HESI MENTAL HEALTH 2026/2027 – EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALE | 2027 Q&A | INSTANT DOWNLOAD PDF
1. A client newly admitted to an inpatient psychiatric unit reports hearing a voice
that others cannot hear. Which term best describes this experience?
A. Delusion
B. Illusion
C. Auditory hallucination
D. Derealization
Rationale: An auditory hallucination is a sensory perception without an external stimulus. A
delusion is a fixed false belief, an illusion is a misinterpretation of an actual stimulus, and
derealization involves feeling that the environment is unreal.
2. During an assessment, a client states, “The television news anchor is sending
me secret messages specifically meant for me.” Which finding does this
statement indicate?
A. Delusion of reference
B. Flight of ideas
C. Thought blocking
D. Depersonalization
Rationale: A delusion of reference occurs when a person incorrectly believes that ordinary
events, media, or communications have special personal significance. The belief persists despite
evidence that contradicts it.
3. A nurse is interviewing a client who is experiencing severe anxiety. Which
physiological response is most consistent with the sympathetic nervous system's
activation?
A. Decreased heart rate
B. Increased gastrointestinal activity
C. Constricted pupils
,D. Increased heart rate and blood pressure
Rationale: Sympathetic activation during anxiety increases heart rate, blood pressure,
respiratory rate, and alertness. Gastrointestinal activity generally decreases as the body
prepares for a perceived threat.
4. A client with moderate anxiety has difficulty concentrating during an interview.
Which nursing intervention is most appropriate?
A. Ask the client to make several important decisions immediately.
B. Use short, simple statements and reduce unnecessary environmental stimuli.
C. Encourage the client to participate in a large group activity.
D. Leave the client alone until the anxiety resolves.
Rationale: Moderate anxiety narrows perceptual ability and can interfere with concentration.
Simple communication and reduced stimulation help the client process information more
effectively.
5. A client experiencing panic-level anxiety is pacing rapidly and repeatedly stating,
“Something terrible is going to happen.” What is the nurse's priority?
A. Explore the client's childhood experiences.
B. Teach detailed relaxation theory.
C. Remain with the client and provide brief, calm directions.
D. Encourage the client to analyze the cause of the panic.
Rationale: During panic-level anxiety, the client's ability to process information is severely
impaired. The immediate priority is safety, calm presence, and simple directions rather than
extensive discussion or teaching.
6. Which statement best demonstrates therapeutic communication with a client who
is grieving?
A. “You need to stay strong for your family.”
B. “Everything happens for a reason.”
C. “I know exactly how you feel.”
D. “Tell me what this loss has been like for you.”
,Rationale: An open-ended statement encourages the client to express feelings and experiences
without imposing the nurse's interpretation. Clichés and statements claiming to know exactly
how the client feels can interfere with communication.
7. A client says, “I don't want to talk about what happened.” Which response by the
nurse is most therapeutic?
A. “You need to discuss it so that you can recover.”
B. “Why are you refusing to talk?”
C. “That's okay. I'll be available when you're ready.”
D. “You should try to forget about it.”
Rationale: Respecting the client's readiness preserves trust and autonomy. The nurse can remain
available without forcing disclosure or judging the client's response.
8. A client with major depressive disorder says, “My family would be better off
without me.” What should the nurse do first?
A. Assess the client directly for suicidal thoughts and plans.
B. Encourage the client to identify positive qualities.
C. Ask the family to visit immediately.
D. Redirect the conversation to future goals.
Rationale: Statements suggesting worthlessness or being a burden can indicate suicide risk.
Direct assessment of suicidal thoughts, intent, plan, means, and immediacy is necessary before
selecting further interventions.
9. Which client statement requires the most immediate follow-up by the nurse?
A. “I haven't enjoyed my hobbies lately.”
B. “I feel tired most of the time.”
C. “I don't have much of an appetite.”
D. “I have decided how I am going to end my life.”
Rationale: A specific suicide plan indicates an immediate safety concern. The nurse should
initiate appropriate suicide precautions and conduct a focused risk assessment.
, 10. A client taking an antidepressant reports that mood has improved but continues
to have thoughts of suicide. Which response by the nurse is most appropriate?
A. “Improved mood means the medication is working.”
B. “Suicidal thoughts are expected during treatment.”
C. “I am concerned about your safety, so I need to assess these thoughts further.”
D. “Try to focus on the positive changes.”
Rationale: Suicide risk must be assessed whenever suicidal thoughts are present, regardless of
improvement in mood. Antidepressant treatment does not eliminate the need for ongoing safety
assessment.
11. A client with generalized anxiety disorder asks why the nurse is teaching
diaphragmatic breathing. What is the best explanation?
A. “It prevents all future anxiety.”
B. “It can reduce physiological arousal by promoting slower, controlled breathing.”
C. “It eliminates the need for prescribed medication.”
D. “It suppresses uncomfortable emotions.”
Rationale: Controlled diaphragmatic breathing can reduce physiological arousal associated
with anxiety. It is a coping strategy rather than a cure or replacement for prescribed treatment.
12. A client with obsessive-compulsive disorder repeatedly washes the hands
because of an intense fear of contamination. Which behavior represents the
compulsion?
A. Fear of contamination
B. Intrusive thoughts about germs
C. Anxiety related to contamination
D. Repeated handwashing
Rationale: An obsession is an intrusive, unwanted thought or image, while a compulsion is a
repetitive behavior or mental act performed to reduce distress associated with an obsession.
13. A client with obsessive-compulsive disorder asks the nurse to repeatedly confirm
that the client's hands are clean. Which response is most therapeutic?
