HESI Mental Health RN V1–V3 – Complete Questions and
Answers with Rationales 2026/2027
1. A client with major depressive disorder says, “My family would be
better off without me.” Which response by the nurse is the priority?
A. “Your family needs you.”
B. “Why do you feel that way?”
C. “Are you thinking about killing yourself?”
D. “Things will improve with treatment.”
Answer: C
Rationale: Directly asking about suicide does not increase suicidal
behavior and is essential for determining immediate risk. The nurse
should assess intent, plan, means, and access to lethal methods.
2. A client experiencing auditory hallucinations says, “The voices are
telling me I am worthless.” Which response is most therapeutic?
A. “The voices aren't real.”
B. “What are the voices telling you to do?”
C. “You need to ignore the voices.”
D. “I don't hear any voices.”
Answer: B
Rationale: The nurse should assess the content of hallucinations,
particularly whether they are command hallucinations directing the
client to harm self or others.
3. A client taking lithium reports severe diarrhea, vomiting, coarse
tremors, and difficulty walking. What should the nurse do first?
A. Administer the next dose with food.
,B. Encourage increased sodium restriction.
C. Hold lithium and notify the provider.
D. Reassure the client that these are expected effects.
Answer: C
Rationale: Severe gastrointestinal symptoms, coarse tremor, and ataxia
suggest lithium toxicity. Lithium should be withheld and the provider
notified promptly.
4. Which finding requires immediate intervention in a client taking an
antipsychotic medication?
A. Mild dry mouth
B. Increased appetite
C. Severe muscle rigidity and fever
D. Mild daytime drowsiness
Answer: C
Rationale: Severe rigidity, hyperthermia, altered mental status, and
autonomic instability may indicate neuroleptic malignant syndrome
(NMS), a medical emergency.
5. A client with panic disorder is experiencing an acute panic attack.
Which nursing intervention is appropriate?
A. Leave the client alone to decrease stimulation.
B. Encourage the client to discuss childhood experiences.
C. Remain with the client and use short, calm statements.
D. Challenge the client's fears.
Answer: C
,Rationale: During acute panic, the client's ability to process information
is reduced. Remaining present and communicating calmly provides
safety and decreases stimulation.
6. Which statement by a client taking an SSRI indicates a need for
further teaching?
A. “I may need several weeks before I feel the full benefit.”
B. “I should not stop the medication suddenly.”
C. “I can double my dose if I miss one.”
D. “I should report unusual agitation or suicidal thoughts.”
Answer: C
Rationale: Clients should never double an antidepressant dose after a
missed dose unless specifically instructed. SSRIs may require several
weeks for full therapeutic effects.
7. A client with schizophrenia says, “The FBI implanted a transmitter in
my tooth.” Which response is best?
A. “That's impossible.”
B. “I understand why you believe that.”
C. “I don't believe there is a transmitter in your tooth.”
D. “Who implanted the transmitter?”
Answer: C
Rationale: The nurse should acknowledge the client's experience
without validating the delusion. Presenting reality in a calm manner is
therapeutic.
, 8. A client receiving clozapine should be monitored closely for which
adverse effect?
A. Agranulocytosis
B. Hypercalcemia
C. Cataracts
D. Hearing loss
Answer: A
Rationale: Clozapine can cause severe neutropenia/agranulocytosis.
Appropriate blood-count monitoring is required.
9. Which client should the psychiatric nurse assess first?
A. A client with anxiety requesting medication
B. A client with depression who has stopped eating
C. A client with schizophrenia reporting voices commanding self-harm
D. A client with insomnia requesting a quiet room
Answer: C
Rationale: Command hallucinations involving self-harm create an
immediate safety risk and require priority assessment and intervention.
10. A client says, “I don't want to talk about my divorce.” Which
response demonstrates therapeutic communication?
