LATEST 2025-2026 UPDATE HESI RN
MENTAL HEALTH EXIT EXAM –
PRACTICE QUESTIONS,WELL
DETAILED ANSWERS & RATIONALES
1.
A client with major depressive disorder states, “I don’t have the energy to get out of bed.” Which
nursing intervention is most appropriate?
A. Tell the client to “try harder.”
B. Encourage rest and sleep.
C. Assist with activities of daily living as needed.
D. Leave the client alone until ready.
Answer: C. Assist with activities of daily living as needed.
Rationale: Depressed clients often lack the energy or motivation for basic care; assisting them
helps maintain dignity and prevents self-neglect, while still promoting gradual independence.
2.
A nurse is planning care for a client with schizophrenia who reports auditory hallucinations.
What is the priority intervention?
A. Tell the client the voices are not real.
B. Encourage the client to describe the hallucinations.
C. Isolate the client until hallucinations resolve.
D. Distract the client with activities and reality-based interactions.
Answer: D. Distract the client with activities and reality-based interactions.
Rationale: Focusing on reality and providing distraction reduces the impact of hallucinations;
directly challenging the hallucination may increase defensiveness and anxiety.
3.
During group therapy, a client with bipolar disorder becomes loud and disruptive. What should
the nurse do first?
A. Ask the client to leave the group.
B. Speak firmly and redirect the client to appropriate behavior.
,C. Ignore the client’s behavior.
D. End the group session early.
Answer: B. Speak firmly and redirect the client to appropriate behavior.
Rationale: Redirection and firm limit-setting help maintain group structure and safety without
unnecessary punishment or disruption of therapy for others.
4.
A client with generalized anxiety disorder states, “I feel like I’m going to lose control.” What is
the nurse’s best initial response?
A. “Tell me more about what you’re feeling.”
B. “Don’t worry, everything will be fine.”
C. “You need to calm down right now.”
D. “That must be very frightening for you.”
Answer: D. “That must be very frightening for you.”
Rationale: Empathic, supportive responses help validate the client’s feelings and reduce anxiety;
false reassurance or commands can increase distress.
5.
Which finding indicates that a client with bulimia nervosa is improving?
A. The client expresses guilt about eating.
B. The client maintains a food journal.
C. The client avoids group meals.
D. The client loses weight rapidly.
Answer: B. The client maintains a food journal.
Rationale: Keeping a food journal indicates engagement in treatment and willingness to monitor
behaviors; avoidance and weight loss are not positive outcomes in recovery.
6.
A client with PTSD reports frequent nightmares and difficulty sleeping. Which intervention is
most therapeutic?
A. Encourage use of alcohol to induce sleep.
B. Teach relaxation techniques before bedtime.
C. Suggest watching TV until sleep occurs.
D. Recommend sleeping during the day instead.
,Answer: B. Teach relaxation techniques before bedtime.
Rationale: Relaxation and sleep hygiene strategies help reduce anxiety and promote rest;
alcohol and daytime sleeping worsen symptoms.
7.
A client with borderline personality disorder engages in self-mutilation. What is the priority
nursing intervention?
A. Allow the client to express anger through self-harm.
B. Apply dressings and move on quickly.
C. Maintain a safe environment and encourage alternative coping.
D. Punish the client for self-harm behavior.
Answer: C. Maintain a safe environment and encourage alternative coping.
Rationale: Safety is the priority; teaching adaptive coping methods helps prevent recurrence,
while punishment is non-therapeutic.
8.
Which symptom is most characteristic of obsessive-compulsive disorder (OCD)?
A. Disorganized speech
B. Persistent, unwanted thoughts and repetitive behaviors
C. Suspicious delusions
D. Grandiose ideas
Answer: B. Persistent, unwanted thoughts and repetitive behaviors.
Rationale: OCD is defined by obsessions (thoughts) and compulsions (behaviors) that cause
distress; psychotic symptoms are unrelated.
9.
A client with substance use disorder is admitted for detoxification. Which assessment finding is
most concerning?
A. Tremors
B. Nausea
C. Seizures
D. Anxiety
, Answer: C. Seizures.
Rationale: Withdrawal seizures are life-threatening and require immediate intervention;
tremors, nausea, and anxiety are expected but less critical.
10.
Which communication technique is most effective when working with a client who is paranoid?
A. Provide lengthy explanations.
B. Use clear, simple, and direct statements.
C. Maintain intense eye contact.
D. Use humor to ease tension.
Answer: B. Use clear, simple, and direct statements.
Rationale: Clients with paranoia benefit from concise communication that avoids
misinterpretation; humor and prolonged eye contact may increase suspicion.
HESI RN Mental Health Exit Exam –
Practice Questions (Complete Set)
11.
A client with schizophrenia is taking haloperidol. Which finding requires immediate action?
A. Constipation
B. Muscle rigidity and high fever
C. Dry mouth
D. Drowsiness
Answer: B. Muscle rigidity and high fever
Rationale: These are signs of neuroleptic malignant syndrome (NMS), a life-threatening reaction
to antipsychotics requiring emergency intervention.
