HESI Mental Health RN V1–V3 with NGN – Complete Questions and
Answers with Rationales 2026/2027
1. A client says, “I don't see any reason to keep living.” Which response
by the nurse is most appropriate?
A. “You have many reasons to live.”
B. “Are you thinking about killing yourself?”
C. “Try to focus on positive things.”
D. “Your family would be devastated.”
Answer: B
Rationale: Directly asking about suicidal thoughts does not increase
suicide risk and allows the nurse to assess intent and safety.
2. A client experiencing acute mania is pacing rapidly and speaking
continuously. Which intervention is the priority?
A. Encourage participation in group therapy.
B. Provide a quiet, low-stimulation environment.
C. Ask the client to explain the cause of the behavior.
D. Encourage the client to socialize with peers.
Answer: B
Rationale: Reducing environmental stimulation helps decrease
agitation and prevents escalation.
3. A client taking lithium reports diarrhea, coarse hand tremors, and
difficulty walking. What should the nurse do first?
A. Administer the next dose with food.
B. Encourage increased caffeine intake.
C. Hold the medication and notify the provider.
D. Reassure the client that these effects are expected.
,Answer: C
Rationale: Gastrointestinal symptoms, coarse tremor, and ataxia may
indicate lithium toxicity and require prompt intervention.
4. Which statement demonstrates therapeutic communication?
A. “Everything will work out.”
B. “Why do you think you feel this way?”
C. “Tell me more about what you experienced.”
D. “You shouldn't worry about that.”
Answer: C
Rationale: An open-ended invitation encourages the client to express
thoughts and feelings.
5. A client with schizophrenia says, “The voices are telling me that I'm
worthless.” Which response is best?
A. “The voices are not real.”
B. “What are the voices telling you to do?”
C. “You should ignore them.”
D. “I don't hear any voices.”
Answer: B
Rationale: The nurse should assess the content of hallucinations,
particularly whether they contain commands to harm the client or
others.
6. A client taking clozapine should be monitored closely for which
adverse effect?
A. Agranulocytosis
,B. Hyperthyroidism
C. Cataracts
D. Hearing loss
Answer: A
Rationale: Clozapine can cause severe neutropenia/agranulocytosis,
requiring blood count monitoring.
7. A client with severe alcohol withdrawal becomes disoriented,
tremulous, febrile, and hypertensive. Which condition should the nurse
suspect?
A. Opioid intoxication
B. Delirium tremens
C. Major depression
D. Neuroleptic malignant syndrome
Answer: B
Rationale: Severe alcohol withdrawal can progress to delirium tremens,
characterized by autonomic instability, confusion, agitation, and
sometimes hallucinations.
8. Which finding is most concerning in a client prescribed an
antipsychotic?
A. Mild dry mouth
B. Increased appetite
C. High fever and severe muscle rigidity
D. Mild drowsiness
Answer: C
Rationale: Fever, severe rigidity, and altered mental status may
indicate neuroleptic malignant syndrome, a medical emergency.
, 9. A client experiencing a panic attack reports chest tightness and
severe fear. What is the nurse's priority intervention?
A. Leave the client alone.
B. Encourage detailed discussion of childhood experiences.
C. Remain with the client and use short, calm statements.
D. Ask the client to participate in group therapy.
Answer: C
Rationale: During severe anxiety, the nurse should remain with the
client and provide simple, reassuring communication.
10. Which behavior is characteristic of obsessive-compulsive disorder?
A. Persistent elevated mood
B. Recurrent intrusive thoughts followed by repetitive behaviors
C. Alternating periods of amnesia
D. Persistent disregard for others' rights
Answer: B
Rationale: OCD involves obsessions, compulsions, or both that cause
distress or impairment.
11. A client with anorexia nervosa has a potassium level of 2.7 mEq/L.
Which action is priority?
