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HESI Mental Health NGN Exams 2025 Actual –
Updated Version A & B | Verified Answers and
Expert Rationales | Graded A+
1. A client with major depressive disorder (MDD) reports feeling hopeless and expresses
suicidal ideation without a plan. What is the nurse’s priority action?
A. Encourage the client to participate in group therapy
B. Assess the client’s risk for suicide in detail
C. Teach the client coping strategies for hopelessness
D. Administer the prescribed antidepressant immediately
Correct Answer: B
Rationale: Suicidal ideation indicates a safety risk, making detailed suicide risk
assessment (e.g., intent, means, plan) the priority per NGN standards. Group therapy,
coping strategies, and medication administration are secondary until safety is ensured.
2. A client with schizophrenia hears voices commanding self-harm. What is the nurse’s
initial intervention?
A. Administer an antipsychotic medication
B. Engage the client in reality-based conversation
C. Ensure a safe environment
D. Teach relaxation techniques
Correct Answer: C
Rationale: Command hallucinations pose an immediate safety risk. Ensuring a safe
environment (e.g., removing harmful objects) is the priority. Medication, conversation,
and relaxation are important but secondary to safety.
3. A client with bipolar disorder, manic episode, is pacing and speaking rapidly. Which
intervention should the nurse implement first?
A. Offer a high-calorie snack
B. Provide a quiet, low-stimulus environment
C. Administer a mood stabilizer
D. Encourage the client to journal thoughts
Correct Answer: B
Rationale: Manic episodes require reduced stimulation to prevent escalation. A low-
stimulus environment addresses hyperactivity and agitation. Snacks, medication, and
journaling are secondary interventions.
4. A client with generalized anxiety disorder (GAD) reports chest tightness and palpitations.
What should the nurse assess first?
A. Recent stressors
B. Vital signs
C. Medication adherence
D. Coping mechanisms
Correct Answer: B
, 2
Rationale: Physical symptoms like chest tightness and palpitations could indicate a
medical emergency (e.g., cardiac issue). Assessing vital signs rules out physiological
causes before addressing psychological factors.
5. A client with post-traumatic stress disorder (PTSD) experiences a flashback during a
session. What is the nurse’s best response?
A. Ask the client to describe the flashback in detail
B. Use grounding techniques to reorient the client
C. Encourage deep breathing exercises
D. Reassure the client that the trauma is over
Correct Answer: B
Rationale: Grounding techniques (e.g., naming objects in the room) help reorient clients
during flashbacks, focusing on the present. Describing the flashback may intensify
distress, and breathing or reassurance are less immediate.
6. A client with obsessive-compulsive disorder (OCD) spends hours checking locks. Which
therapeutic approach is most effective?
A. Cognitive behavioral therapy (CBT) with exposure and response prevention
B. Psychoanalytic therapy to explore childhood trauma
C. Group therapy to share experiences
D. Hypnotherapy to reduce anxiety
Correct Answer: A
Rationale: CBT with exposure and response prevention is the gold standard for OCD,
helping clients confront obsessions and resist compulsions. Other therapies are less
evidence-based for OCD.
7. A client with borderline personality disorder (BPD) threatens to harm themselves after a
staff change. What is the nurse’s priority?
A. Validate the client’s feelings of abandonment
B. Assess for immediate self-harm risk
C. Assign a new staff member to build trust
D. Teach dialectical behavior therapy (DBT) skills
Correct Answer: B
Rationale: Threats of self-harm require immediate risk assessment to ensure safety, a
priority in NGN scenarios. Validation, staff changes, and DBT skills follow after safety is
addressed.
8. A client with anorexia nervosa refuses to eat, citing fear of weight gain. What is the
nurse’s initial intervention?
A. Offer a high-calorie supplement
B. Explore the client’s body image concerns
C. Monitor vital signs and weight
D. Educate the client on nutrition
Correct Answer: C
Rationale: Refusal to eat in anorexia nervosa can lead to medical instability. Monitoring
vital signs and weight assesses for life-threatening complications (e.g., bradycardia).
Other interventions follow stabilization.
9. A client with substance use disorder (SUD) reports cravings after discharge. Which
resource should the nurse recommend?