12.
MENTAL HEALTH EXIT EXAM –
PRACTICE QUESTIONS,WELL
DETAILED ANSWERS & RATIONALES
1.
A client with major depressive disorder states, “I don’t have the energy to get out of bed.” Which
nursing intervention is most appropriate?
A. Tell the client to “try harder.”
B. Encourage rest and sleep.
C. Assist with activities of daily living as needed.
D. Leave the client alone until ready.
Answer: C. Assist with activities of daily living as needed.
Rationale: Depressed clients often lack the energy or motivation for basic care; assisting them
helps maintain dignity and prevents self-neglect, while still promoting gradual independence.
2.
A nurse is planning care for a client with schizophrenia who reports auditory hallucinations.
What is the priority intervention?
A. Tell the client the voices are not real.
B. Encourage the client to describe the hallucinations.
C. Isolate the client until hallucinations resolve.
D. Distract the client with activities and reality-based interactions.
Answer: D. Distract the client with activities and reality-based interactions.
Rationale: Focusing on reality and providing distraction reduces the impact of hallucinations;
directly challenging the hallucination may increase defensiveness and anxiety.
3.
During group therapy, a client with bipolar disorder becomes loud and disruptive. What should
the nurse do first?
A. Ask the client to leave the group.
B. Speak firmly and redirect the client to appropriate behavior.
,C. Ignore the client’s behavior.
D. End the group session early.
Answer: B. Speak firmly and redirect the client to appropriate behavior.
Rationale: Redirection and firm limit-setting help maintain group structure and safety without
unnecessary punishment or disruption of therapy for others.
4.
A client with generalized anxiety disorder states, “I feel like I’m going to lose control.” What is
the nurse’s best initial response?
A. “Tell me more about what you’re feeling.”
B. “Don’t worry, everything will be fine.”
C. “You need to calm down right now.”
D. “That must be very frightening for you.”
Answer: D. “That must be very frightening for you.”
Rationale: Empathic, supportive responses help validate the client’s feelings and reduce anxiety;
false reassurance or commands can increase distress.
5.
Which finding indicates that a client with bulimia nervosa is improving?
A. The client expresses guilt about eating.
B. The client maintains a food journal.
C. The client avoids group meals.
D. The client loses weight rapidly.
Answer: B. The client maintains a food journal.
Rationale: Keeping a food journal indicates engagement in treatment and willingness to monitor
behaviors; avoidance and weight loss are not positive outcomes in recovery.
6.
A client with PTSD reports frequent nightmares and difficulty sleeping. Which intervention is
most therapeutic?
A. Encourage use of alcohol to induce sleep.
B. Teach relaxation techniques before bedtime.
C. Suggest watching TV until sleep occurs.
D. Recommend sleeping during the day instead.
,Answer: B. Teach relaxation techniques before bedtime.
Rationale: Relaxation and sleep hygiene strategies help reduce anxiety and promote rest;
alcohol and daytime sleeping worsen symptoms.
7.
A client with borderline personality disorder engages in self-mutilation. What is the priority
nursing intervention?
A. Allow the client to express anger through self-harm.
B. Apply dressings and move on quickly.
C. Maintain a safe environment and encourage alternative coping.
D. Punish the client for self-harm behavior.
Answer: C. Maintain a safe environment and encourage alternative coping.
Rationale: Safety is the priority; teaching adaptive coping methods helps prevent recurrence,
while punishment is non-therapeutic.
8.
Which symptom is most characteristic of obsessive-compulsive disorder (OCD)?
A. Disorganized speech
B. Persistent, unwanted thoughts and repetitive behaviors
C. Suspicious delusions
D. Grandiose ideas
Answer: B. Persistent, unwanted thoughts and repetitive behaviors.
Rationale: OCD is defined by obsessions (thoughts) and compulsions (behaviors) that cause
distress; psychotic symptoms are unrelated.
9.
A client with substance use disorder is admitted for detoxification. Which assessment finding is
most concerning?
A. Tremors
B. Nausea
C. Seizures
D. Anxiety
, Answer: C. Seizures.
Rationale: Withdrawal seizures are life-threatening and require immediate intervention;
tremors, nausea, and anxiety are expected but less critical.
10.
Which communication technique is most effective when working with a client who is paranoid?
A. Provide lengthy explanations.
B. Use clear, simple, and direct statements.
C. Maintain intense eye contact.
D. Use humor to ease tension.
Answer: B. Use clear, simple, and direct statements.
Rationale: Clients with paranoia benefit from concise communication that avoids
misinterpretation; humor and prolonged eye contact may increase suspicion.
HESI RN Mental Health Exit Exam –
Practice Questions (Complete Set)
11.
A client with schizophrenia is taking haloperidol. Which finding requires immediate action?
A. Constipation
B. Muscle rigidity and high fever
C. Dry mouth
D. Drowsiness
Answer: B. Muscle rigidity and high fever
Rationale: These are signs of neuroleptic malignant syndrome (NMS), a life-threatening reaction
to antipsychotics requiring emergency intervention.
12.