A. Encourage exercise.
B. Initiate cardiac monitoring as prescribed.
C. Restrict fluids.
D. Encourage the client to skip meals.
Answers with Rationales 2026/2027
1. A client says, “I don't see any reason to keep living.” Which response
by the nurse is most appropriate?
A. “You have many reasons to live.”
B. “Are you thinking about killing yourself?”
C. “Try to focus on positive things.”
D. “Your family would be devastated.”
Answer: B
Rationale: Directly asking about suicidal thoughts does not increase
suicide risk and allows the nurse to assess intent and safety.
2. A client experiencing acute mania is pacing rapidly and speaking
continuously. Which intervention is the priority?
A. Encourage participation in group therapy.
B. Provide a quiet, low-stimulation environment.
C. Ask the client to explain the cause of the behavior.
D. Encourage the client to socialize with peers.
Answer: B
Rationale: Reducing environmental stimulation helps decrease
agitation and prevents escalation.
3. A client taking lithium reports diarrhea, coarse hand tremors, and
difficulty walking. What should the nurse do first?
A. Administer the next dose with food.
B. Encourage increased caffeine intake.
C. Hold the medication and notify the provider.
D. Reassure the client that these effects are expected.
,Answer: C
Rationale: Gastrointestinal symptoms, coarse tremor, and ataxia may
indicate lithium toxicity and require prompt intervention.
4. Which statement demonstrates therapeutic communication?
A. “Everything will work out.”
B. “Why do you think you feel this way?”
C. “Tell me more about what you experienced.”
D. “You shouldn't worry about that.”
Answer: C
Rationale: An open-ended invitation encourages the client to express
thoughts and feelings.
5. A client with schizophrenia says, “The voices are telling me that I'm
worthless.” Which response is best?
A. “The voices are not real.”
B. “What are the voices telling you to do?”
C. “You should ignore them.”
D. “I don't hear any voices.”
Answer: B
Rationale: The nurse should assess the content of hallucinations,
particularly whether they contain commands to harm the client or
others.
6. A client taking clozapine should be monitored closely for which
adverse effect?
A. Agranulocytosis
,B. Hyperthyroidism
C. Cataracts
D. Hearing loss
Answer: A
Rationale: Clozapine can cause severe neutropenia/agranulocytosis,
requiring blood count monitoring.
7. A client with severe alcohol withdrawal becomes disoriented,
tremulous, febrile, and hypertensive. Which condition should the nurse
suspect?
A. Opioid intoxication
B. Delirium tremens
C. Major depression
D. Neuroleptic malignant syndrome
Answer: B
Rationale: Severe alcohol withdrawal can progress to delirium tremens,
characterized by autonomic instability, confusion, agitation, and
sometimes hallucinations.
8. Which finding is most concerning in a client prescribed an
antipsychotic?
A. Mild dry mouth
B. Increased appetite
C. High fever and severe muscle rigidity
D. Mild drowsiness
Answer: C
Rationale: Fever, severe rigidity, and altered mental status may
indicate neuroleptic malignant syndrome, a medical emergency.
, 9. A client experiencing a panic attack reports chest tightness and
severe fear. What is the nurse's priority intervention?
A. Leave the client alone.
B. Encourage detailed discussion of childhood experiences.
C. Remain with the client and use short, calm statements.
D. Ask the client to participate in group therapy.
Answer: C
Rationale: During severe anxiety, the nurse should remain with the
client and provide simple, reassuring communication.
10. Which behavior is characteristic of obsessive-compulsive disorder?
A. Persistent elevated mood
B. Recurrent intrusive thoughts followed by repetitive behaviors
C. Alternating periods of amnesia
D. Persistent disregard for others' rights
Answer: B
Rationale: OCD involves obsessions, compulsions, or both that cause
distress or impairment.
11. A client with anorexia nervosa has a potassium level of 2.7 mEq/L.
Which action is priority?
A. Encourage exercise.
B. Initiate cardiac monitoring as prescribed.
C. Restrict fluids.
D. Encourage the client to skip meals.
