MENTAL HEALTH HESI MOCK EXAMINATION
(2026–2027)
PRACTICE EXAMINATION FOR
PSYCHIATRIC/MENTAL HEALTH NURSING
CONTENT MASTERY
Field of Study: Psychiatric/Mental Health Nursing / HESI Preparation
Edition: 2026–2027
1. A client with major depressive disorder tells the nurse, "I am worthless and everyone would be
better off if I were dead." What is the nurse's priority response?
A) "Don't say that. You have so much to live for."
B) "Are you thinking about harming yourself?"
C) "Why do you feel that way?"
D) "You should talk to your family about how you feel."
Correct Answer: B
Rationale: The client's statement indicates suicidal ideation. The nurse must directly assess for suicidal
thoughts and plans. Option A dismisses the client's feelings. Asking "why" (C) is not therapeutic and
can feel accusatory. Encouraging family discussion (D) is secondary to safety assessment.
2. The nurse is caring for a client with generalized anxiety disorder who is pacing and
hyperventilating. Which nursing intervention is most appropriate initially?
A) Ask the client to describe what is causing the anxiety
B) Place the client in a quiet, low-stimuli environment
C) Teach the client deep breathing exercises
D) Administer PRN lorazepam
,Correct Answer: B
Rationale: During severe anxiety, the client cannot process information or learn new skills. Reducing
environmental stimuli helps decrease anxiety. Discussing causes (A) and teaching (C) are appropriate
when anxiety is mild to moderate. Medication (D) may be given but the environment is the first non-
pharmacological intervention.
3. A client with bipolar disorder in the manic phase is dressed in a revealing outfit and is making
sexual comments to staff. Which nursing intervention is most appropriate?
A) Ignore the behavior to avoid reinforcing it
B) Place the client in seclusion
C) Set firm limits on unacceptable behavior in a matter-of-fact manner
D) Restrain the client
Correct Answer: C
Rationale: Limit setting is essential in the manic phase. The nurse should calmly and consistently state
what behavior is unacceptable and redirect the client. Ignoring (A) may be appropriate for some
attention-seeking behaviors, but sexual comments require intervention. Seclusion (B) and restraints
(D) are used only when the client is a danger to self or others.
4. The nurse is evaluating a client with schizophrenia who has been taking haloperidol. The client
displays lip smacking, tongue protrusion, and facial grimacing. The nurse should suspect:
A) Acute dystonia
B) Tardive dyskinesia
C) Akathisia
D) Parkinsonism
Correct Answer: B
Rationale: Tardive dyskinesia is characterized by involuntary, repetitive movements of the face, tongue,
and extremities, often associated with long-term use of first-generation antipsychotics like haloperidol.
,Acute dystonia (A) involves sudden muscle spasms, often of the neck and eyes. Akathisia (C) is motor
restlessness. Parkinsonism (D) presents with tremors, rigidity, and bradykinesia.
5. A client with obsessive-compulsive disorder (OCD) is repeatedly washing hands until they are
raw. Which intervention should the nurse implement?
A) Restrict the client's access to soap and water
B) Allow the behavior but set limits on the time spent hand washing
C) Tell the client that the behavior is irrational
D) Ignore the behavior completely
Correct Answer: B
Rationale: Abruptly preventing the ritual (A) can increase anxiety. Setting limits on the time allowed
for the ritual helps the client gain some control while beginning to reduce the compulsion. Challenging
the irrationality (C) is not therapeutic initially. Ignoring (D) may lead to physical harm if the skin
becomes infected.
6. The nurse is caring for a client who is withdrawing from alcohol. Which assessment finding
indicates that the client is experiencing delirium tremens (DTs)?
A) Bradycardia and hypotension
B) Severe confusion, hallucinations, and autonomic hyperactivity
C) Lethargy and slurred speech
D) Euphoria and increased appetite
Correct Answer: B
Rationale: Delirium tremens is a medical emergency characterized by severe confusion, hallucinations
(often visual), tachycardia, hypertension, diaphoresis, and tremors. Bradycardia (A) is not
characteristic. Lethargy and slurred speech (C) suggest intoxication, not withdrawal. Euphoria (D) is
not associated with DTs.
7. A client with major depressive disorder is started on fluoxetine. The nurse should teach the client
that the therapeutic effect may take:
, A) 24 to 48 hours
B) 1 to 2 weeks
C) 2 to 4 weeks
D) 6 to 8 weeks
Correct Answer: C
Rationale: SSRIs like fluoxetine typically take 2 to 4 weeks to reach full therapeutic effect, although
some initial improvement in energy and sleep may be seen earlier. Option A is for fast-acting
anxiolytics. Option B is too early for full response. Option D is longer than usual.
8. The nurse is evaluating a client who is taking lithium. Which serum lithium level would indicate
toxicity?
A) 0.5 mEq/L
B) 1.0 mEq/L
C) 1.5 mEq/L
D) 2.5 mEq/L
Correct Answer: D
Rationale: Therapeutic lithium levels range from 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L are
considered toxic, and levels above 2.0 mEq/L require immediate intervention. Option A is
subtherapeutic. Options B and C are within therapeutic range.
9. A client with borderline personality disorder tells the nurse, "You are the only one who
understands me. The other nurses are awful." What is the best response by the nurse?
A) "Thank you. I try to be understanding."
B) "The other nurses are very competent."
C) "I am here to help you, but all the staff work together as a team."
D) "Why do you think the other nurses are awful?"
