1
HESI RN Mental Health NGN Exams
2025 – Version A & B with 100%
Verified Answers and Clinical
Rationales | Updated & Accurate
Content
Version A
Therapeutic Communication
1. A patient with depression says, “I feel like a failure.” What is the nurse’s best response?
A. “You’re not a failure; you have many strengths.”
B. “You feel like a failure. Can you tell me more about that?”
C. “Everyone feels that way sometimes.”
D. “Let’s focus on something positive instead.”
Rationale: Using open-ended, reflective statements encourages the patient to express
feelings, promoting therapeutic communication, per psychiatric nursing principles.
2. A patient with schizophrenia says, “The voices are telling me to hide.” What should the
nurse say?
A. “There are no voices; it’s just your imagination.”
B. “That must be scary. What do the voices say?”
C. “Ignore the voices and they’ll go away.”
D. “You need to stop listening to them.”
Rationale: Acknowledging the patient’s experience validates their feelings without
reinforcing delusions, fostering trust, per therapeutic communication guidelines.
3. A patient with anxiety says, “I can’t handle this anymore.” What is the nurse’s best
response?
A. “You need to calm down.”
B. “It sounds overwhelming. Let’s try some deep breathing together.”
C. “You’ll feel better soon.”
D. “Why are you so upset?”
Rationale: Offering a calming intervention like deep breathing addresses anxiety while
showing empathy, per therapeutic communication principles.
4. (SATA) Which responses demonstrate therapeutic communication with a patient with
bipolar disorder? (Select all that apply)
A. “I’m here to listen. What’s on your mind?”
B. “You shouldn’t feel that way.”
C. “It sounds like you’re feeling very energetic today.”
, 2
D. “Your behavior is inappropriate.”
E. “Can you describe what you’re experiencing?”
Rationale: Open-ended, nonjudgmental, and reflective statements promote trust and
exploration of feelings, while judgmental responses hinder communication, per
psychiatric nursing standards.
5. A patient with post-traumatic stress disorder (PTSD) is withdrawn. What should the
nurse say?
A. “Why don’t you want to talk?”
B. “I’m here when you’re ready to share.”
C. “You need to participate in group therapy.”
D. “You’re making this harder for everyone.”
Rationale: Offering availability without pressure respects the patient’s need for space,
common in PTSD, per therapeutic communication guidelines.
Psychopharmacology
6. A patient is prescribed fluoxetine 20 mg daily. What should the nurse monitor for?
A. Hypoglycemia
B. Suicidal thoughts
C. Hypertension
D. Weight loss
Rationale: Fluoxetine, an SSRI, increases suicide risk, especially in the first weeks,
requiring close monitoring, per psychopharmacology.
7. A patient on lithium reports nausea and hand tremors. What should the nurse do?
A. Increase the lithium dose
B. Notify the provider immediately
C. Administer an antiemetic
D. Document the symptoms only
Rationale: Nausea and tremors suggest lithium toxicity, requiring urgent provider
evaluation and serum level checks, per mood stabilizer pharmacology.
8. A patient is prescribed haloperidol. What is a priority side effect to monitor?
A. Hyperglycemia
B. Extrapyramidal symptoms
C. Rash
D. Insomnia
Rationale: Haloperidol, a typical antipsychotic, commonly causes extrapyramidal
symptoms (e.g., dystonia, parkinsonism), requiring monitoring, per antipsychotic
pharmacology.
9. A patient on sertraline reports agitation and sweating. What should the nurse suspect?
A. Allergic reaction
B. Serotonin syndrome
C. Dehydration
D. Hypoglycemia
Rationale: Agitation and sweating are signs of serotonin syndrome, a serious SSRI side
effect, requiring immediate intervention, per psychopharmacology.
, 3
10. (SATA) Which teaching points should the nurse include for a patient starting olanzapine?
