HESI Psychiatric–Mental Health Nursing Comprehensive
Review (2026–2027): 300 Practice Questions with Detailed
Rationales
1. An adolescent male receives a prescription for an antidepressant drug because he is
exhibiting a depressed affect. While the client is taking the antidepressant, which
comparison of the client's behavior before and after taking the drug is most important for
the nurse to obtain?
A. His appetite.
B. The emotional quality of his attitude
C. His level of activity.
D. The interactions he has with others. - ANSWER--B
2. A nurse is providing education about strategies for a safety plan for a female client who is a
victim of intimate partner violence. Which strategies should be included in the safety plan?
Select all that apply.
A. Purchase a gun to use for protection
B. Establish a code with family and friends to signify violence.
C. Plan an escape route to use if the abuser blocks the main exit.
D. Have a bag ready that has extra clothes for self and children - ANSWER--B C D
3. While sitting in the dayroom of the mental health unit, a male adolescent avoids eye contact,
looks at the floor, and talks softly when interacting verbally with the nurse. The two trade
places, and the nurse demonstrate the client's behavior. What is the main goal of this
therapeutic techniques?
A. Discuss the client's feeling when he responds.
B. Allow the client to identify the way he interacts.
C. Initiate a non-threatening conversation with the client.
D. Dialog about the ineffectiveness of his interactions.) - ANSWER--B
4. A client with depression remains in bed most of the day, and declines activities. 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
5. The RN is preparing medications for a client with bipolar disorder and notices that the client
discontinued antipsychotic medication for several days. Which medication should also be
discontinued?
a. Lithium. (Lithotabs)
b. Benzotropine (Cogentin).
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, c. Alprazolam (Xanax).
d. Magnesium (Milk of Magnesia). - ANSWER--B
6. A female client requests that her husband be allowed to stay in the room during the
admission assessment. When interviewing the client, the RN notes a discrepancy between
the client's verbal and nonverbal communication. What action does the RN take?
A. Pay close attention and document the nonverbal messages.
B. Ask the client's husband to interpret the discrepancy.
C. Ignore the nonverbal behavior and focus on the client's verbal messages.
D. Integrate the verbal and nonverbal messages and interpret them as one. - ANSWER--
A
7. A male client approaches the RN with an angry expression on his face 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 RN recognizes
that the client is using which defense mechanism?
A. Denial.
B. Projection.
C. Rationalization.
D. Splitting. - ANSWER--B
8. A male client with bipolar disorder who began taking lithium carbonate five days ago is
complaining of excessive thirst, and the RN finds him attempting to drink water from the
bathroom sink faucet. Which intervention should the RN implement?
A. Report the client's serum lithium level to the HCP.
B. Encourage the client to suck on hard candy to relieve the symptoms.
C. No action is needed since polydipsia is a common side effect.
D. Tell the client that drinking from the faucet is not allowed. - ANSWER--A
9. The RN is teaching a client about the initiation of the prescribed abstinence therapy using
disulfiram (Antabuse). What information should the client acknowledge understanding?
A. Completely abstain from heroin or cocaine use.
B. Remain alcohol free for 12 hours prior to the first dose.
C. Attend monthly meetings of alcoholics anonymous.
D. Admit to others that he is a substance user. - ANSWER--B
10. A male client with schizophrenia is admitted to the mental health unit after abruptly
stopping his prescription for ziprasidone (Geodon) one month ago. Which question is most
important for the RN to ask the client?
A. Have you lost interest in the things that you used to enjoy?
B. Is your ability to think or concentrate decreased?
C. How many continuous hours do you sleep at night?
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, D. Do you hear sounds or voices that others do not hear? - ANSWER--D
11. During an annual physical by the occupational RN working in a corporate clinic, a male
employee tells the RN that is high-stress job is causing trouble in his personal life. He further
explains that he often gets so angry while driving to and from work that he has considered
"getting even" with other drivers. How should the RN respond?
