HESI PSYCHIATRIC/MENTAL HEALTH PRACTICE EXAM
2025 UPDATED
At the first meeting of a group of older adults at a daycare center for the elderly, the nurse asks one of
the members what kinds of things she would like to do with the group. The older woman shrugs her
shoulders and says, "You tell me, you're the leader." What is the best response for the nurse to make?
- "Yes, I am the leader today. Would you like to be the leader tomorrow?"
- "Yes, I will be leading this group. What would you like to accomplish during this time?"
- "Yes, I have been assigned to be the leader of this group. I will be here for the next six weeks."
- "Yes, I am the leader. You seem angry about not being the leader yourself." - ANSWER - "Yes, I will be
leading this group. What would you like to accomplish during this time?"
Anxiety over participation in a group and testing of the leader characteristically occur in the initial phase
of group dynamics. (B) provides information and focuses the group back to defining its function. (A) is
manipulative bargaining. Although (C) provides information, it does not focus the group on its purpose
or task. (D) is interpreting the client's feelings and is almost challenging.
Over a period of several weeks, one male participant of a socialization group at a community day care
center for the elderly monopolizes most of the group's time and interrupts others when they are talking.
What is the best action for the nurse to take in this situation?
- Talk to the client outside the group about his behavior during group meetings.
- Remind the client to allow others in the group a chance to talk.
- Allow the group to handle the problem.
- Ask the client to join another group. - ANSWER - Allow the group to handle the problem.
,After several weeks, the group is in the working phase and the group members should be allowed to
determine the direction of the group. The nurse should ignore the client's comments and allow the
group to handle the situation (C). A good leader should not have separate meetings with group
members (A), as such behavior is manipulative on the part of the leader. (B) is dictatorial and is not in
keeping with good leadership skills. (D) is avoiding the problem. Remember, identify what phase the
group is in--initial, working, or termination--this will help determine communication style.
An 86-year-old female client with Alzheimer's disease is wandering the busy halls of the extended care
facility and asks the nurse, "Where should I stand for the parade?" Which response is best for the nurse
to provide?
- "Anywhere you want to stand as long as you do not get hurt by those in the parade."
- "You are confused because of all the activity in the hall. There is no parade."
- "Let's go back to the activity room and see what is going on in there."
- "Remember I told you that this is a nursing home and I am your nurse." - ANSWER - "Let's go back to
the activity room and see what is going on in there."
It is common for those with Alzheimer's disease to use the wrong words. Redirecting the client (using an
accepting non-judgmental dialogue) to a safer place and familiar activities (C) is most helpful because
clients experience short-term memory loss. (A) dismisses the client's attempt to find order and does not
help her relate to her surroundings. (B) dismisses the client and may increase her anxiety level because
it merely labels the client's behavior and offers no solution. It is very frustrating for those with
Alzheimer's disease to "remember," and scolding them (D) may hurt their feelings.
Physical examination of a 6-year-old reveals several bite marks in various locations on his body. X-ray
examination reveals healed fractures of the ribs. The mother tells the nurse that her child is always
having accidents. Which initial response by the nurse is most appropriate?
- "I need to inform the healthcare provider about your child's tendency to be accident prone."
- "Tell me more specifically about your child's accidents."
- "I must report these injuries to the authorities because they do not seem accidental."
,- "Boys this age always seem to require more supervision and can be quite accident prone." - ANSWER -
"Tell me more specifically about your child's accidents."
(B) seeks more information using an open ended, non-threatening statement. (A) could be appropriate,
but it is not the best answer because the nurse is being somewhat sarcastic and is also avoiding the
situation by referring it to the healthcare provider for resolution. Although it is true that suspected cases
of child abuse must be reported, (C) is virtually an attack and is jumping to conclusions before conclusive
data has been obtained. (D) is a clich and dismisses the seriousness of the situation.
A child is brought to the emergency room with a broken arm. Because of other injuries, the nurse
suspects the child may be a victim of abuse. When the nurse tries to give the child an injection, the
child's mother becomes very loud and shouts, "I won't leave my son! Don't you touch him! You'll hurt
my child!" What is the best interpretation of the mother's statements? The mother is
- regressing to an earlier behavior pattern.
- sublimating her anger.
- projecting her feelings onto the nurse.
- suppressing her fear. - ANSWER - projecting her feelings onto the nurse.
