NGN Mental Health HESI Exams 2025
(Version A & B) with Actual Exam
Questions and Correct Answers with
Rationales | Graded A+
Version A
Question 1 A client with depression remains in bed most of the day, declines activities, and
refuses meals. Which nursing problem has the greatest priority for this client? A. Loss of interest
in diversional activity B. Social isolation C. Refusal to address nutritional needs D. Low self-
esteem Answer: C. Refusal to address nutritional needs Rationale: Physiological needs
(nutrition) take priority over psychosocial needs per Maslow's hierarchy. Severe malnutrition can
lead to life-threatening complications like refeeding syndrome or organ failure in depressed
clients.
Question 2 A male client approaches the nurse with an angry expression and raises his voice,
saying, "My roommate is the most selfish, self-centered, angry person I have ever met. If he
loses his temper one more time with me, I am going to punch him out!" The nurse recognizes
that the client is using which defense mechanism? A. Denial B. Projection C. Rationalization D.
Displacement Answer: B. Projection Rationale: Projection involves attributing one's own
unacceptable feelings (anger) to another person. This client is describing his own traits in the
roommate to avoid self-awareness.
Question 3 A client who has just been sexually assaulted is calm and quiet. The nurse analyzes
this behavior as indicating which defense mechanism? A. Denial B. Projection C. Rationalization
D. Intellectualization Answer: A. Denial Rationale: Denial is a common initial response to
trauma, where the client suppresses awareness of the event to protect the ego. Calmness may
mask shock; further assessment is needed.
Question 4 The nurse is interviewing a client with schizophrenia. Which question is most
important to ask regarding auditory hallucinations? A. "How do these voices make you feel?" B.
"Do the voices tell you to harm yourself or others?" C. "When did the voices start?" D. "Are the
voices male or female?" Answer: B. Do the voices tell you to harm yourself or others?
Rationale: Assessing for command hallucinations is priority to ensure safety, as they increase
risk of self-harm or violence. Other questions explore content but safety first.
Question 5 A client with bipolar disorder is prescribed lithium. The client reports nausea and
tremors. What is the nurse's priority action? A. Administer an antiemetic B. Check the client's
, lithium level C. Encourage more water intake D. Notify the provider Answer: B. Check the
client's lithium level Rationale: Nausea and tremors suggest lithium toxicity (therapeutic range
0.6–1.2 mEq/L). Immediate lab check guides further intervention to prevent neurotoxicity.
Question 6 A mental health worker is caring for a client with escalating aggressive behavior.
Which action by the MHW warrants immediate intervention by the RN? A. Approaching the
client from the front with arms at sides B. Speaking in a calm, low tone C. Standing with feet
apart for stability D. Maintaining eye contact at all times Answer: D. Maintaining eye contact
at all times Rationale: Prolonged eye contact can be perceived as threatening and escalate
agitation. De-escalation prioritizes non-confrontational body language.
Question 7 A client says to the nurse, "I'm going to die, and I wish my family would stop hoping
for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." The
therapeutic response is: A. "Have you shared your feelings with your family?" B. "I think you
need to accept the inevitable." C. "Anger is a normal part of dying." D. "Why don't you tell me
how you feel about dying?" Answer: A. Have you shared your feelings with your family?
Rationale: This encourages expression and problem-solving, fostering communication. It
validates feelings without false reassurance or confrontation.
Question 8 A female client presents in the ED after being raped last night. Which question is
most important for the nurse to ask? A. "Has she taken a bath since the rape occurred?" B. "Is the
place where she lives a safe place?" C. "Does she know the person who raped her?" D. "Did she
fight back?" Answer: A. Has she taken a bath since the rape occurred? Rationale: Bathing
can destroy forensic evidence; preserving it is priority for legal purposes. Safety and relationship
questions follow.
Question 9 Which data indicate to the nurse that a client is experiencing effective coping
following the loss of a spouse? A. The client reports sleeping 12 hours per night B. The client
avoids discussing the spouse C. The client participates in support group activities D. The client
refuses antidepressants Answer: C. The client participates in support group activities
Rationale: Active engagement in support systems shows adaptive coping and social
reconnection, key to grief resolution.
Question 10 A client with borderline personality disorder threatens to cut themselves during
group therapy. The nurse's priority action is: A. Administer PRN anxiolytic B. Place in seclusion
C. Assess safety risk and level of agitation D. Instruct to sit quietly Answer: C. Assess safety
risk and level of agitation Rationale: Assessment guides interventions; immediate safety
evaluation prevents harm without premature escalation.
Question 11 A client with schizophrenia reports hearing voices telling him to harm others. The
nurse's immediate action? A. Administer antipsychotic B. Encourage journaling C. Implement
one-to-one observation D. Teach coping strategies Answer: C. Implement one-to-one
observation Rationale: Command hallucinations pose imminent danger; constant monitoring
ensures safety until medicated or de-escalated.
