HESI RN Mental Health Exam- Latest Update 2026/2027 | 200
Questions and Verified Answers | Complete Q&A Guide | A+ Graded
SECTION 1: THERAPEUTIC COMMUNICATION & THE NURSECLIENT RELATIONSHIP (Questions 1–25)
1. A client tells the nurse, "I don't think I can go on anymore. Everything is hopeless." Which response by
the nurse is most therapeutic?
A) "You have so much to live for. Think about your family."
B) "Everyone feels down sometimes. You'll feel better soon."
C) "You are feeling hopeless right now. Tell me more about what's going on."
D) "Don't say that. You have a lot to be thankful for."
Correct Answer: C
Rationale: The most therapeutic response is to acknowledge the client's feelings and encourage further
exploration. Validating the client's emotion ("You are feeling hopeless") and using an openended
question ("Tell me more") fosters therapeutic communication and allows the nurse to assess suicide
risk. Options A, B, and D are dismissive and use false reassurance or platitudes, which block further
communication.
2. A client with schizophrenia tells the nurse, "The voices are telling me I'm evil." Which response by the
nurse is most therapeutic?
A) "I don't hear any voices. You must be imagining things."
B) "The voices are not real. Try to ignore them."
C) "That must be frightening for you. What are the voices saying?"
D) "You need to take your medication so the voices will stop."
,Correct Answer: C
Rationale: The most therapeutic response acknowledges the client's distress and explores the content of
the hallucinations without challenging the client's reality. This approach builds trust and allows the
nurse to assess for command hallucinations that may indicate risk of harm to self or others. Telling the
client the voices are not real or to ignore them can increase anxiety and damage the therapeutic
relationship.
3. A client with borderline personality disorder tells the nurse, "You're the only one who understands
me. The other nurses are all incompetent." Which defense mechanism is the client using?
A) Projection
B) Splitting
C) Denial
D) Displacement
Correct Answer: B
Rationale: Splitting is a defense mechanism commonly seen in borderline personality disorder, where
the client idealizes one person while devaluing others. The client views the nurse as "all good" and other
staff as "all bad," reflecting an inability to integrate positive and negative aspects of others.
4. A client who is angry and agitated is pacing in the hallway. Which nursing intervention is most
appropriate?
A) Approach the client and tell them to stop pacing
B) Maintain a calm demeanor and speak in a low, slow voice
C) Place the client in seclusion immediately
D) Ignore the client's behavior until they calm down
,Correct Answer: B
Rationale: When a client is agitated, the nurse should remain calm and use a low, slow voice to
deescalate the situation. This approach reduces the client's anxiety and models selfcontrol. Option A
may escalate the situation, option C is too restrictive without attempting deescalation, and option D
ignores a safety concern.
5. A nurse is caring for a client who is at risk for suicide. What is the priority nursing action?
A) Place the client on suicide precautions with oneonone observation
B) Ask the client if they have a plan and means to carry out suicide
C) Remove all potentially harmful objects from the client's room
D) Notify the healthcare provider of the client's suicidal ideation
Correct Answer: B
Rationale: The priority action when a client is at risk for suicide is to directly assess for suicidal ideation,
intent, plan, and means. This assessment is critical for determining the level of risk and appropriate
interventions. Options A, C, and D are important interventions but should follow the direct assessment
of risk.
6. A client with depression has been prescribed an SSRI. Which statement by the client indicates
understanding of the medication teaching?
A) "I will feel better immediately after taking this medication."
B) "I can stop taking this medication when I feel better."
C) "It may take 2 to 4 weeks before I notice improvement in my symptoms."
D) "I should take this medication only when I feel depressed."
, Correct Answer: C
Rationale: SSRIs typically take 2 to 4 weeks to reach therapeutic effect. Clients need to understand this
delay to prevent premature discontinuation. Telling the client the medication works immediately (A) is
incorrect; stopping the medication when feeling better (B) can lead to relapse; and taking the
medication only when feeling depressed (D) is not how SSRIs are prescribed.
7. A client with bipolar disorder who is taking lithium has a serum lithium level of 1.8 mEq/L. Which signs
and symptoms should the nurse expect?
A) Fine hand tremors and polyuria
B) Nausea, vomiting, and confusion
C) Sedation and weight gain
D) Dry mouth and constipation
Correct Answer: B
Rationale: The therapeutic range for lithium is 0.8–1.2 mEq/L. A level of 1.8 mEq/L indicates lithium
toxicity. Early signs of lithium toxicity include nausea, vomiting, diarrhea, drowsiness, confusion, and
coarse tremors. Fine tremors and polyuria (A) are common side effects at therapeutic levels. Sedation
and weight gain (C) are more common with other mood stabilizers.
8. A client with schizophrenia is prescribed clozapine. Which laboratory value is most important to
monitor?