A. Inpatient detoxification program
, 3
B. 12-step support group
C. Individual psychotherapy
D. Family therapy sessions
Correct Answer: B
Rationale: 12-step groups (e.g., Alcoholics Anonymous) provide peer support to manage
cravings and maintain sobriety post-discharge. Other options may be appropriate but are
less immediate.
10. A client with dementia becomes agitated at night. What is the nurse’s best intervention?
A. Administer a PRN antipsychotic
B. Implement a consistent bedtime routine
C. Restrain the client for safety
D. Increase daytime stimulation
Correct Answer: B
Rationale: A consistent bedtime routine reduces sundowning in dementia by promoting
familiarity and calm. Antipsychotics are a last resort, restraints are unsafe, and increased
stimulation may worsen agitation.
11. A client with MDD is prescribed sertraline. What should the nurse teach the client to
report immediately?
A. Increased appetite
B. Worsening suicidal thoughts
C. Mild drowsiness
D. Dry mouth
Correct Answer: B
Rationale: SSRIs like sertraline can increase suicidal ideation, especially early in
treatment, requiring immediate reporting. Other side effects are common and less urgent.
12. A client with schizophrenia refuses medication, stating, “It’s poison.” What is the nurse’s
best response?
A. “You must take it to get better.”
B. “Why do you think it’s poison?”
C. “I’ll get a different medication.”
D. “You don’t need it right now.”
Correct Answer: B
Rationale: Exploring the client’s belief therapeutically addresses delusions and builds
trust. Coercion, promising alternatives, or dismissing medication undermines rapport.
13. A client with panic disorder reports fear of leaving home. What is this symptom called?
A. Agoraphobia
B. Social phobia
C. Claustrophobia
D. Specific phobia
Correct Answer: A
Rationale: Agoraphobia, common in panic disorder, involves fear of situations like
leaving home due to potential panic attacks. Other phobias have different triggers.
14. A client with bipolar disorder is non-adherent to lithium. What should the nurse assess
first?
A. Serum lithium levels
B. Reasons for non-adherence
HESI Mental Health NGN Exams 2025 Actual –
Updated Version A & B | Verified Answers and
Expert Rationales | Graded A+
1. A client with major depressive disorder (MDD) reports feeling hopeless and expresses
suicidal ideation without a plan. What is the nurse’s priority action?
A. Encourage the client to participate in group therapy
B. Assess the client’s risk for suicide in detail
C. Teach the client coping strategies for hopelessness
D. Administer the prescribed antidepressant immediately
Correct Answer: B
Rationale: Suicidal ideation indicates a safety risk, making detailed suicide risk
assessment (e.g., intent, means, plan) the priority per NGN standards. Group therapy,
coping strategies, and medication administration are secondary until safety is ensured.
2. A client with schizophrenia hears voices commanding self-harm. What is the nurse’s
initial intervention?
A. Administer an antipsychotic medication
B. Engage the client in reality-based conversation
C. Ensure a safe environment
D. Teach relaxation techniques
Correct Answer: C
Rationale: Command hallucinations pose an immediate safety risk. Ensuring a safe
environment (e.g., removing harmful objects) is the priority. Medication, conversation,
and relaxation are important but secondary to safety.
3. A client with bipolar disorder, manic episode, is pacing and speaking rapidly. Which
intervention should the nurse implement first?
A. Offer a high-calorie snack
B. Provide a quiet, low-stimulus environment
C. Administer a mood stabilizer
D. Encourage the client to journal thoughts
Correct Answer: B
Rationale: Manic episodes require reduced stimulation to prevent escalation. A low-
stimulus environment addresses hyperactivity and agitation. Snacks, medication, and
journaling are secondary interventions.
4. A client with generalized anxiety disorder (GAD) reports chest tightness and palpitations.
What should the nurse assess first?
A. Recent stressors
B. Vital signs
C. Medication adherence
D. Coping mechanisms
Correct Answer: B
, 2
Rationale: Physical symptoms like chest tightness and palpitations could indicate a
medical emergency (e.g., cardiac issue). Assessing vital signs rules out physiological
causes before addressing psychological factors.