A. "Anger is contagious and could result in major confrontation."
B. "Try not to let your anger cause you to act impulsively."
C. "Expressing your anger to a stranger could result in an unsafe situation."
D. "It sounds as if there are many situations that make you feel angry." - ANSWER--D
12. A client who has agoraphobia (a fear of crowds) is beginning desensitization with the
therapist, and the RN is reinforcing the process. Which intervention has the highest priority
for this client's plan of care?
A. Encourage substitution of positive thoughts and negative ones.
B. Establish trust by providing a calm, safe environment.
C. Progressively expose the client to larger crowds.
D. Encourage deep breathing when anxiety escalates in a crowd. - ANSWER--B
13. Which nursing actions are likely to help promote the self-esteem of a male client with
modern depression?
A. Ask the client what his long term goals are.
B. Discuss the challenges of his medical condition.
C. Include the client in determining treatment protocol.
D. Encourage the client to engage in recreational therapy.
E. Provide opportunities for the client to discuss his concerns. - ANSWER--A D E
14. A male client is admitted to the psychiatric unit for recurrent negative symptoms of chronic
schizophrenia and medication adjustment of Risperidone (Risperdal). When the client walks
to the nurse's station in a laterally contracted position, he states that something has made
his body contort into a monster. What action should the RN take?
A. Medicate the client with the prescribed antipsychotic thioridazine (Mellaril).
B. Offer the client a prescribed physical therapy hot pack for muscle spasms.
C. Direct client to occupational therapy to distract him from somatic complaints.
D. Administer the prescribed anticholinergic benztropine (Cogentin) for dystonia. -
ANSWER--D
15. A mental health worker is caring for a client with escalating aggressive behavior. Which
action by the MHW warrant immediate intervention by the RN?
A. Is attempting to physically restrain the patient.
B. Tells the client to go to the quiet area of the unit.
C. Is using a loid voice to talk to the client.
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, D. Remains at a distance of 4 feet from the client. - ANSWER--A
16. A client on the mental health unit is becoming more agitated, shouting at the staff, and
pacing in the hallway. When the PRN medication is offered, the client refuses the medication
and defiantly sits on the floor in the middle of the unit hallway. What nursing intervention
should the RN implement first?
A. Transport of the client to the seclusion room.
B. Quietly approach the client with additional staff members.
C. Take other clients in the area to the client lounge.
D. Administer medication to chemically restrain the patient. - ANSWER--C
17. A client is admitted to the mental health unit and reports taking extra antianxiety medication
because, "I'm so stressed out. I just want to go to sleep." The RN should plan one-on-one
observation of the client based on which statement?
A. "What should I do? Nothing seems to help."
B. "I have been so tired lately and needed to sleep."
C. "I really think that I don't need to be here."
D. "I don't want to walk. Nothing matters anymore." - ANSWER--D
18. A male hospital employee is pushed out the way by a female employee because of an
oncoming gurney. The pushed employee becomes very angry and swings at the female
employee. Both employees are referred for counseling with the staff psychiatric RN. Which
factor in the pushed employee's history is most related to the reaction that occurred?
A. Is worried about losing his job to a woman.
B. Tortured animals as a child.
C. Was physically abused by his mother.
D. Hates to be touched by anyone. - ANSWER--C
19. The RN documents the mental status of a female client who has been hospitalized for several
days by court order. The client states, "I don't need to be here" and tells the RN that she
believes the television talks to her. The RN should document these assessment findings in
which section of the mental status exam/
A. Level of concentration.
B. Insightandjudgement.
C. Remotememory. D. Mood and affect. - ANSWER--B
20. A client is admitted to the mental health unit reports shortness of breath and dizziness. The
client tells the RN, "I feel like I'm going to die". Which nursing problem should the RN include
in this client's plan of care?
