HESI RN MENTAL HEALTH
COMPREHENSIVE PRACTICE
EXAM
150 original exam-style questions
Correct answers and detailed rationales
2026-2027 EDITION
Independent practice resource. Not affiliated with, endorsed by, or composed of official HESI or Elsevier examination items.
,HESI RN MENTAL HEALTH - INDEPENDENT PRACTICE EXAM
About This Practice Exam
This resource contains 150 original nursing questions designed to approximate the clinical-judgment emphasis
commonly used in comprehensive nursing assessment. It does not reproduce the proprietary HESI Mental
Health Specialty Exam, and no public source provides its exact current item bank or scoring blueprint. HESI
scores are calculated through a proprietary model; therefore, a raw percentage on this practice set cannot be
converted into an official HESI score.
How the questions are styled
Questions emphasize client safety, prioritization, assessment before intervention, therapeutic communication,
medication monitoring, delegation boundaries, least-restrictive care, and recognition of urgent complications.
The bank includes single-best-answer, select-all-that-apply (SATA), priority, and clinical-judgment items.
Unless otherwise stated, assume prescriptions and organizational protocols are available and that the nurse
practices within applicable law and scope.
Content domain Items
Therapeutic Communication 5
Safety and Crisis 5
Mood Disorders 5
Psychotic Disorders 5
Anxiety and Trauma 20
Substance Use 15
Psychopharmacology 40
Personality and Behavior 10
Eating Disorders 10
Neurocognitive Disorders 10
Children and Adolescents 10
Perinatal and Older Adult 5
Legal and Ethical Care 10
TOTAL 150
Original educational resource | 2026-2027 edition Page 2
,HESI RN MENTAL HEALTH - INDEPENDENT PRACTICE EXAM
Test-Taking Framework
1. Identify the threat Look first for suicidal or homicidal intent, respiratory compromise, severe
medication reactions, delirium, withdrawal complications, violence, or
medical instability.
2. Assess before Obtain the focused assessment needed to define danger, except when an
routine action emergency intervention such as ventilation support is already clearly
required.
3. Choose least Use de-escalation and environmental modification before coercive
restrictive care measures when immediate safety permits.
4. Communicate Use direct, concrete, nonjudgmental language. Acknowledge feelings
therapeutically without validating delusions or promising secrecy.
5. Reassess After any intervention, evaluate safety, symptoms, adverse effects,
understanding, and need for escalation.
Suggested administration: Complete all 150 questions in one sitting or use three 50-question blocks. Mark one
answer unless the item says “Select all that apply.” Do not review the answer key until a block is complete.
Original educational resource | 2026-2027 edition Page 3
, HESI RN MENTAL HEALTH - INDEPENDENT PRACTICE EXAM
Practice Examination
Choose the best response for each item. For SATA items, select every option that is correct.
Therapeutic Communication
1. [Single best answer] A nurse assesses a client with possible Major depressive disorder.
Which finding most strongly supports this concern?
A. stable vital signs with no functional change
B. a single preference that causes no distress or impairment
C. encourage major decisions immediately
D. persistent low mood, anhedonia, early-morning awakening, guilt, and impaired concentration
2. [Priority] The nurse is caring for a client with Major depressive disorder. Which action
should the nurse take first?
A. wait for the next shift to determine whether the finding persists
B. ask directly about suicidal thoughts, plan, intent, access to means, and past attempts
C. promise to keep suicidal thoughts secret
D. complete all discharge teaching before reassessing the client
3. [Therapeutic communication] Which response by the nurse is most therapeutic for a
client experiencing Major depressive disorder?
A. “Everything will be fine if you try to think positively.”
B. “Why would you behave that way when you know it causes problems?”
C. “You should not feel that way; other people have it worse.”
D. “You sound overwhelmed. Tell me what feels hardest to manage right now.”
4. [Select all that apply] The nurse provides teaching related to Major depressive
disorder. Which instructions should the nurse include? Select all that apply.
A. use cheerful reassurance to stop discussion
B. report new or worsening suicidal thoughts promptly
C. encourage major decisions immediately
D. take prescribed antidepressants consistently
E. expect therapeutic benefit to develop over several weeks
5. [Clinical judgment] During reassessment of a client with Major depressive disorder,
which finding requires the most immediate follow-up?