(Select all that apply)
A. �WMonitor for weight gain
B. Avoid checking blood glucose
C. Report muscle stiffness immediately
D. Take at bedtime to reduce sedation
E. Increase alcohol intake
Rationale: Olanzapine, an atypical antipsychotic, causes weight gain, extrapyramidal
symptoms, and sedation. Alcohol exacerbates sedation, and glucose monitoring is needed
due to metabolic risks, per antipsychotic education.
11. A patient is prescribed diazepam for anxiety. What should the nurse teach?
A. Take as needed without limits
B. Avoid alcohol while taking this medication
C. Drive immediately after taking
D. Stop abruptly if no longer needed
Rationale: Diazepam, a benzodiazepine, potentiates CNS depression with alcohol,
increasing sedation risk, per anxiolytic pharmacology.
12. A patient on phenelzine reports eating aged cheese. What is the nurse’s priority?
A. Encourage a low-sodium diet
B. Assess for hypertensive crisis
C. Administer an antacid
D. Document the dietary choice
Rationale: Phenelzine, an MAOI, interacts with tyramine-rich foods like aged cheese,
risking hypertensive crisis, per MAOI pharmacology.
13. A patient on risperidone develops muscle rigidity. What should the nurse do?
A. Continue the medication
B. Notify the provider immediately
C. Administer a muscle relaxant
D. Monitor for 24 hours
Rationale: Muscle rigidity suggests extrapyramidal symptoms or neuroleptic malignant
syndrome, serious risperidone side effects, requiring urgent provider notification, per
antipsychotic pharmacology.
14. A patient is prescribed bupropion. What is a contraindication for this medication?
A. Hypertension
B. Seizure disorder
C. Diabetes
D. Asthma
Rationale: Bupropion lowers the seizure threshold, making it contraindicated in seizure
disorders, per antidepressant pharmacology.
15. A patient on valproic acid reports nausea and hair loss. What should the nurse do?
A. Increase the dose
B. Notify the provider
C. Administer an antiemetic
D. Document the symptoms only
Rationale: Nausea and hair loss are side effects of valproic acid, requiring provider
HESI RN Mental Health NGN Exams
2025 – Version A & B with 100%
Verified Answers and Clinical
Rationales | Updated & Accurate
Content
Version A
Therapeutic Communication
1. A patient with depression says, “I feel like a failure.” What is the nurse’s best response?
A. “You’re not a failure; you have many strengths.”
B. “You feel like a failure. Can you tell me more about that?”
C. “Everyone feels that way sometimes.”
D. “Let’s focus on something positive instead.”
Rationale: Using open-ended, reflective statements encourages the patient to express
feelings, promoting therapeutic communication, per psychiatric nursing principles.
2. A patient with schizophrenia says, “The voices are telling me to hide.” What should the
nurse say?
A. “There are no voices; it’s just your imagination.”
B. “That must be scary. What do the voices say?”
C. “Ignore the voices and they’ll go away.”
D. “You need to stop listening to them.”
Rationale: Acknowledging the patient’s experience validates their feelings without
reinforcing delusions, fostering trust, per therapeutic communication guidelines.
3. A patient with anxiety says, “I can’t handle this anymore.” What is the nurse’s best
response?
A. “You need to calm down.”
B. “It sounds overwhelming. Let’s try some deep breathing together.”
C. “You’ll feel better soon.”
D. “Why are you so upset?”
Rationale: Offering a calming intervention like deep breathing addresses anxiety while
showing empathy, per therapeutic communication principles.
4. (SATA) Which responses demonstrate therapeutic communication with a patient with
bipolar disorder? (Select all that apply)
A. “I’m here to listen. What’s on your mind?”
B. “You shouldn’t feel that way.”
C. “It sounds like you’re feeling very energetic today.”
, 2
D. “Your behavior is inappropriate.”
E. “Can you describe what you’re experiencing?”
Rationale: Open-ended, nonjudgmental, and reflective statements promote trust and
exploration of feelings, while judgmental responses hinder communication, per
psychiatric nursing standards.