A. Mood disturbance.
B. Moderate anxiety.
C. Alteredthoughts.
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Review (2026–2027): 300 Practice Questions with Detailed
Rationales
1. An adolescent male receives a prescription for an antidepressant drug because he is
exhibiting a depressed affect. While the client is taking the antidepressant, which
comparison of the client's behavior before and after taking the drug is most important for
the nurse to obtain?
A. His appetite.
B. The emotional quality of his attitude
C. His level of activity.
D. The interactions he has with others. - ANSWER--B
2. A nurse is providing education about strategies for a safety plan for a female client who is a
victim of intimate partner violence. Which strategies should be included in the safety plan?
Select all that apply.
A. Purchase a gun to use for protection
B. Establish a code with family and friends to signify violence.
C. Plan an escape route to use if the abuser blocks the main exit.
D. Have a bag ready that has extra clothes for self and children - ANSWER--B C D
3. While sitting in the dayroom of the mental health unit, a male adolescent avoids eye contact,
looks at the floor, and talks softly when interacting verbally with the nurse. The two trade
places, and the nurse demonstrate the client's behavior. What is the main goal of this
therapeutic techniques?
A. Discuss the client's feeling when he responds.
B. Allow the client to identify the way he interacts.
C. Initiate a non-threatening conversation with the client.
D. Dialog about the ineffectiveness of his interactions.) - ANSWER--B
4. A client with depression remains in bed most of the day, and declines activities. 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
5. The RN is preparing medications for a client with bipolar disorder and notices that the client
discontinued antipsychotic medication for several days. Which medication should also be
discontinued?
a. Lithium. (Lithotabs)
b. Benzotropine (Cogentin).
1|Page
, c. Alprazolam (Xanax).
d. Magnesium (Milk of Magnesia). - ANSWER--B
6. A female client requests that her husband be allowed to stay in the room during the
admission assessment. When interviewing the client, the RN notes a discrepancy between
the client's verbal and nonverbal communication. What action does the RN take?
A. Pay close attention and document the nonverbal messages.
B. Ask the client's husband to interpret the discrepancy.
C. Ignore the nonverbal behavior and focus on the client's verbal messages.
D. Integrate the verbal and nonverbal messages and interpret them as one. - ANSWER--
A
7. A male client approaches the RN with an angry expression on his face 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 RN recognizes
that the client is using which defense mechanism?
A. Denial.
B. Projection.
C. Rationalization.
D. Splitting. - ANSWER--B
8. A male client with bipolar disorder who began taking lithium carbonate five days ago is
complaining of excessive thirst, and the RN finds him attempting to drink water from the
bathroom sink faucet. Which intervention should the RN implement?
A. Report the client's serum lithium level to the HCP.
B. Encourage the client to suck on hard candy to relieve the symptoms.
C. No action is needed since polydipsia is a common side effect.
D. Tell the client that drinking from the faucet is not allowed. - ANSWER--A
9. The RN is teaching a client about the initiation of the prescribed abstinence therapy using
disulfiram (Antabuse). What information should the client acknowledge understanding?
A. Completely abstain from heroin or cocaine use.
B. Remain alcohol free for 12 hours prior to the first dose.
C. Attend monthly meetings of alcoholics anonymous.
D. Admit to others that he is a substance user. - ANSWER--B
10. A male client with schizophrenia is admitted to the mental health unit after abruptly
stopping his prescription for ziprasidone (Geodon) one month ago. Which question is most
important for the RN to ask the client?
A. Have you lost interest in the things that you used to enjoy?
B. Is your ability to think or concentrate decreased?
C. How many continuous hours do you sleep at night?
2|Page
, D. Do you hear sounds or voices that others do not hear? - ANSWER--D
11. During an annual physical by the occupational RN working in a corporate clinic, a male
employee tells the RN that is high-stress job is causing trouble in his personal life. He further
explains that he often gets so angry while driving to and from work that he has considered
"getting even" with other drivers. How should the RN respond?