A) Serum lithium level
B) Complete blood count (CBC) with differential
C) Liver function tests
D) Serum glucose
Questions and Verified Answers | Complete Q&A Guide | A+ Graded
SECTION 1: THERAPEUTIC COMMUNICATION & THE NURSECLIENT RELATIONSHIP (Questions 1–25)
1. A client tells the nurse, "I don't think I can go on anymore. Everything is hopeless." Which response by
the nurse is most therapeutic?
A) "You have so much to live for. Think about your family."
B) "Everyone feels down sometimes. You'll feel better soon."
C) "You are feeling hopeless right now. Tell me more about what's going on."
D) "Don't say that. You have a lot to be thankful for."
Correct Answer: C
Rationale: The most therapeutic response is to acknowledge the client's feelings and encourage further
exploration. Validating the client's emotion ("You are feeling hopeless") and using an openended
question ("Tell me more") fosters therapeutic communication and allows the nurse to assess suicide
risk. Options A, B, and D are dismissive and use false reassurance or platitudes, which block further
communication.
2. A client with schizophrenia tells the nurse, "The voices are telling me I'm evil." Which response by the
nurse is most therapeutic?
A) "I don't hear any voices. You must be imagining things."
B) "The voices are not real. Try to ignore them."
C) "That must be frightening for you. What are the voices saying?"
D) "You need to take your medication so the voices will stop."
,Correct Answer: C
Rationale: The most therapeutic response acknowledges the client's distress and explores the content of
the hallucinations without challenging the client's reality. This approach builds trust and allows the
nurse to assess for command hallucinations that may indicate risk of harm to self or others. Telling the
client the voices are not real or to ignore them can increase anxiety and damage the therapeutic
relationship.
3. A client with borderline personality disorder tells the nurse, "You're the only one who understands
me. The other nurses are all incompetent." Which defense mechanism is the client using?
A) Projection
B) Splitting
C) Denial
D) Displacement
Correct Answer: B
Rationale: Splitting is a defense mechanism commonly seen in borderline personality disorder, where
the client idealizes one person while devaluing others. The client views the nurse as "all good" and other
staff as "all bad," reflecting an inability to integrate positive and negative aspects of others.
4. A client who is angry and agitated is pacing in the hallway. Which nursing intervention is most
appropriate?
A) Approach the client and tell them to stop pacing
B) Maintain a calm demeanor and speak in a low, slow voice
C) Place the client in seclusion immediately
D) Ignore the client's behavior until they calm down
,Correct Answer: B
Rationale: When a client is agitated, the nurse should remain calm and use a low, slow voice to
deescalate the situation. This approach reduces the client's anxiety and models selfcontrol. Option A
may escalate the situation, option C is too restrictive without attempting deescalation, and option D
ignores a safety concern.
5. A nurse is caring for a client who is at risk for suicide. What is the priority nursing action?
A) Place the client on suicide precautions with oneonone observation
B) Ask the client if they have a plan and means to carry out suicide
C) Remove all potentially harmful objects from the client's room
D) Notify the healthcare provider of the client's suicidal ideation
Correct Answer: B
Rationale: The priority action when a client is at risk for suicide is to directly assess for suicidal ideation,
intent, plan, and means. This assessment is critical for determining the level of risk and appropriate
interventions. Options A, C, and D are important interventions but should follow the direct assessment
of risk.
6. A client with depression has been prescribed an SSRI. Which statement by the client indicates
understanding of the medication teaching?
A) "I will feel better immediately after taking this medication."
B) "I can stop taking this medication when I feel better."
C) "It may take 2 to 4 weeks before I notice improvement in my symptoms."
D) "I should take this medication only when I feel depressed."
, Correct Answer: C
Rationale: SSRIs typically take 2 to 4 weeks to reach therapeutic effect. Clients need to understand this
delay to prevent premature discontinuation. Telling the client the medication works immediately (A) is
incorrect; stopping the medication when feeling better (B) can lead to relapse; and taking the
medication only when feeling depressed (D) is not how SSRIs are prescribed.
7. A client with bipolar disorder who is taking lithium has a serum lithium level of 1.8 mEq/L. Which signs
and symptoms should the nurse expect?
A) Fine hand tremors and polyuria
B) Nausea, vomiting, and confusion
C) Sedation and weight gain
D) Dry mouth and constipation
Correct Answer: B
Rationale: The therapeutic range for lithium is 0.8–1.2 mEq/L. A level of 1.8 mEq/L indicates lithium
toxicity. Early signs of lithium toxicity include nausea, vomiting, diarrhea, drowsiness, confusion, and
coarse tremors. Fine tremors and polyuria (A) are common side effects at therapeutic levels. Sedation
and weight gain (C) are more common with other mood stabilizers.
8. A client with schizophrenia is prescribed clozapine. Which laboratory value is most important to
monitor?
A) Serum lithium level
B) Complete blood count (CBC) with differential
C) Liver function tests
D) Serum glucose