A. “You need to talk about it eventually.”
B. “Why don't you want to discuss it?”
C. “We can talk about something else if you'd prefer.”
D. “Your divorce is probably causing your depression.”
Answer: C
Answers with Rationales 2026/2027
1. A client with major depressive disorder says, “My family would be
better off without me.” Which response by the nurse is the priority?
A. “Your family needs you.”
B. “Why do you feel that way?”
C. “Are you thinking about killing yourself?”
D. “Things will improve with treatment.”
Answer: C
Rationale: Directly asking about suicide does not increase suicidal
behavior and is essential for determining immediate risk. The nurse
should assess intent, plan, means, and access to lethal methods.
2. A client experiencing auditory hallucinations says, “The voices are
telling me I am worthless.” Which response is most therapeutic?
A. “The voices aren't real.”
B. “What are the voices telling you to do?”
C. “You need to ignore the voices.”
D. “I don't hear any voices.”
Answer: B
Rationale: The nurse should assess the content of hallucinations,
particularly whether they are command hallucinations directing the
client to harm self or others.
3. A client taking lithium reports severe diarrhea, vomiting, coarse
tremors, and difficulty walking. What should the nurse do first?
A. Administer the next dose with food.
,B. Encourage increased sodium restriction.
C. Hold lithium and notify the provider.
D. Reassure the client that these are expected effects.
Answer: C
Rationale: Severe gastrointestinal symptoms, coarse tremor, and ataxia
suggest lithium toxicity. Lithium should be withheld and the provider
notified promptly.
4. Which finding requires immediate intervention in a client taking an
antipsychotic medication?
A. Mild dry mouth
B. Increased appetite
C. Severe muscle rigidity and fever
D. Mild daytime drowsiness
Answer: C
Rationale: Severe rigidity, hyperthermia, altered mental status, and
autonomic instability may indicate neuroleptic malignant syndrome
(NMS), a medical emergency.
5. A client with panic disorder is experiencing an acute panic attack.
Which nursing intervention is appropriate?
A. Leave the client alone to decrease stimulation.
B. Encourage the client to discuss childhood experiences.
C. Remain with the client and use short, calm statements.
D. Challenge the client's fears.
Answer: C
,Rationale: During acute panic, the client's ability to process information
is reduced. Remaining present and communicating calmly provides
safety and decreases stimulation.
6. Which statement by a client taking an SSRI indicates a need for
further teaching?
A. “I may need several weeks before I feel the full benefit.”
B. “I should not stop the medication suddenly.”
C. “I can double my dose if I miss one.”
D. “I should report unusual agitation or suicidal thoughts.”
Answer: C
Rationale: Clients should never double an antidepressant dose after a
missed dose unless specifically instructed. SSRIs may require several
weeks for full therapeutic effects.
7. A client with schizophrenia says, “The FBI implanted a transmitter in
my tooth.” Which response is best?
A. “That's impossible.”
B. “I understand why you believe that.”
C. “I don't believe there is a transmitter in your tooth.”
D. “Who implanted the transmitter?”
Answer: C
Rationale: The nurse should acknowledge the client's experience
without validating the delusion. Presenting reality in a calm manner is
therapeutic.
, 8. A client receiving clozapine should be monitored closely for which
adverse effect?
A. Agranulocytosis
B. Hypercalcemia
C. Cataracts
D. Hearing loss
Answer: A
Rationale: Clozapine can cause severe neutropenia/agranulocytosis.
Appropriate blood-count monitoring is required.
9. Which client should the psychiatric nurse assess first?
A. A client with anxiety requesting medication
B. A client with depression who has stopped eating
C. A client with schizophrenia reporting voices commanding self-harm
D. A client with insomnia requesting a quiet room
Answer: C
Rationale: Command hallucinations involving self-harm create an
immediate safety risk and require priority assessment and intervention.
10. A client says, “I don't want to talk about my divorce.” Which
response demonstrates therapeutic communication?
A. “You need to talk about it eventually.”
B. “Why don't you want to discuss it?”
C. “We can talk about something else if you'd prefer.”
D. “Your divorce is probably causing your depression.”
Answer: C