A. "Anger is contagious and could result in major confrontation."
B. "Try not to let your anger cause you to act impulsively."
C. "Expressing your anger to a stranger could result in an unsafe situation."
D. "It sounds as if there are many situations that make you feel angry." - ANSWER--D
12. A client who has agoraphobia (a fear of crowds) is beginning desensitization with the
therapist, and the RN is reinforcing the process. Which intervention has the highest priority
for this client's plan of care?
A. Encourage substitution of positive thoughts and negative ones.
B. Establish trust by providing a calm, safe environment.
C. Progressively expose the client to larger crowds.
D. Encourage deep breathing when anxiety escalates in a crowd. - ANSWER--B
13. Which nursing actions are likely to help promote the self-esteem of a male client with
modern depression?
A. Ask the client what his long term goals are.
B. Discuss the challenges of his medical condition.
C. Include the client in determining treatment protocol.
D. Encourage the client to engage in recreational therapy.
E. Provide opportunities for the client to discuss his concerns. - ANSWER--A D E
14. A male client is admitted to the psychiatric unit for recurrent negative symptoms of chronic
schizophrenia and medication adjustment of Risperidone (Risperdal). When the client walks
to the nurse's station in a laterally contracted position, he states that something has made
his body contort into a monster. What action should the RN take?
A. Medicate the client with the prescribed antipsychotic thioridazine (Mellaril).
B. Offer the client a prescribed physical therapy hot pack for muscle spasms.
C. Direct client to occupational therapy to distract him from somatic complaints.
D. Administer the prescribed anticholinergic benztropine (Cogentin) for dystonia. -
ANSWER--D
15. A mental health worker is caring for a client with escalating aggressive behavior. Which
action by the MHW warrant immediate intervention by the RN?
A. Is attempting to physically restrain the patient.
B. Tells the client to go to the quiet area of the unit.
C. Is using a loid voice to talk to the client.
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, D. Remains at a distance of 4 feet from the client. - ANSWER--A
16. A client on the mental health unit is becoming more agitated, shouting at the staff, and
pacing in the hallway. When the PRN medication is offered, the client refuses the medication
and defiantly sits on the floor in the middle of the unit hallway. What nursing intervention
should the RN implement first?
A. Transport of the client to the seclusion room.
B. Quietly approach the client with additional staff members.
C. Take other clients in the area to the client lounge.
D. Administer medication to chemically restrain the patient. - ANSWER--C
17. A client is admitted to the mental health unit and reports taking extra antianxiety medication
because, "I'm so stressed out. I just want to go to sleep." The RN should plan one-on-one
observation of the client based on which statement?
A. "What should I do? Nothing seems to help."
B. "I have been so tired lately and needed to sleep."
C. "I really think that I don't need to be here."
D. "I don't want to walk. Nothing matters anymore." - ANSWER--D
18. A male hospital employee is pushed out the way by a female employee because of an
oncoming gurney. The pushed employee becomes very angry and swings at the female
employee. Both employees are referred for counseling with the staff psychiatric RN. Which
factor in the pushed employee's history is most related to the reaction that occurred?
A. Is worried about losing his job to a woman.
B. Tortured animals as a child.
C. Was physically abused by his mother.
D. Hates to be touched by anyone. - ANSWER--C
19. The RN documents the mental status of a female client who has been hospitalized for several
days by court order. The client states, "I don't need to be here" and tells the RN that she
believes the television talks to her. The RN should document these assessment findings in
which section of the mental status exam/
A. Level of concentration.
B. Insightandjudgement.
C. Remotememory. D. Mood and affect. - ANSWER--B
20. A client is admitted to the mental health unit reports shortness of breath and dizziness. The
client tells the RN, "I feel like I'm going to die". Which nursing problem should the RN include
in this client's plan of care?
A. Mood disturbance.
B. Moderate anxiety.
C. Alteredthoughts.
4|Page
