HESI RN Mental Health Exit Exam
2025/2026 – Verified Questions with
Correct Answers and Rationales
Therapeutic Communication (Questions 1-30)
Question 1
A nurse is communicating with a client who has schizophrenia and is experiencing
hallucinations. Which statement by the nurse best demonstrates therapeutic communication?
A. "I don't hear the voices you're hearing, but I believe you are experiencing something."
B. "You shouldn't listen to those voices; they are not real."
C. "Tell me more about what the voices are saying."
D. "Let's ignore the voices and talk about something else."
Correct Answer: A
Rationale: Therapeutic communication acknowledges the client's experience without reinforcing
delusions or hallucinations. Option A validates the client's perception while gently redirecting to
reality. Options B, C, and D either dismiss, encourage, or avoid the issue, which can increase
anxiety.
Question 2
A client with depression states, "I feel like a burden to everyone." What is the most therapeutic
response?
A. "Everyone feels that way sometimes; you'll get over it."
B. "What makes you feel that way?"
C. "You're not a burden; your family loves you."
D. "Let's focus on positive things instead."
Correct Answer: B
Rationale: Open-ended questions like "What makes you feel that way?" encourage the client to
explore feelings, promoting self-expression. Other options minimize feelings or provide false
reassurance, which is non-therapeutic.
Question 3
During a group therapy session, a client with anxiety becomes agitated and starts yelling. How
should the nurse respond?
A. Ignore the behavior to avoid escalation.
B. Tell the client to calm down immediately.
C. Use a calm tone and say, "I see you're upset; can you tell me what's happening?"
D. Remove the client from the group forcefully.
,Correct Answer: C
Rationale: Therapeutic communication uses empathy and active listening to de-escalate.
Acknowledging emotions helps the client feel heard. Ignoring or commanding can worsen
agitation, and force is a last resort.
Question 4
A nurse is assessing a client with bipolar disorder in a manic phase. Which technique promotes
therapeutic communication?
A. Arguing with the client's grandiose ideas.
B. Setting clear limits on conversation topics.
C. Allowing the client to dominate the discussion.
D. Using humor to lighten the mood.
Correct Answer: B
Rationale: Clients in mania need structure; setting limits maintains focus and prevents
exhaustion. Arguing reinforces delusions, allowing dominance disrupts therapy, and humor may
be misinterpreted.
Question 5
A client with PTSD avoids discussing trauma. The nurse says, "It seems difficult to talk about
that." This is an example of:
A. Reflecting.
B. Paraphrasing.
C. Giving advice.
D. Probing.
Correct Answer: A
Rationale: Reflecting involves restating the client's feelings or words to show understanding.
This technique builds trust without pressuring the client.
Question 6
Which non-therapeutic communication blocks rapport with a suicidal client?
A. "Why do you want to hurt yourself?"
B. "You have so much to live for."
C. "Tell me about your feelings right now."
D. "How long have you felt this way?"
Correct Answer: B
Rationale: Minimizing the client's pain with false reassurance like "You have so much to live
for" blocks emotional expression. Open questions (A, C, D) are therapeutic.
Question 7
A nurse uses silence during a session with a grieving client. This technique is most effective for:
A. Filling awkward pauses.
B. Allowing the client time to gather thoughts.
, C. Interrupting the client's monologue.
D. Demonstrating disinterest.
Correct Answer: B
Rationale: Silence gives the client space to process emotions and speak when ready, enhancing
therapeutic alliance. Misuse can create discomfort.
Question 8
A client with borderline personality disorder accuses the nurse of abandonment. The therapeutic
response is:
A. "I am not abandoning you; I'll be back tomorrow."
B. "You always feel abandoned, don't you?"
C. "Let's discuss why you feel that way."
D. "That's not true; stop accusing me."
Correct Answer: C
Rationale: Exploring feelings helps address underlying issues. Defensiveness (D) or denial (A)
escalates; generalizing (B) may invalidate.
Question 9
In therapeutic communication, clarifying is used when:
A. The client uses vague language.
B. The nurse wants to give advice.
C. The client is angry.
D. The session is ending.
Correct Answer: A
Rationale: Clarifying seeks to understand ambiguous statements, ensuring accurate
communication. It's not for advice, anger management, or closure.
Question 10
A nurse restates a client's words: "So you're saying the medication makes you tired?" This is:
A. Paraphrasing.
B. Summarizing.
C. Reflecting.
D. Interpreting.
Correct Answer: A
Rationale: Paraphrasing rephrases the client's message in the nurse's words to confirm
understanding. Reflecting focuses on feelings.