Correct Answer: C
Rationale: The client is exhibiting splitting behavior, pitting staff against each other. The nurse should
(2026–2027)
PRACTICE EXAMINATION FOR
PSYCHIATRIC/MENTAL HEALTH NURSING
CONTENT MASTERY
Field of Study: Psychiatric/Mental Health Nursing / HESI Preparation
Edition: 2026–2027
1. A client with major depressive disorder tells the nurse, "I am worthless and everyone would be
better off if I were dead." What is the nurse's priority response?
A) "Don't say that. You have so much to live for."
B) "Are you thinking about harming yourself?"
C) "Why do you feel that way?"
D) "You should talk to your family about how you feel."
Correct Answer: B
Rationale: The client's statement indicates suicidal ideation. The nurse must directly assess for suicidal
thoughts and plans. Option A dismisses the client's feelings. Asking "why" (C) is not therapeutic and
can feel accusatory. Encouraging family discussion (D) is secondary to safety assessment.
2. The nurse is caring for a client with generalized anxiety disorder who is pacing and
hyperventilating. Which nursing intervention is most appropriate initially?
A) Ask the client to describe what is causing the anxiety
B) Place the client in a quiet, low-stimuli environment
C) Teach the client deep breathing exercises
D) Administer PRN lorazepam
,Correct Answer: B
Rationale: During severe anxiety, the client cannot process information or learn new skills. Reducing
environmental stimuli helps decrease anxiety. Discussing causes (A) and teaching (C) are appropriate
when anxiety is mild to moderate. Medication (D) may be given but the environment is the first non-
pharmacological intervention.
3. A client with bipolar disorder in the manic phase is dressed in a revealing outfit and is making
sexual comments to staff. Which nursing intervention is most appropriate?
A) Ignore the behavior to avoid reinforcing it
B) Place the client in seclusion
C) Set firm limits on unacceptable behavior in a matter-of-fact manner
D) Restrain the client
Correct Answer: C
Rationale: Limit setting is essential in the manic phase. The nurse should calmly and consistently state
what behavior is unacceptable and redirect the client. Ignoring (A) may be appropriate for some
attention-seeking behaviors, but sexual comments require intervention. Seclusion (B) and restraints
(D) are used only when the client is a danger to self or others.
4. The nurse is evaluating a client with schizophrenia who has been taking haloperidol. The client
displays lip smacking, tongue protrusion, and facial grimacing. The nurse should suspect:
A) Acute dystonia
B) Tardive dyskinesia
C) Akathisia
D) Parkinsonism
Correct Answer: B
Rationale: Tardive dyskinesia is characterized by involuntary, repetitive movements of the face, tongue,
and extremities, often associated with long-term use of first-generation antipsychotics like haloperidol.
,Acute dystonia (A) involves sudden muscle spasms, often of the neck and eyes. Akathisia (C) is motor
restlessness. Parkinsonism (D) presents with tremors, rigidity, and bradykinesia.
5. A client with obsessive-compulsive disorder (OCD) is repeatedly washing hands until they are
raw. Which intervention should the nurse implement?
A) Restrict the client's access to soap and water
B) Allow the behavior but set limits on the time spent hand washing
C) Tell the client that the behavior is irrational
D) Ignore the behavior completely
Correct Answer: B
Rationale: Abruptly preventing the ritual (A) can increase anxiety. Setting limits on the time allowed
for the ritual helps the client gain some control while beginning to reduce the compulsion. Challenging
the irrationality (C) is not therapeutic initially. Ignoring (D) may lead to physical harm if the skin
becomes infected.
6. The nurse is caring for a client who is withdrawing from alcohol. Which assessment finding
indicates that the client is experiencing delirium tremens (DTs)?
A) Bradycardia and hypotension
B) Severe confusion, hallucinations, and autonomic hyperactivity
C) Lethargy and slurred speech
D) Euphoria and increased appetite
Correct Answer: B
Rationale: Delirium tremens is a medical emergency characterized by severe confusion, hallucinations
(often visual), tachycardia, hypertension, diaphoresis, and tremors. Bradycardia (A) is not
characteristic. Lethargy and slurred speech (C) suggest intoxication, not withdrawal. Euphoria (D) is
not associated with DTs.
7. A client with major depressive disorder is started on fluoxetine. The nurse should teach the client
that the therapeutic effect may take:
, A) 24 to 48 hours
B) 1 to 2 weeks
C) 2 to 4 weeks
D) 6 to 8 weeks
Correct Answer: C
Rationale: SSRIs like fluoxetine typically take 2 to 4 weeks to reach full therapeutic effect, although
some initial improvement in energy and sleep may be seen earlier. Option A is for fast-acting
anxiolytics. Option B is too early for full response. Option D is longer than usual.
8. The nurse is evaluating a client who is taking lithium. Which serum lithium level would indicate
toxicity?
A) 0.5 mEq/L
B) 1.0 mEq/L
C) 1.5 mEq/L
D) 2.5 mEq/L
Correct Answer: D
Rationale: Therapeutic lithium levels range from 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L are
considered toxic, and levels above 2.0 mEq/L require immediate intervention. Option A is
subtherapeutic. Options B and C are within therapeutic range.
9. A client with borderline personality disorder tells the nurse, "You are the only one who
understands me. The other nurses are awful." What is the best response by the nurse?
A) "Thank you. I try to be understanding."
B) "The other nurses are very competent."
C) "I am here to help you, but all the staff work together as a team."
D) "Why do you think the other nurses are awful?"
Correct Answer: C
Rationale: The client is exhibiting splitting behavior, pitting staff against each other. The nurse should
