HESI PN MENTAL HEALTH EXAM LEVEL
3 QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
CORE DOMAINS
Foundations of Mental Health Nursing
Therapeutic Communication and Relationships
Anxiety, Trauma, and Somatic Disorders
Depressive Disorders and Suicide Risk
Bipolar and Related Disorders
Psychotic Disorders and Schizophrenia
Substance Use and Addictive Disorders
Eating Disorders and Personality Disorders
Neurocognitive Disorders
Legal and Ethical Issues in Mental Health
INTRODUCTION
The HESI PN Mental Health Exam Level 3 evaluates the practical nursing student's mastery
of psychiatric-mental health nursing concepts and readiness for NCLEX-PN success. The
examination assesses clinical judgment through multiple-choice and Next Generation
NCLEX-style items emphasizing therapeutic communication, safety prioritization, and
psychopharmacology. Content covers all psychiatric domains with emphasis on suicide risk
assessment, crisis intervention, de-escalation, and medication management. This
assessment measures the candidate's ability to recognize and analyze cues, prioritize
hypotheses, generate solutions, and evaluate outcomes in realistic mental health scenarios.
A HESI score of 900 or greater suggests optimal readiness for first-time NCLEX-PN success.
SECTION ONE: QUESTIONS 1–100
1. A client diagnosed with depression tells the PN, "I don't see any point in going on
anymore." What is the most appropriate response by the PN?
,A. "You have so much to live for, you just need to think positively."
B. "I understand how you feel, I would feel the same way in your situation."
C. "Tell me more about what makes you feel this way."
D. "Don't say that, things will get better soon."
Correct answer: C
RATIONALE: Encouraging the client to express their feelings in more detail is the most
therapeutic response. This open-ended question allows the client to explore their emotions
and provides the nurse with crucial assessment information about the client's suicidal
ideation. Offering false reassurance (A and D) dismisses the client's feelings and closes off
communication. Stating "I understand how you feel" (B) is nontherapeutic because it
assumes the nurse knows exactly what the client is experiencing, which can invalidate the
client's unique experience.
2. A client with depression tells the PN, "I don't think I can go on living like this."
What is the PN's priority action?
A. Encourage the client to talk about their feelings
B. Notify the client's family of the statement
C. Ask the client if they have a plan to harm themselves
D. Document the statement in the client's chart
Correct answer: C
RATIONALE: The client's statement indicates a potential risk for suicide. The priority
action is to assess for suicidal ideation, including whether the client has a specific plan, as
this guides immediate safety interventions. Encouraging discussion, notifying family, or
documenting are secondary to ensuring the client's safety.
3. A client with borderline personality disorder is manipulating staff members by
pitting one nurse against another. What is the most appropriate nursing
intervention?
A. Confront the client about their manipulative behavior directly.
B. Discuss the manipulation with the client during a group therapy session.
C. Ensure all staff members present a consistent, unified approach to the client.
D. Ignore the manipulative behavior and focus on other issues.
, Correct answer: C
RATIONALE: Clients with borderline personality disorder often engage in "splitting"
behaviors where they see staff as either all-good or all-bad and may attempt to divide staff.
A consistent, unified team approach is essential to prevent manipulation and provide clear,
predictable boundaries. Direct confrontation (A) may escalate the situation. Discussing
the manipulation in group (B) could be humiliating and untherapeutic. Ignoring the
behavior (D) allows the manipulation to continue and undermines staff authority.
4. The PN is caring for a client with paranoid schizophrenia who states, "The FBI is
watching me through the television." What is the most therapeutic response?
A. "That's not true, the FBI is not watching you."
B. "Why would the FBI be interested in you?"
C. "I understand you believe that, but I don't see anyone watching you."
D. "Let's talk about something else instead."
Correct answer: C
RATIONALE: This response validates the client's feelings without confirming the
delusion. It acknowledges the client's reality while gently presenting the nurse's
perspective, maintaining a therapeutic relationship without reinforcing the delusional
belief. Directly contradicting the client (A) may damage trust and increase defensiveness.
Asking "why" (B) can lead to further elaboration of the delusion. Changing the subject (D)
dismisses the client's concerns and may be perceived as uncaring.