Projection is attributing one's own thoughts, impulses, or behaviors onto another--it is the mother who
is probably harming the child and she is attributing her actions to the nurse (C). The mother may be
immature, but (A) is not the best description of her behavior. (B) is substituting a socially acceptable
feeling for an unacceptable one. These are not socially acceptable feelings. The mother may be
suppressing her fear (D) by displaying anger, but such an interpretation cannot be concluded from the
data presented.
A 38-year-old female client is admitted with a diagnosis of paranoid schizophrenia. When her tray is
brought to her, she refuses to eat and tells the nurse, "I know you are trying to poison me with that
food." Which response would be most appropriate for the nurse to make?
- "I'll leave your tray here. I am available if you need anything else."
, - "You're not being poisoned. Why do you think someone is trying to poison you?"
- "No one on this unit has ever died from poisoning. You're safe here."
- "I will talk to your healthcare provider about the possibility of changing your diet." - ANSWER - "I'll
leave your tray here. I am available if you need anything else."
(A) is the best choice cited. The nurse does not argue with the client nor demand that she eat, but offers
support by agreeing to "be there if needed", e. g., to warm the food. (B and C) are arguing with the
client's delusions, and (B) asks "why" which is usually not a good question for a psychotic client. (D) has
nothing to do with the actual problem; i. e., the problem is not the diet (she thinks any food given to her
is poisoned).
A 25-year-old female client has been particularly restless and the nurse finds her trying to leave the
psychiatric unit. She tells the nurse, "Please let me go! I must leave because the secret police are after
me." Which response is best for the nurse to make?
- "No one is after you, you're safe here."
- "You'll feel better after you have rested."
- "I know you must feel lonely and frightened."
- "Come with me to your room and I will sit with you." - ANSWER - "Come with me to your room and I
will sit with you."
(D) is the best response because it offers support without judgment or demands. (A) is arguing with the
client's delusion. (B) is offering false reassurance. (C) is a violation of therapeutic communication in that
the nurse is telling the client how she feels (frightened and lonely), rather than allowing the client to
describe her own feelings. Hallucinating and/or delusional clients are not capable of discussing their
feelings, particularly when they perceive a crisis.
A 45-year-old male client tells the nurse that he used to believe that he was Jesus Christ, but now he
knows he is not. Which response is best for the nurse to make?
- "Did you really believe you were Jesus Christ?"
2025 UPDATED
At the first meeting of a group of older adults at a daycare center for the elderly, the nurse asks one of
the members what kinds of things she would like to do with the group. The older woman shrugs her
shoulders and says, "You tell me, you're the leader." What is the best response for the nurse to make?
- "Yes, I am the leader today. Would you like to be the leader tomorrow?"
- "Yes, I will be leading this group. What would you like to accomplish during this time?"
- "Yes, I have been assigned to be the leader of this group. I will be here for the next six weeks."
- "Yes, I am the leader. You seem angry about not being the leader yourself." - ANSWER - "Yes, I will be
leading this group. What would you like to accomplish during this time?"
Anxiety over participation in a group and testing of the leader characteristically occur in the initial phase
of group dynamics. (B) provides information and focuses the group back to defining its function. (A) is
manipulative bargaining. Although (C) provides information, it does not focus the group on its purpose
or task. (D) is interpreting the client's feelings and is almost challenging.
Over a period of several weeks, one male participant of a socialization group at a community day care
center for the elderly monopolizes most of the group's time and interrupts others when they are talking.
What is the best action for the nurse to take in this situation?
- Talk to the client outside the group about his behavior during group meetings.
- Remind the client to allow others in the group a chance to talk.
- Allow the group to handle the problem.
- Ask the client to join another group. - ANSWER - Allow the group to handle the problem.
,After several weeks, the group is in the working phase and the group members should be allowed to
determine the direction of the group. The nurse should ignore the client's comments and allow the
group to handle the situation (C). A good leader should not have separate meetings with group
members (A), as such behavior is manipulative on the part of the leader. (B) is dictatorial and is not in
keeping with good leadership skills. (D) is avoiding the problem. Remember, identify what phase the
group is in--initial, working, or termination--this will help determine communication style.
An 86-year-old female client with Alzheimer's disease is wandering the busy halls of the extended care
facility and asks the nurse, "Where should I stand for the parade?" Which response is best for the nurse
to provide?
- "Anywhere you want to stand as long as you do not get hurt by those in the parade."
- "You are confused because of all the activity in the hall. There is no parade."
- "Let's go back to the activity room and see what is going on in there."