(Version A & B) with Actual Exam
Questions and Correct Answers with
Rationales | Graded A+
Version A
Question 1 A client with depression remains in bed most of the day, declines activities, and
refuses meals. Which nursing problem has the greatest priority for this client? A. Loss of interest
in diversional activity B. Social isolation C. Refusal to address nutritional needs D. Low self-
esteem Answer: C. Refusal to address nutritional needs Rationale: Physiological needs
(nutrition) take priority over psychosocial needs per Maslow's hierarchy. Severe malnutrition can
lead to life-threatening complications like refeeding syndrome or organ failure in depressed
clients.
Question 2 A male client approaches the nurse with an angry expression and raises his voice,
saying, "My roommate is the most selfish, self-centered, angry person I have ever met. If he
loses his temper one more time with me, I am going to punch him out!" The nurse recognizes
that the client is using which defense mechanism? A. Denial B. Projection C. Rationalization D.
Displacement Answer: B. Projection Rationale: Projection involves attributing one's own
unacceptable feelings (anger) to another person. This client is describing his own traits in the
roommate to avoid self-awareness.
Question 3 A client who has just been sexually assaulted is calm and quiet. The nurse analyzes
this behavior as indicating which defense mechanism? A. Denial B. Projection C. Rationalization
D. Intellectualization Answer: A. Denial Rationale: Denial is a common initial response to
trauma, where the client suppresses awareness of the event to protect the ego. Calmness may
mask shock; further assessment is needed.
Question 4 The nurse is interviewing a client with schizophrenia. Which question is most
important to ask regarding auditory hallucinations? A. "How do these voices make you feel?" B.
"Do the voices tell you to harm yourself or others?" C. "When did the voices start?" D. "Are the
voices male or female?" Answer: B. Do the voices tell you to harm yourself or others?
Rationale: Assessing for command hallucinations is priority to ensure safety, as they increase
risk of self-harm or violence. Other questions explore content but safety first.
Question 5 A client with bipolar disorder is prescribed lithium. The client reports nausea and
tremors. What is the nurse's priority action? A. Administer an antiemetic B. Check the client's
, lithium level C. Encourage more water intake D. Notify the provider Answer: B. Check the
client's lithium level Rationale: Nausea and tremors suggest lithium toxicity (therapeutic range
0.6–1.2 mEq/L). Immediate lab check guides further intervention to prevent neurotoxicity.
Question 6 A mental health worker is caring for a client with escalating aggressive behavior.
Which action by the MHW warrants immediate intervention by the RN? A. Approaching the
client from the front with arms at sides B. Speaking in a calm, low tone C. Standing with feet
apart for stability D. Maintaining eye contact at all times Answer: D. Maintaining eye contact
at all times Rationale: Prolonged eye contact can be perceived as threatening and escalate
agitation. De-escalation prioritizes non-confrontational body language.
Question 7 A client says to the nurse, "I'm going to die, and I wish my family would stop hoping
for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." The
therapeutic response is: A. "Have you shared your feelings with your family?" B. "I think you
need to accept the inevitable." C. "Anger is a normal part of dying." D. "Why don't you tell me
how you feel about dying?" Answer: A. Have you shared your feelings with your family?
Rationale: This encourages expression and problem-solving, fostering communication. It
validates feelings without false reassurance or confrontation.
Question 8 A female client presents in the ED after being raped last night. Which question is
most important for the nurse to ask? A. "Has she taken a bath since the rape occurred?" B. "Is the
place where she lives a safe place?" C. "Does she know the person who raped her?" D. "Did she
fight back?" Answer: A. Has she taken a bath since the rape occurred? Rationale: Bathing
can destroy forensic evidence; preserving it is priority for legal purposes. Safety and relationship
questions follow.
Question 9 Which data indicate to the nurse that a client is experiencing effective coping
following the loss of a spouse? A. The client reports sleeping 12 hours per night B. The client
avoids discussing the spouse C. The client participates in support group activities D. The client
refuses antidepressants Answer: C. The client participates in support group activities
Rationale: Active engagement in support systems shows adaptive coping and social
reconnection, key to grief resolution.
Question 10 A client with borderline personality disorder threatens to cut themselves during
group therapy. The nurse's priority action is: A. Administer PRN anxiolytic B. Place in seclusion
C. Assess safety risk and level of agitation D. Instruct to sit quietly Answer: C. Assess safety
risk and level of agitation Rationale: Assessment guides interventions; immediate safety
evaluation prevents harm without premature escalation.
Question 11 A client with schizophrenia reports hearing voices telling him to harm others. The
nurse's immediate action? A. Administer antipsychotic B. Encourage journaling C. Implement
one-to-one observation D. Teach coping strategies Answer: C. Implement one-to-one
observation Rationale: Command hallucinations pose imminent danger; constant monitoring
ensures safety until medicated or de-escalated.