5. A client with schizophrenia is experiencing auditory hallucinations. Which
statement by the PN demonstrates therapeutic communication?
A. "Those voices aren't real; you need to ignore them."
B. "What are the voices telling you to do?"
C. "Why do you think you're hearing voices?"
D. "Let's talk about something else to distract you."
Correct answer: B
RATIONALE: Asking what the voices are saying validates the client's experience
without reinforcing the hallucination and helps assess for potential harmful commands,
, which is critical for safety. Dismissing the voices, questioning their cause, or changing the
subject may invalidate the client's feelings or miss critical information.
6. The PN is caring for a client who is withdrawn and avoids eye contact. Which
nursing action is most appropriate to establish a therapeutic relationship?
A. Sit with the client in silence for brief periods throughout the day.
B. Encourage the client to participate in group activities immediately.
C. Ask the client direct questions about why they are avoiding interaction.
D. Leave the client alone until they are ready to initiate conversation.
Correct answer: A
RATIONALE: Sitting with the client in silence demonstrates acceptance and
availability without demanding interaction. This non-threatening presence helps build
trust and allows the client to set the pace for engagement. Encouraging immediate group
participation (B) may overwhelm the withdrawn client and increase anxiety. Direct
questioning (C) can be perceived as confrontational and push the client further away.
Leaving the client completely alone (D) may be interpreted as rejection and abandonment.
7. A client with a diagnosis of schizophrenia tells the PN, "I can't take this
medication anymore. It makes me feel like a zombie." What is the PN's best
response?
A. "You must take the medication as prescribed."
B. "I understand. Let's talk about what you're experiencing and discuss this with your
provider."
C. "The medication is necessary for your condition."
D. "That is a common side effect; you'll get used to it."
Correct answer: B
RATIONALE: This response validates the client's feelings, addresses the concern, and
involves the client in their care planning. Medication adherence is best supported through
collaborative problem-solving rather than directives or dismissiveness.
8. A client with bipolar disorder is prescribed lithium carbonate. Which laboratory
value should the PN monitor closely?
3 QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
CORE DOMAINS
Foundations of Mental Health Nursing
Therapeutic Communication and Relationships
Anxiety, Trauma, and Somatic Disorders
Depressive Disorders and Suicide Risk
Bipolar and Related Disorders
Psychotic Disorders and Schizophrenia
Substance Use and Addictive Disorders
Eating Disorders and Personality Disorders
Neurocognitive Disorders
Legal and Ethical Issues in Mental Health
INTRODUCTION
The HESI PN Mental Health Exam Level 3 evaluates the practical nursing student's mastery
of psychiatric-mental health nursing concepts and readiness for NCLEX-PN success. The
examination assesses clinical judgment through multiple-choice and Next Generation
NCLEX-style items emphasizing therapeutic communication, safety prioritization, and
psychopharmacology. Content covers all psychiatric domains with emphasis on suicide risk
assessment, crisis intervention, de-escalation, and medication management. This
assessment measures the candidate's ability to recognize and analyze cues, prioritize
hypotheses, generate solutions, and evaluate outcomes in realistic mental health scenarios.
A HESI score of 900 or greater suggests optimal readiness for first-time NCLEX-PN success.
SECTION ONE: QUESTIONS 1–100
1. A client diagnosed with depression tells the PN, "I don't see any point in going on
anymore." What is the most appropriate response by the PN?
,A. "You have so much to live for, you just need to think positively."
B. "I understand how you feel, I would feel the same way in your situation."
C. "Tell me more about what makes you feel this way."
D. "Don't say that, things will get better soon."
Correct answer: C
RATIONALE: Encouraging the client to express their feelings in more detail is the most
therapeutic response. This open-ended question allows the client to explore their emotions
and provides the nurse with crucial assessment information about the client's suicidal
ideation. Offering false reassurance (A and D) dismisses the client's feelings and closes off
communication. Stating "I understand how you feel" (B) is nontherapeutic because it
assumes the nurse knows exactly what the client is experiencing, which can invalidate the
client's unique experience.