Question 11
For a client with dementia exhibiting confusion, the best communication approach is:
A. Speaking loudly and slowly.
B. Using simple, direct sentences.
2025/2026 – Verified Questions with
Correct Answers and Rationales
Therapeutic Communication (Questions 1-30)
Question 1
A nurse is communicating with a client who has schizophrenia and is experiencing
hallucinations. Which statement by the nurse best demonstrates therapeutic communication?
A. "I don't hear the voices you're hearing, but I believe you are experiencing something."
B. "You shouldn't listen to those voices; they are not real."
C. "Tell me more about what the voices are saying."
D. "Let's ignore the voices and talk about something else."
Correct Answer: A
Rationale: Therapeutic communication acknowledges the client's experience without reinforcing
delusions or hallucinations. Option A validates the client's perception while gently redirecting to
reality. Options B, C, and D either dismiss, encourage, or avoid the issue, which can increase
anxiety.
Question 2
A client with depression states, "I feel like a burden to everyone." What is the most therapeutic
response?
A. "Everyone feels that way sometimes; you'll get over it."
B. "What makes you feel that way?"
C. "You're not a burden; your family loves you."
D. "Let's focus on positive things instead."
Correct Answer: B
Rationale: Open-ended questions like "What makes you feel that way?" encourage the client to
explore feelings, promoting self-expression. Other options minimize feelings or provide false
reassurance, which is non-therapeutic.
Question 3
During a group therapy session, a client with anxiety becomes agitated and starts yelling. How
should the nurse respond?
A. Ignore the behavior to avoid escalation.
B. Tell the client to calm down immediately.
C. Use a calm tone and say, "I see you're upset; can you tell me what's happening?"
D. Remove the client from the group forcefully.
,Correct Answer: C
Rationale: Therapeutic communication uses empathy and active listening to de-escalate.
Acknowledging emotions helps the client feel heard. Ignoring or commanding can worsen
agitation, and force is a last resort.
Question 4
A nurse is assessing a client with bipolar disorder in a manic phase. Which technique promotes
therapeutic communication?
A. Arguing with the client's grandiose ideas.
B. Setting clear limits on conversation topics.
C. Allowing the client to dominate the discussion.
D. Using humor to lighten the mood.
Correct Answer: B
Rationale: Clients in mania need structure; setting limits maintains focus and prevents
exhaustion. Arguing reinforces delusions, allowing dominance disrupts therapy, and humor may
be misinterpreted.
Question 5
A client with PTSD avoids discussing trauma. The nurse says, "It seems difficult to talk about
that." This is an example of:
A. Reflecting.
B. Paraphrasing.
C. Giving advice.
D. Probing.
Correct Answer: A
Rationale: Reflecting involves restating the client's feelings or words to show understanding.
This technique builds trust without pressuring the client.
Question 6
Which non-therapeutic communication blocks rapport with a suicidal client?
A. "Why do you want to hurt yourself?"
B. "You have so much to live for."
C. "Tell me about your feelings right now."
D. "How long have you felt this way?"
Correct Answer: B
Rationale: Minimizing the client's pain with false reassurance like "You have so much to live
for" blocks emotional expression. Open questions (A, C, D) are therapeutic.
Question 7
A nurse uses silence during a session with a grieving client. This technique is most effective for:
A. Filling awkward pauses.
B. Allowing the client time to gather thoughts.
, C. Interrupting the client's monologue.
D. Demonstrating disinterest.
Correct Answer: B
Rationale: Silence gives the client space to process emotions and speak when ready, enhancing
therapeutic alliance. Misuse can create discomfort.
Question 8
A client with borderline personality disorder accuses the nurse of abandonment. The therapeutic
response is:
A. "I am not abandoning you; I'll be back tomorrow."
B. "You always feel abandoned, don't you?"
C. "Let's discuss why you feel that way."
D. "That's not true; stop accusing me."
Correct Answer: C
Rationale: Exploring feelings helps address underlying issues. Defensiveness (D) or denial (A)
escalates; generalizing (B) may invalidate.
Question 9
In therapeutic communication, clarifying is used when:
A. The client uses vague language.
B. The nurse wants to give advice.
C. The client is angry.
D. The session is ending.
Correct Answer: A
Rationale: Clarifying seeks to understand ambiguous statements, ensuring accurate
communication. It's not for advice, anger management, or closure.
Question 10
A nurse restates a client's words: "So you're saying the medication makes you tired?" This is:
A. Paraphrasing.
B. Summarizing.
C. Reflecting.
D. Interpreting.
Correct Answer: A
Rationale: Paraphrasing rephrases the client's message in the nurse's words to confirm
understanding. Reflecting focuses on feelings.
Question 11
For a client with dementia exhibiting confusion, the best communication approach is:
A. Speaking loudly and slowly.
B. Using simple, direct sentences.