5. A patient with post-traumatic stress disorder (PTSD) is withdrawn. What should the
nurse say?
A. “Why don’t you want to talk?”
B. “I’m here when you’re ready to share.”
C. “You need to participate in group therapy.”
D. “You’re making this harder for everyone.”
Rationale: Offering availability without pressure respects the patient’s need for space,
common in PTSD, per therapeutic communication guidelines.
Psychopharmacology
6. A patient is prescribed fluoxetine 20 mg daily. What should the nurse monitor for?
A. Hypoglycemia
B. Suicidal thoughts
C. Hypertension
D. Weight loss
Rationale: Fluoxetine, an SSRI, increases suicide risk, especially in the first weeks,
requiring close monitoring, per psychopharmacology.
7. A patient on lithium reports nausea and hand tremors. What should the nurse do?
A. Increase the lithium dose
B. Notify the provider immediately
C. Administer an antiemetic
D. Document the symptoms only
Rationale: Nausea and tremors suggest lithium toxicity, requiring urgent provider
evaluation and serum level checks, per mood stabilizer pharmacology.
8. A patient is prescribed haloperidol. What is a priority side effect to monitor?
A. Hyperglycemia
B. Extrapyramidal symptoms
C. Rash
D. Insomnia
Rationale: Haloperidol, a typical antipsychotic, commonly causes extrapyramidal
symptoms (e.g., dystonia, parkinsonism), requiring monitoring, per antipsychotic
pharmacology.
9. A patient on sertraline reports agitation and sweating. What should the nurse suspect?
A. Allergic reaction
B. Serotonin syndrome
C. Dehydration
D. Hypoglycemia
Rationale: Agitation and sweating are signs of serotonin syndrome, a serious SSRI side
effect, requiring immediate intervention, per psychopharmacology.
, 3
10. (SATA) Which teaching points should the nurse include for a patient starting olanzapine?
(Select all that apply)
A. �WMonitor for weight gain
B. Avoid checking blood glucose
C. Report muscle stiffness immediately
D. Take at bedtime to reduce sedation
E. Increase alcohol intake
Rationale: Olanzapine, an atypical antipsychotic, causes weight gain, extrapyramidal
symptoms, and sedation. Alcohol exacerbates sedation, and glucose monitoring is needed
due to metabolic risks, per antipsychotic education.
11. A patient is prescribed diazepam for anxiety. What should the nurse teach?
A. Take as needed without limits
B. Avoid alcohol while taking this medication
C. Drive immediately after taking
D. Stop abruptly if no longer needed
Rationale: Diazepam, a benzodiazepine, potentiates CNS depression with alcohol,
increasing sedation risk, per anxiolytic pharmacology.
12. A patient on phenelzine reports eating aged cheese. What is the nurse’s priority?
A. Encourage a low-sodium diet
B. Assess for hypertensive crisis
C. Administer an antacid
D. Document the dietary choice
Rationale: Phenelzine, an MAOI, interacts with tyramine-rich foods like aged cheese,
risking hypertensive crisis, per MAOI pharmacology.
13. A patient on risperidone develops muscle rigidity. What should the nurse do?
A. Continue the medication
B. Notify the provider immediately
C. Administer a muscle relaxant
D. Monitor for 24 hours
Rationale: Muscle rigidity suggests extrapyramidal symptoms or neuroleptic malignant
syndrome, serious risperidone side effects, requiring urgent provider notification, per
antipsychotic pharmacology.
14. A patient is prescribed bupropion. What is a contraindication for this medication?
A. Hypertension
B. Seizure disorder
C. Diabetes
D. Asthma
Rationale: Bupropion lowers the seizure threshold, making it contraindicated in seizure
disorders, per antidepressant pharmacology.
15. A patient on valproic acid reports nausea and hair loss. What should the nurse do?
A. Increase the dose
B. Notify the provider
C. Administer an antiemetic
D. Document the symptoms only
Rationale: Nausea and hair loss are side effects of valproic acid, requiring provider