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALE | 2027 Q&A | INSTANT DOWNLOAD PDF
1. A client newly admitted to an inpatient psychiatric unit reports hearing a voice
that others cannot hear. Which term best describes this experience?
A. Delusion
B. Illusion
C. Auditory hallucination
D. Derealization
Rationale: An auditory hallucination is a sensory perception without an external stimulus. A
delusion is a fixed false belief, an illusion is a misinterpretation of an actual stimulus, and
derealization involves feeling that the environment is unreal.
2. During an assessment, a client states, “The television news anchor is sending
me secret messages specifically meant for me.” Which finding does this
statement indicate?
A. Delusion of reference
B. Flight of ideas
C. Thought blocking
D. Depersonalization
Rationale: A delusion of reference occurs when a person incorrectly believes that ordinary
events, media, or communications have special personal significance. The belief persists despite
evidence that contradicts it.
3. A nurse is interviewing a client who is experiencing severe anxiety. Which
physiological response is most consistent with the sympathetic nervous system's
activation?
A. Decreased heart rate
B. Increased gastrointestinal activity
C. Constricted pupils
,D. Increased heart rate and blood pressure
Rationale: Sympathetic activation during anxiety increases heart rate, blood pressure,
respiratory rate, and alertness. Gastrointestinal activity generally decreases as the body
prepares for a perceived threat.
4. A client with moderate anxiety has difficulty concentrating during an interview.
Which nursing intervention is most appropriate?
A. Ask the client to make several important decisions immediately.
B. Use short, simple statements and reduce unnecessary environmental stimuli.
C. Encourage the client to participate in a large group activity.
D. Leave the client alone until the anxiety resolves.
Rationale: Moderate anxiety narrows perceptual ability and can interfere with concentration.
Simple communication and reduced stimulation help the client process information more
effectively.
5. A client experiencing panic-level anxiety is pacing rapidly and repeatedly stating,
“Something terrible is going to happen.” What is the nurse's priority?
A. Explore the client's childhood experiences.
B. Teach detailed relaxation theory.
C. Remain with the client and provide brief, calm directions.
D. Encourage the client to analyze the cause of the panic.
Rationale: During panic-level anxiety, the client's ability to process information is severely
impaired. The immediate priority is safety, calm presence, and simple directions rather than
extensive discussion or teaching.
6. Which statement best demonstrates therapeutic communication with a client who
is grieving?
A. “You need to stay strong for your family.”
B. “Everything happens for a reason.”
C. “I know exactly how you feel.”
D. “Tell me what this loss has been like for you.”
,Rationale: An open-ended statement encourages the client to express feelings and experiences
without imposing the nurse's interpretation. Clichés and statements claiming to know exactly
how the client feels can interfere with communication.
7. A client says, “I don't want to talk about what happened.” Which response by the
nurse is most therapeutic?
A. “You need to discuss it so that you can recover.”
B. “Why are you refusing to talk?”
C. “That's okay. I'll be available when you're ready.”
D. “You should try to forget about it.”
Rationale: Respecting the client's readiness preserves trust and autonomy. The nurse can remain
available without forcing disclosure or judging the client's response.
8. A client with major depressive disorder says, “My family would be better off
without me.” What should the nurse do first?
A. Assess the client directly for suicidal thoughts and plans.
B. Encourage the client to identify positive qualities.
C. Ask the family to visit immediately.
D. Redirect the conversation to future goals.
Rationale: Statements suggesting worthlessness or being a burden can indicate suicide risk.
Direct assessment of suicidal thoughts, intent, plan, means, and immediacy is necessary before
selecting further interventions.
9. Which client statement requires the most immediate follow-up by the nurse?
A. “I haven't enjoyed my hobbies lately.”
B. “I feel tired most of the time.”
C. “I don't have much of an appetite.”
D. “I have decided how I am going to end my life.”
Rationale: A specific suicide plan indicates an immediate safety concern. The nurse should
initiate appropriate suicide precautions and conduct a focused risk assessment.
, 10. A client taking an antidepressant reports that mood has improved but continues
to have thoughts of suicide. Which response by the nurse is most appropriate?
A. “Improved mood means the medication is working.”
B. “Suicidal thoughts are expected during treatment.”
C. “I am concerned about your safety, so I need to assess these thoughts further.”
D. “Try to focus on the positive changes.”
Rationale: Suicide risk must be assessed whenever suicidal thoughts are present, regardless of
improvement in mood. Antidepressant treatment does not eliminate the need for ongoing safety
assessment.
11. A client with generalized anxiety disorder asks why the nurse is teaching
diaphragmatic breathing. What is the best explanation?
A. “It prevents all future anxiety.”
B. “It can reduce physiological arousal by promoting slower, controlled breathing.”
C. “It eliminates the need for prescribed medication.”
D. “It suppresses uncomfortable emotions.”
Rationale: Controlled diaphragmatic breathing can reduce physiological arousal associated
with anxiety. It is a coping strategy rather than a cure or replacement for prescribed treatment.
12. A client with obsessive-compulsive disorder repeatedly washes the hands
because of an intense fear of contamination. Which behavior represents the
compulsion?
A. Fear of contamination
B. Intrusive thoughts about germs
C. Anxiety related to contamination
D. Repeated handwashing
Rationale: An obsession is an intrusive, unwanted thought or image, while a compulsion is a
repetitive behavior or mental act performed to reduce distress associated with an obsession.
13. A client with obsessive-compulsive disorder asks the nurse to repeatedly confirm
that the client's hands are clean. Which response is most therapeutic?
