HESI MENTAL HEALTH EXAM 2026/2027 – EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
1. A client with major depressive disorder says, “Nothing matters anymore.
Everyone would be better off without me.” Which response by the nurse is most
appropriate?
A. “You should focus on the positive things in your life.”
B. “Why do you think everyone would be better off without you?”
C. “Are you thinking about hurting or killing yourself?”
D. “Your family would be devastated if something happened to you.”
Rationale: Directly asking about suicidal thoughts is appropriate and does not increase suicidal
behavior. A clear assessment of suicidal ideation helps determine the client’s immediate level of
risk and need for safety interventions.
2. A nurse is communicating with a client experiencing acute anxiety. Which nursing
action is most therapeutic?
A. Use short, simple statements and remain with the client.
B. Encourage the client to explain all sources of anxiety immediately.
C. Ask the client to participate in a complex problem-solving activity.
D. Leave the client alone to decrease environmental stimulation.
Rationale: During acute anxiety, concentration and information processing are reduced. Simple
communication and the nurse’s calm presence provide structure and reduce stimulation.
3. A client newly diagnosed with schizophrenia reports hearing a voice saying, “You
are worthless.” Which response demonstrates therapeutic communication?
A. “The voice is not real, so you should ignore it.”
B. “What did you do to make the voice angry?”
C. “You need to stop listening to the voice.”
D. “I understand that you hear a voice, but I do not hear it.”
,Rationale: The nurse acknowledges the client’s experience without validating the hallucination
as reality. Presenting reality calmly helps maintain a therapeutic relationship.
4. A client taking lithium for bipolar disorder reports severe diarrhea, vomiting,
coarse hand tremors, and difficulty walking. What is the nurse’s priority action?
A. Encourage the client to increase physical activity.
B. Hold the medication and notify the healthcare provider.
C. Administer the next dose with food.
D. Reassure the client that these effects are expected.
Rationale: Severe gastrointestinal symptoms, coarse tremors, and impaired coordination can
indicate lithium toxicity. The medication should be withheld and the healthcare provider notified
promptly.
5. Which finding is most characteristic of mania?
A. Social withdrawal and slowed speech
B. Persistent sadness and hypersomnia
C. Decreased need for sleep with increased goal-directed activity
D. Fear of leaving the home because of panic attacks
Rationale: Mania commonly involves elevated or irritable mood, increased energy, decreased
need for sleep, rapid speech, and increased goal-directed or risky activity.
6. A client with generalized anxiety disorder repeatedly seeks reassurance from the
nurse. Which nursing approach is most appropriate?
A. Provide reassurance every time the client asks.
B. Tell the client that reassurance is unnecessary.
C. Avoid responding to the client’s concerns.
D. Encourage the client to identify and use previously learned coping strategies.
Rationale: Repeated reassurance can reinforce anxiety and dependence. Encouraging effective
coping strategies promotes autonomy and helps the client manage anxiety independently.
, 7. A client experiencing a panic attack is pacing rapidly and reports feeling unable
to breathe. Which intervention should the nurse implement first?
A. Ask the client to describe the source of the panic.
B. Teach detailed relaxation theory.
C. Stay with the client and use calm, brief statements.
D. Encourage the client to make several decisions about treatment.
Rationale: During a panic attack, the client’s ability to process information is severely impaired.
Staying with the client and providing simple, calm communication promotes safety and reduces
stimulation.
8. A client with obsessive-compulsive disorder repeatedly washes the hands
because of an intense fear of contamination. Which nursing intervention is
appropriate?
A. Force the client to stop washing immediately.
B. Tell the client that contamination fears are irrational.
C. Participate in the handwashing ritual.
D. Set reasonable limits while helping the client develop alternative coping behaviors.
Rationale: The nurse should avoid reinforcing compulsive rituals while maintaining a supportive
approach. Gradual development of alternative coping behaviors can reduce reliance on
compulsions.
9. A client taking an antipsychotic medication develops severe muscle rigidity, high
fever, confusion, and unstable blood pressure. Which complication should the
nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Tardive dyskinesia
D. Acute dystonia
Rationale: Severe rigidity, hyperthermia, altered mental status, and autonomic instability are
classic features of neuroleptic malignant syndrome, a potentially life-threatening reaction to
antipsychotic medications.
, 10. A client taking an antipsychotic medication develops involuntary chewing
movements and repetitive tongue movements. Which adverse effect is most
likely?
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Rationale: Tardive dyskinesia is characterized by involuntary repetitive movements, particularly
of the mouth, tongue, face, and sometimes limbs. Long-term exposure to antipsychotic
medications increases the risk.
11. A client with schizophrenia states, “The television announcer is sending special
messages directly to me.” Which symptom is the client demonstrating?
A. Somatic delusion
B. Thought broadcasting
C. Ideas of reference
D. Flight of ideas
Rationale: Ideas of reference occur when a person incorrectly believes that ordinary events,
such as television broadcasts, contain special personal messages directed toward them.
12. A client tells the nurse, “I know the staff are poisoning my food.” Which response
is most therapeutic?
A. “That is impossible because the staff are trained professionals.”
B. “You need to stop thinking that way.”
C. “Who specifically is trying to poison you?”
D. “That sounds frightening. I do not have evidence that your food is being poisoned.”
Rationale: The nurse acknowledges the client’s emotional response while presenting reality
without arguing about the delusion or reinforcing it.
13. A client with depression has been prescribed a selective serotonin reuptake
inhibitor (SSRI). Which statement indicates appropriate understanding?