- "Remember I told you that this is a nursing home and I am your nurse." - ANSWER - "Let's go back to
the activity room and see what is going on in there."
It is common for those with Alzheimer's disease to use the wrong words. Redirecting the client (using an
accepting non-judgmental dialogue) to a safer place and familiar activities (C) is most helpful because
clients experience short-term memory loss. (A) dismisses the client's attempt to find order and does not
help her relate to her surroundings. (B) dismisses the client and may increase her anxiety level because
it merely labels the client's behavior and offers no solution. It is very frustrating for those with
Alzheimer's disease to "remember," and scolding them (D) may hurt their feelings.
Physical examination of a 6-year-old reveals several bite marks in various locations on his body. X-ray
examination reveals healed fractures of the ribs. The mother tells the nurse that her child is always
having accidents. Which initial response by the nurse is most appropriate?
- "I need to inform the healthcare provider about your child's tendency to be accident prone."
- "Tell me more specifically about your child's accidents."
- "I must report these injuries to the authorities because they do not seem accidental."
,- "Boys this age always seem to require more supervision and can be quite accident prone." - ANSWER -
"Tell me more specifically about your child's accidents."
(B) seeks more information using an open ended, non-threatening statement. (A) could be appropriate,
but it is not the best answer because the nurse is being somewhat sarcastic and is also avoiding the
situation by referring it to the healthcare provider for resolution. Although it is true that suspected cases
of child abuse must be reported, (C) is virtually an attack and is jumping to conclusions before conclusive
data has been obtained. (D) is a clich and dismisses the seriousness of the situation.
A child is brought to the emergency room with a broken arm. Because of other injuries, the nurse
suspects the child may be a victim of abuse. When the nurse tries to give the child an injection, the
child's mother becomes very loud and shouts, "I won't leave my son! Don't you touch him! You'll hurt
my child!" What is the best interpretation of the mother's statements? The mother is
- regressing to an earlier behavior pattern.
- sublimating her anger.
- projecting her feelings onto the nurse.
- suppressing her fear. - ANSWER - projecting her feelings onto the nurse.
Projection is attributing one's own thoughts, impulses, or behaviors onto another--it is the mother who
is probably harming the child and she is attributing her actions to the nurse (C). The mother may be
immature, but (A) is not the best description of her behavior. (B) is substituting a socially acceptable
feeling for an unacceptable one. These are not socially acceptable feelings. The mother may be
suppressing her fear (D) by displaying anger, but such an interpretation cannot be concluded from the
data presented.
A 38-year-old female client is admitted with a diagnosis of paranoid schizophrenia. When her tray is
brought to her, she refuses to eat and tells the nurse, "I know you are trying to poison me with that
food." Which response would be most appropriate for the nurse to make?
- "I'll leave your tray here. I am available if you need anything else."
, - "You're not being poisoned. Why do you think someone is trying to poison you?"
- "No one on this unit has ever died from poisoning. You're safe here."
- "I will talk to your healthcare provider about the possibility of changing your diet." - ANSWER - "I'll
leave your tray here. I am available if you need anything else."
(A) is the best choice cited. The nurse does not argue with the client nor demand that she eat, but offers
support by agreeing to "be there if needed", e. g., to warm the food. (B and C) are arguing with the
client's delusions, and (B) asks "why" which is usually not a good question for a psychotic client. (D) has
nothing to do with the actual problem; i. e., the problem is not the diet (she thinks any food given to her
is poisoned).
A 25-year-old female client has been particularly restless and the nurse finds her trying to leave the
psychiatric unit. She tells the nurse, "Please let me go! I must leave because the secret police are after
me." Which response is best for the nurse to make?
- "No one is after you, you're safe here."
- "You'll feel better after you have rested."
- "I know you must feel lonely and frightened."
- "Come with me to your room and I will sit with you." - ANSWER - "Come with me to your room and I
will sit with you."
(D) is the best response because it offers support without judgment or demands. (A) is arguing with the
client's delusion. (B) is offering false reassurance. (C) is a violation of therapeutic communication in that
the nurse is telling the client how she feels (frightened and lonely), rather than allowing the client to
describe her own feelings. Hallucinating and/or delusional clients are not capable of discussing their
feelings, particularly when they perceive a crisis.
A 45-year-old male client tells the nurse that he used to believe that he was Jesus Christ, but now he
knows he is not. Which response is best for the nurse to make?
- "Did you really believe you were Jesus Christ?"