5. A client with post-traumatic stress disorder (PTSD) experiences a flashback during a
session. What is the nurse’s best response?
A. Ask the client to describe the flashback in detail
B. Use grounding techniques to reorient the client
C. Encourage deep breathing exercises
D. Reassure the client that the trauma is over
Correct Answer: B
Rationale: Grounding techniques (e.g., naming objects in the room) help reorient clients
during flashbacks, focusing on the present. Describing the flashback may intensify
distress, and breathing or reassurance are less immediate.
6. A client with obsessive-compulsive disorder (OCD) spends hours checking locks. Which
therapeutic approach is most effective?
A. Cognitive behavioral therapy (CBT) with exposure and response prevention
B. Psychoanalytic therapy to explore childhood trauma
C. Group therapy to share experiences
D. Hypnotherapy to reduce anxiety
Correct Answer: A
Rationale: CBT with exposure and response prevention is the gold standard for OCD,
helping clients confront obsessions and resist compulsions. Other therapies are less
evidence-based for OCD.
7. A client with borderline personality disorder (BPD) threatens to harm themselves after a
staff change. What is the nurse’s priority?
A. Validate the client’s feelings of abandonment
B. Assess for immediate self-harm risk
C. Assign a new staff member to build trust
D. Teach dialectical behavior therapy (DBT) skills
Correct Answer: B
Rationale: Threats of self-harm require immediate risk assessment to ensure safety, a
priority in NGN scenarios. Validation, staff changes, and DBT skills follow after safety is
addressed.
8. A client with anorexia nervosa refuses to eat, citing fear of weight gain. What is the
nurse’s initial intervention?
A. Offer a high-calorie supplement
B. Explore the client’s body image concerns
C. Monitor vital signs and weight
D. Educate the client on nutrition
Correct Answer: C
Rationale: Refusal to eat in anorexia nervosa can lead to medical instability. Monitoring
vital signs and weight assesses for life-threatening complications (e.g., bradycardia).
Other interventions follow stabilization.
9. A client with substance use disorder (SUD) reports cravings after discharge. Which
resource should the nurse recommend?
A. Inpatient detoxification program
, 3
B. 12-step support group
C. Individual psychotherapy
D. Family therapy sessions
Correct Answer: B
Rationale: 12-step groups (e.g., Alcoholics Anonymous) provide peer support to manage
cravings and maintain sobriety post-discharge. Other options may be appropriate but are
less immediate.
10. A client with dementia becomes agitated at night. What is the nurse’s best intervention?
A. Administer a PRN antipsychotic
B. Implement a consistent bedtime routine
C. Restrain the client for safety
D. Increase daytime stimulation
Correct Answer: B
Rationale: A consistent bedtime routine reduces sundowning in dementia by promoting
familiarity and calm. Antipsychotics are a last resort, restraints are unsafe, and increased
stimulation may worsen agitation.
11. A client with MDD is prescribed sertraline. What should the nurse teach the client to
report immediately?
A. Increased appetite
B. Worsening suicidal thoughts
C. Mild drowsiness
D. Dry mouth
Correct Answer: B
Rationale: SSRIs like sertraline can increase suicidal ideation, especially early in
treatment, requiring immediate reporting. Other side effects are common and less urgent.
12. A client with schizophrenia refuses medication, stating, “It’s poison.” What is the nurse’s
best response?
A. “You must take it to get better.”
B. “Why do you think it’s poison?”
C. “I’ll get a different medication.”
D. “You don’t need it right now.”
Correct Answer: B
Rationale: Exploring the client’s belief therapeutically addresses delusions and builds
trust. Coercion, promising alternatives, or dismissing medication undermines rapport.
13. A client with panic disorder reports fear of leaving home. What is this symptom called?
A. Agoraphobia
B. Social phobia
C. Claustrophobia
D. Specific phobia
Correct Answer: A
Rationale: Agoraphobia, common in panic disorder, involves fear of situations like
leaving home due to potential panic attacks. Other phobias have different triggers.
14. A client with bipolar disorder is non-adherent to lithium. What should the nurse assess
first?
A. Serum lithium levels
B. Reasons for non-adherence
