HESI Mental Health Nursing Specialty Exam:
Comprehensive Practice Questions
Instructions
The following are 80 original multiple-choice questions designed for the Mental Health
Nursing Specialty portion of the HESI Exam. These questions cover therapeutic commu-
nication, psychiatric medications, psychiatric disorders (e.g., depression, schizophrenia),
suicide prevention, and crisis intervention, with real-world clinical judgment scenarios.
Each question has four answer choices (A–D), with the correct answer clearly marked.
1. A nurse is speaking with a patient diagnosed with major depressive disorder who
says, “I’m worthless and nobody cares.” Which therapeutic communication re-
sponse is most appropriate?
A. “You’re not worthless; you’re just feeling down.”
B. “Can you tell me more about how you’re feeling?”
C. “Everyone feels like that sometimes.”
D. “You need to think more positively.”
Correct Answer: B
2. A patient with bipolar disorder is prescribed lithium. Which laboratory value
should the nurse monitor closely?
A. Blood glucose
B. Serum lithium levels
C. Platelet count
D. Hemoglobin
Correct Answer: B
3. A patient with schizophrenia reports hearing voices telling them to harm them-
selves. Which nursing action is the priority?
A. Ignore the voices as they are not real
B. Ask, “What are the voices saying to you?”
C. Administer an antipsychotic immediately
1
, D. Place the patient in seclusion
Correct Answer: B
4. A nurse is assessing a patient for suicide risk. Which statement by the patient
indicates the highest risk?
A. “I feel sad most days.”
B. “I have a plan to overdose on my pills tonight.”
C. “I don’t enjoy things like I used to.”
D. “I wish I could sleep better.”
Correct Answer: B
5. During a crisis intervention, a patient who witnessed a traumatic event is hyper-
ventilating and pacing. Which nursing action is most effective?
A. Instruct the patient to breathe rapidly
B. Guide the patient to a quiet area and encourage slow breathing
C. Tell the patient to stop overreacting
D. Leave the patient alone to calm down
Correct Answer: B
6. A patient with generalized anxiety disorder says, “I can’t stop worrying about
everything.” Which therapeutic response is best?
A. “Why don’t you just relax?”
B. “It sounds overwhelming. Can you share what’s been worrying you?”
C. “You’re worrying too much.”
D. “Everyone worries sometimes.”
Correct Answer: B
7. A patient is prescribed fluoxetine for depression. Which side effect should the nurse
educate the patient about?
A. Weight loss
B. Bradycardia
C. Hypotension
D. Sedation
Correct Answer: A
8. A patient with paranoid schizophrenia refuses medication, stating, “The pills are
poisoned.” Which nursing response is most therapeutic?
A. “These pills are safe; you have to take them.”
B. “I understand you’re concerned. Can we discuss why you feel this way?”
2
Comprehensive Practice Questions
Instructions
The following are 80 original multiple-choice questions designed for the Mental Health
Nursing Specialty portion of the HESI Exam. These questions cover therapeutic commu-
nication, psychiatric medications, psychiatric disorders (e.g., depression, schizophrenia),
suicide prevention, and crisis intervention, with real-world clinical judgment scenarios.
Each question has four answer choices (A–D), with the correct answer clearly marked.
1. A nurse is speaking with a patient diagnosed with major depressive disorder who
says, “I’m worthless and nobody cares.” Which therapeutic communication re-
sponse is most appropriate?
A. “You’re not worthless; you’re just feeling down.”
B. “Can you tell me more about how you’re feeling?”
C. “Everyone feels like that sometimes.”
D. “You need to think more positively.”
Correct Answer: B
2. A patient with bipolar disorder is prescribed lithium. Which laboratory value
should the nurse monitor closely?
A. Blood glucose
B. Serum lithium levels
C. Platelet count
D. Hemoglobin
Correct Answer: B
3. A patient with schizophrenia reports hearing voices telling them to harm them-
selves. Which nursing action is the priority?
A. Ignore the voices as they are not real
B. Ask, “What are the voices saying to you?”
C. Administer an antipsychotic immediately
1
, D. Place the patient in seclusion
Correct Answer: B
4. A nurse is assessing a patient for suicide risk. Which statement by the patient
indicates the highest risk?
A. “I feel sad most days.”
B. “I have a plan to overdose on my pills tonight.”
C. “I don’t enjoy things like I used to.”
D. “I wish I could sleep better.”
Correct Answer: B
5. During a crisis intervention, a patient who witnessed a traumatic event is hyper-
ventilating and pacing. Which nursing action is most effective?
A. Instruct the patient to breathe rapidly
B. Guide the patient to a quiet area and encourage slow breathing
C. Tell the patient to stop overreacting
D. Leave the patient alone to calm down
Correct Answer: B
6. A patient with generalized anxiety disorder says, “I can’t stop worrying about
everything.” Which therapeutic response is best?
A. “Why don’t you just relax?”
B. “It sounds overwhelming. Can you share what’s been worrying you?”
C. “You’re worrying too much.”
D. “Everyone worries sometimes.”
Correct Answer: B
7. A patient is prescribed fluoxetine for depression. Which side effect should the nurse
educate the patient about?
A. Weight loss
B. Bradycardia
C. Hypotension
D. Sedation
Correct Answer: A
8. A patient with paranoid schizophrenia refuses medication, stating, “The pills are
poisoned.” Which nursing response is most therapeutic?
A. “These pills are safe; you have to take them.”
B. “I understand you’re concerned. Can we discuss why you feel this way?”
2