2. A client with depression tells the PN, "I don't think I can go on living like this."
What is the PN's priority action?
A. Encourage the client to talk about their feelings
B. Notify the client's family of the statement
C. Ask the client if they have a plan to harm themselves
D. Document the statement in the client's chart
Correct answer: C
RATIONALE: The client's statement indicates a potential risk for suicide. The priority
action is to assess for suicidal ideation, including whether the client has a specific plan, as
this guides immediate safety interventions. Encouraging discussion, notifying family, or
documenting are secondary to ensuring the client's safety.
3. A client with borderline personality disorder is manipulating staff members by
pitting one nurse against another. What is the most appropriate nursing
intervention?
A. Confront the client about their manipulative behavior directly.
B. Discuss the manipulation with the client during a group therapy session.
C. Ensure all staff members present a consistent, unified approach to the client.
D. Ignore the manipulative behavior and focus on other issues.
, Correct answer: C
RATIONALE: Clients with borderline personality disorder often engage in "splitting"
behaviors where they see staff as either all-good or all-bad and may attempt to divide staff.
A consistent, unified team approach is essential to prevent manipulation and provide clear,
predictable boundaries. Direct confrontation (A) may escalate the situation. Discussing
the manipulation in group (B) could be humiliating and untherapeutic. Ignoring the
behavior (D) allows the manipulation to continue and undermines staff authority.
4. The PN is caring for a client with paranoid schizophrenia who states, "The FBI is
watching me through the television." What is the most therapeutic response?
A. "That's not true, the FBI is not watching you."
B. "Why would the FBI be interested in you?"
C. "I understand you believe that, but I don't see anyone watching you."
D. "Let's talk about something else instead."
Correct answer: C
RATIONALE: This response validates the client's feelings without confirming the
delusion. It acknowledges the client's reality while gently presenting the nurse's
perspective, maintaining a therapeutic relationship without reinforcing the delusional
belief. Directly contradicting the client (A) may damage trust and increase defensiveness.
Asking "why" (B) can lead to further elaboration of the delusion. Changing the subject (D)
dismisses the client's concerns and may be perceived as uncaring.
5. A client with schizophrenia is experiencing auditory hallucinations. Which
statement by the PN demonstrates therapeutic communication?
A. "Those voices aren't real; you need to ignore them."
B. "What are the voices telling you to do?"
C. "Why do you think you're hearing voices?"
D. "Let's talk about something else to distract you."
Correct answer: B
RATIONALE: Asking what the voices are saying validates the client's experience
without reinforcing the hallucination and helps assess for potential harmful commands,
, which is critical for safety. Dismissing the voices, questioning their cause, or changing the
subject may invalidate the client's feelings or miss critical information.
6. The PN is caring for a client who is withdrawn and avoids eye contact. Which
nursing action is most appropriate to establish a therapeutic relationship?
A. Sit with the client in silence for brief periods throughout the day.
B. Encourage the client to participate in group activities immediately.
C. Ask the client direct questions about why they are avoiding interaction.
D. Leave the client alone until they are ready to initiate conversation.
Correct answer: A
RATIONALE: Sitting with the client in silence demonstrates acceptance and
availability without demanding interaction. This non-threatening presence helps build
trust and allows the client to set the pace for engagement. Encouraging immediate group
participation (B) may overwhelm the withdrawn client and increase anxiety. Direct
questioning (C) can be perceived as confrontational and push the client further away.
Leaving the client completely alone (D) may be interpreted as rejection and abandonment.
7. A client with a diagnosis of schizophrenia tells the PN, "I can't take this
medication anymore. It makes me feel like a zombie." What is the PN's best
response?
A. "You must take the medication as prescribed."
B. "I understand. Let's talk about what you're experiencing and discuss this with your
provider."
C. "The medication is necessary for your condition."
D. "That is a common side effect; you'll get used to it."
Correct answer: B
RATIONALE: This response validates the client's feelings, addresses the concern, and
involves the client in their care planning. Medication adherence is best supported through
collaborative problem-solving rather than directives or dismissiveness.
8. A client with bipolar disorder is prescribed lithium carbonate. Which laboratory
value should the PN monitor closely?