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
1. A client with major depressive disorder says, “Nothing matters anymore.
Everyone would be better off without me.” Which response by the nurse is most
appropriate?
A. “You should focus on the positive things in your life.”
B. “Why do you think everyone would be better off without you?”
C. “Are you thinking about hurting or killing yourself?”
D. “Your family would be devastated if something happened to you.”
Rationale: Directly asking about suicidal thoughts is appropriate and does not increase suicidal
behavior. A clear assessment of suicidal ideation helps determine the client’s immediate level of
risk and need for safety interventions.
2. A nurse is communicating with a client experiencing acute anxiety. Which nursing
action is most therapeutic?
A. Use short, simple statements and remain with the client.
B. Encourage the client to explain all sources of anxiety immediately.
C. Ask the client to participate in a complex problem-solving activity.
D. Leave the client alone to decrease environmental stimulation.
Rationale: During acute anxiety, concentration and information processing are reduced. Simple
communication and the nurse’s calm presence provide structure and reduce stimulation.
3. A client newly diagnosed with schizophrenia reports hearing a voice saying, “You
are worthless.” Which response demonstrates therapeutic communication?
A. “The voice is not real, so you should ignore it.”
B. “What did you do to make the voice angry?”
C. “You need to stop listening to the voice.”
D. “I understand that you hear a voice, but I do not hear it.”
,Rationale: The nurse acknowledges the client’s experience without validating the hallucination
as reality. Presenting reality calmly helps maintain a therapeutic relationship.
4. A client taking lithium for bipolar disorder reports severe diarrhea, vomiting,
coarse hand tremors, and difficulty walking. What is the nurse’s priority action?
A. Encourage the client to increase physical activity.
B. Hold the medication and notify the healthcare provider.
C. Administer the next dose with food.
D. Reassure the client that these effects are expected.
Rationale: Severe gastrointestinal symptoms, coarse tremors, and impaired coordination can
indicate lithium toxicity. The medication should be withheld and the healthcare provider notified
promptly.
5. Which finding is most characteristic of mania?
A. Social withdrawal and slowed speech
B. Persistent sadness and hypersomnia
C. Decreased need for sleep with increased goal-directed activity
D. Fear of leaving the home because of panic attacks
Rationale: Mania commonly involves elevated or irritable mood, increased energy, decreased
need for sleep, rapid speech, and increased goal-directed or risky activity.
6. A client with generalized anxiety disorder repeatedly seeks reassurance from the
nurse. Which nursing approach is most appropriate?
A. Provide reassurance every time the client asks.
B. Tell the client that reassurance is unnecessary.
C. Avoid responding to the client’s concerns.
D. Encourage the client to identify and use previously learned coping strategies.
Rationale: Repeated reassurance can reinforce anxiety and dependence. Encouraging effective
coping strategies promotes autonomy and helps the client manage anxiety independently.
, 7. A client experiencing a panic attack is pacing rapidly and reports feeling unable
to breathe. Which intervention should the nurse implement first?
A. Ask the client to describe the source of the panic.
B. Teach detailed relaxation theory.
C. Stay with the client and use calm, brief statements.
D. Encourage the client to make several decisions about treatment.
Rationale: During a panic attack, the client’s ability to process information is severely impaired.
Staying with the client and providing simple, calm communication promotes safety and reduces
stimulation.
8. A client with obsessive-compulsive disorder repeatedly washes the hands
because of an intense fear of contamination. Which nursing intervention is
appropriate?
A. Force the client to stop washing immediately.
B. Tell the client that contamination fears are irrational.
C. Participate in the handwashing ritual.
D. Set reasonable limits while helping the client develop alternative coping behaviors.
Rationale: The nurse should avoid reinforcing compulsive rituals while maintaining a supportive
approach. Gradual development of alternative coping behaviors can reduce reliance on
compulsions.
9. A client taking an antipsychotic medication develops severe muscle rigidity, high
fever, confusion, and unstable blood pressure. Which complication should the
nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Tardive dyskinesia
D. Acute dystonia
Rationale: Severe rigidity, hyperthermia, altered mental status, and autonomic instability are
classic features of neuroleptic malignant syndrome, a potentially life-threatening reaction to
antipsychotic medications.
, 10. A client taking an antipsychotic medication develops involuntary chewing
movements and repetitive tongue movements. Which adverse effect is most
likely?
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Rationale: Tardive dyskinesia is characterized by involuntary repetitive movements, particularly
of the mouth, tongue, face, and sometimes limbs. Long-term exposure to antipsychotic
medications increases the risk.
11. A client with schizophrenia states, “The television announcer is sending special
messages directly to me.” Which symptom is the client demonstrating?
A. Somatic delusion
B. Thought broadcasting
C. Ideas of reference
D. Flight of ideas
Rationale: Ideas of reference occur when a person incorrectly believes that ordinary events,
such as television broadcasts, contain special personal messages directed toward them.
12. A client tells the nurse, “I know the staff are poisoning my food.” Which response
is most therapeutic?
A. “That is impossible because the staff are trained professionals.”
B. “You need to stop thinking that way.”
C. “Who specifically is trying to poison you?”
D. “That sounds frightening. I do not have evidence that your food is being poisoned.”
Rationale: The nurse acknowledges the client’s emotional response while presenting reality
without arguing about the delusion or reinforcing it.
13. A client with depression has been prescribed a selective serotonin reuptake
inhibitor (SSRI). Which statement indicates appropriate understanding?