A. the client requests written information about follow-up care
B. the client says the room temperature is uncomfortable
C. the client suddenly becomes calm after giving away possessions
D. the client asks when the next meal will arrive
Safety and Crisis
Original educational resource | 2026-2027 edition Page 4
COMPREHENSIVE PRACTICE
EXAM
150 original exam-style questions
Correct answers and detailed rationales
2026-2027 EDITION
Independent practice resource. Not affiliated with, endorsed by, or composed of official HESI or Elsevier examination items.
,HESI RN MENTAL HEALTH - INDEPENDENT PRACTICE EXAM
About This Practice Exam
This resource contains 150 original nursing questions designed to approximate the clinical-judgment emphasis
commonly used in comprehensive nursing assessment. It does not reproduce the proprietary HESI Mental
Health Specialty Exam, and no public source provides its exact current item bank or scoring blueprint. HESI
scores are calculated through a proprietary model; therefore, a raw percentage on this practice set cannot be
converted into an official HESI score.
How the questions are styled
Questions emphasize client safety, prioritization, assessment before intervention, therapeutic communication,
medication monitoring, delegation boundaries, least-restrictive care, and recognition of urgent complications.
The bank includes single-best-answer, select-all-that-apply (SATA), priority, and clinical-judgment items.
Unless otherwise stated, assume prescriptions and organizational protocols are available and that the nurse
practices within applicable law and scope.
Content domain Items
Therapeutic Communication 5
Safety and Crisis 5
Mood Disorders 5
Psychotic Disorders 5
Anxiety and Trauma 20
Substance Use 15
Psychopharmacology 40
Personality and Behavior 10
Eating Disorders 10
Neurocognitive Disorders 10
Children and Adolescents 10
Perinatal and Older Adult 5
Legal and Ethical Care 10
TOTAL 150
Original educational resource | 2026-2027 edition Page 2
,HESI RN MENTAL HEALTH - INDEPENDENT PRACTICE EXAM
Test-Taking Framework
1. Identify the threat Look first for suicidal or homicidal intent, respiratory compromise, severe
medication reactions, delirium, withdrawal complications, violence, or
medical instability.
2. Assess before Obtain the focused assessment needed to define danger, except when an
routine action emergency intervention such as ventilation support is already clearly
required.
3. Choose least Use de-escalation and environmental modification before coercive
restrictive care measures when immediate safety permits.
4. Communicate Use direct, concrete, nonjudgmental language. Acknowledge feelings
therapeutically without validating delusions or promising secrecy.
5. Reassess After any intervention, evaluate safety, symptoms, adverse effects,
understanding, and need for escalation.
Suggested administration: Complete all 150 questions in one sitting or use three 50-question blocks. Mark one
answer unless the item says “Select all that apply.” Do not review the answer key until a block is complete.
Original educational resource | 2026-2027 edition Page 3
, HESI RN MENTAL HEALTH - INDEPENDENT PRACTICE EXAM
Practice Examination
Choose the best response for each item. For SATA items, select every option that is correct.
Therapeutic Communication
1. [Single best answer] A nurse assesses a client with possible Major depressive disorder.
Which finding most strongly supports this concern?
A. stable vital signs with no functional change
B. a single preference that causes no distress or impairment
C. encourage major decisions immediately
D. persistent low mood, anhedonia, early-morning awakening, guilt, and impaired concentration
2. [Priority] The nurse is caring for a client with Major depressive disorder. Which action
should the nurse take first?
A. wait for the next shift to determine whether the finding persists
B. ask directly about suicidal thoughts, plan, intent, access to means, and past attempts
C. promise to keep suicidal thoughts secret
D. complete all discharge teaching before reassessing the client
3. [Therapeutic communication] Which response by the nurse is most therapeutic for a
client experiencing Major depressive disorder?
A. “Everything will be fine if you try to think positively.”
B. “Why would you behave that way when you know it causes problems?”
C. “You should not feel that way; other people have it worse.”
D. “You sound overwhelmed. Tell me what feels hardest to manage right now.”
4. [Select all that apply] The nurse provides teaching related to Major depressive
disorder. Which instructions should the nurse include? Select all that apply.
A. use cheerful reassurance to stop discussion
B. report new or worsening suicidal thoughts promptly
C. encourage major decisions immediately
D. take prescribed antidepressants consistently
E. expect therapeutic benefit to develop over several weeks
5. [Clinical judgment] During reassessment of a client with Major depressive disorder,
which finding requires the most immediate follow-up?
A. the client requests written information about follow-up care
B. the client says the room temperature is uncomfortable
C. the client suddenly becomes calm after giving away possessions
D. the client asks when the next meal will arrive
Safety and Crisis
Original educational resource | 2026-2027 edition Page 4
