribed.
Taking extra doses increases the risk of adverse effects and overdose.
8. A client with anorexia nervosa has a heart rate of 42/min. What is
the nurse’s priority?
A. Encourage journaling.
B. Assess cardiovascular status and notify the provider.
C. Discuss body-image concerns.
D. Offer a low-calorie snack.
, Answer: B
Rationale: Severe bradycardia can occur with malnutrition and may
indicate cardiovascular instability requiring urgent evaluation.
9. Which client should the psychiatric nurse assess first?
A. A client with generalized anxiety requesting medication
B. A client with depression who reports sleeping 10 hours nightly
C. A client with schizophrenia who says, “I have a plan to hurt my
roommate.”
D. A client with OCD who reports frequent handwashing
Answer: C
Rationale: A specific plan to harm another person represents an
immediate safety concern and requires priority assessment and
intervention.
10. A client experiencing alcohol withdrawal develops severe tremors,
confusion, fever, and visual hallucinations. The nurse recognizes these
findings as most consistent with:
A. Wernicke encephalopathy
B. Delirium tremens
C. Alcohol intoxication
D. Korsakoff syndrome
Answer: B
Rationale: Delirium tremens is a severe alcohol-withdrawal syndrome
characterized by autonomic hyperactivity, confusion, agitation,
hallucinations, and potentially life-threatening complications.
Answers with Rationales 2026/2027
1. A client with major depressive disorder says, “My family would be
better off without me.” What is the nurse’s priority response?
A. “Your family needs you.”
B. “Are you thinking about killing yourself?”
C. “Why do you feel that way?”
D. “Try to think about positive things.”
Answer: B
Rationale: Directly assessing suicidal thoughts is therapeutic and helps
determine immediate safety needs. Asking about suicide does not
cause suicidal behavior.
2. A client experiencing a panic attack is pacing rapidly and
hyperventilating. Which intervention is best initially?
A. Leave the client alone to decrease stimulation.
B. Encourage detailed discussion of the trigger.
C. Stay with the client and use short, simple statements.
D. Ask the client to participate in group therapy.
Answer: C
Rationale: During severe anxiety or panic, concentration and
information processing are impaired. Remaining with the client and
providing simple directions promotes safety and decreases stimulation.
3. A client taking lithium reports diarrhea, vomiting, coarse tremors,
and difficulty walking. What should the nurse do?
A. Administer the next dose with food.
B. Encourage increased exercise.
,C. Hold lithium and notify the provider.
D. Reassure the client that these effects are expected.
Answer: C
Rationale: Gastrointestinal symptoms, coarse tremor, and ataxia can
indicate lithium toxicity. The medication should be withheld and the
provider notified promptly.
4. Which finding in a client taking clozapine requires immediate follow-
up?
A. Mild drowsiness
B. Increased appetite
C. Sore throat and fever
D. Dry mouth
Answer: C
Rationale: Clozapine can cause severe neutropenia/agranulocytosis.
Fever and sore throat may indicate infection associated with a
dangerously low white blood cell count.
5. A client says, “The voices are telling me that I am worthless.” Which
response is most therapeutic?
A. “The voices aren't real.”
B. “I don't hear the voices, but I understand that you hear them.”
C. “You should ignore them.”
D. “What did you do to make them angry?”
Answer: B
Rationale: The nurse acknowledges the client’s experience without
validating the hallucination as reality.
,6. A client with schizophrenia suddenly becomes agitated and begins
shouting. What should the nurse do first?
A. Challenge the client's behavior.
B. Ask several questions about the hallucinations.
C. Reduce environmental stimulation and maintain a safe distance.
D. Immediately place the client in restraints.
Answer: C
Rationale: Early de-escalation includes reducing stimulation,
maintaining personal space, using calm communication, and assessing
safety.
7. Which statement by a client taking an SSRI indicates a need for
further teaching?
A. “I may not notice improvement immediately.”
B. “I should not stop the medication suddenly.”
C. “I will call if I develop suicidal thoughts.”
D. “I can take extra doses when I feel especially depressed.”
Answer: D
Rationale: Antidepressants should be taken exactly as prescribed.
Taking extra doses increases the risk of adverse effects and overdose.
8. A client with anorexia nervosa has a heart rate of 42/min. What is
the nurse’s priority?
A. Encourage journaling.
B. Assess cardiovascular status and notify the provider.
C. Discuss body-image concerns.
D. Offer a low-calorie snack.
, Answer: B
Rationale: Severe bradycardia can occur with malnutrition and may
indicate cardiovascular instability requiring urgent evaluation.
9. Which client should the psychiatric nurse assess first?
A. A client with generalized anxiety requesting medication
B. A client with depression who reports sleeping 10 hours nightly
C. A client with schizophrenia who says, “I have a plan to hurt my
roommate.”
D. A client with OCD who reports frequent handwashing
Answer: C
Rationale: A specific plan to harm another person represents an
immediate safety concern and requires priority assessment and
intervention.
10. A client experiencing alcohol withdrawal develops severe tremors,
confusion, fever, and visual hallucinations. The nurse recognizes these
findings as most consistent with:
A. Wernicke encephalopathy
B. Delirium tremens
C. Alcohol intoxication
D. Korsakoff syndrome
Answer: B
Rationale: Delirium tremens is a severe alcohol-withdrawal syndrome
characterized by autonomic hyperactivity, confusion, agitation,
hallucinations, and potentially life-threatening complications.
