HESI RN MENTAL HEALTH EXIT
EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES
GRADED A+ LATEST
1. A patient with major depressive disorder states, “I feel worthless and want
to die.” The nurse’s best initial response is:
A. “You should not feel that way; things will get better.”
B. “You are just having a bad day.”
C. “Are you thinking about harming yourself?”
D. “You should go for a walk and try to relax.”
Answer: C
Rationale: The nurse must assess for suicidal ideation immediately. This is a
safety priority and guides further intervention.
,2. A patient with schizophrenia is experiencing auditory hallucinations. The
nurse should first:
A. Encourage the patient to ignore the voices.
B. Ask the patient what the voices are saying.
C. Tell the patient the voices are not real.
D. Provide reassurance and use reality orientation.
Answer: D
Rationale: Reassurance and reality orientation reduce anxiety and provide safety.
Directly challenging hallucinations may increase distress.
3. A patient with bipolar disorder is manic and pacing the hall. The best
nursing intervention is:
A. Offer coffee and allow pacing.
B. Provide a structured, low-stimulation environment.
C. Encourage group activities.
D. Tell the patient to stop pacing immediately.
Answer: B
Rationale: A structured environment decreases stimulation and reduces risk of
injury and escalation.
4. A patient diagnosed with PTSD reports nightmares and hypervigilance.
The nurse should prioritize:
A. Encouraging avoidance of all reminders.
B. Teaching relaxation and grounding techniques.
C. Promoting social isolation.
D. Administering sedatives without assessment.
Answer: B
Rationale: Grounding and relaxation techniques help reduce symptoms and
improve coping without avoidance or isolation.
,5. A patient with generalized anxiety disorder asks for PRN medication. The
nurse should first:
A. Administer the medication immediately.
B. Ask the patient to describe current symptoms and coping strategies.
C. Refuse because anxiety is not dangerous.
D. Tell the patient to “calm down.”
Answer: B
Rationale: Assessing symptoms and coping strategies helps determine if
medication is needed and supports therapeutic intervention.
6. A patient is experiencing an acute panic attack. The most appropriate
nursing action is:
A. Encourage deep breathing and stay with the patient.
B. Provide a detailed explanation of anxiety.
C. Leave the patient alone to calm down.
D. Tell the patient to “stop being irrational.”
Answer: A
Rationale: Remaining with the patient and using breathing techniques helps
reduce panic symptoms and promotes safety.
7. A patient with anorexia nervosa refuses meals. The nurse’s best response is:
A. “If you don’t eat, you will be placed on a feeding tube.”
B. “You must eat to gain control of your health.”
C. “I understand this is difficult. Let’s talk about what you are feeling.”
D. “You can skip meals as long as you exercise.”
Answer: C
Rationale: Therapeutic communication explores feelings and supports motivation
without threats or judgment.
, 8. A patient with borderline personality disorder becomes angry and
threatens staff. The nurse should:
A. Ignore the behavior.
B. Set clear limits and maintain a calm, firm tone.
C. Argue with the patient.
D. Use physical restraints immediately.
Answer: B
Rationale: Setting limits maintains safety and structure while reducing escalation.
Restraints are last resort.
9. A patient with alcohol withdrawal is tremulous, anxious, and diaphoretic.
The nurse should prioritize:
A. Encouraging oral fluids.
B. Assessing for delirium tremens and initiating CIWA protocol.
C. Providing relaxation music.
D. Scheduling group therapy.
Answer: B
Rationale: Alcohol withdrawal can progress to delirium tremens; CIWA
assessment and intervention are priority for safety.
10. A patient with dementia is confused and wandering. The nurse’s best
intervention is:
A. Restrain the patient to prevent wandering.
B. Provide a safe, structured environment and frequent orientation.
C. Tell the patient to stay in bed.
D. Ignore the behavior.
Answer: B
Rationale: A safe environment and orientation reduce confusion and wandering
without using restraints.
EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES
GRADED A+ LATEST
1. A patient with major depressive disorder states, “I feel worthless and want
to die.” The nurse’s best initial response is:
A. “You should not feel that way; things will get better.”
B. “You are just having a bad day.”
C. “Are you thinking about harming yourself?”
D. “You should go for a walk and try to relax.”
Answer: C
Rationale: The nurse must assess for suicidal ideation immediately. This is a
safety priority and guides further intervention.
,2. A patient with schizophrenia is experiencing auditory hallucinations. The
nurse should first:
A. Encourage the patient to ignore the voices.
B. Ask the patient what the voices are saying.
C. Tell the patient the voices are not real.
D. Provide reassurance and use reality orientation.
Answer: D
Rationale: Reassurance and reality orientation reduce anxiety and provide safety.
Directly challenging hallucinations may increase distress.
3. A patient with bipolar disorder is manic and pacing the hall. The best
nursing intervention is:
A. Offer coffee and allow pacing.
B. Provide a structured, low-stimulation environment.
C. Encourage group activities.
D. Tell the patient to stop pacing immediately.
Answer: B
Rationale: A structured environment decreases stimulation and reduces risk of
injury and escalation.
4. A patient diagnosed with PTSD reports nightmares and hypervigilance.
The nurse should prioritize:
A. Encouraging avoidance of all reminders.
B. Teaching relaxation and grounding techniques.
C. Promoting social isolation.
D. Administering sedatives without assessment.
Answer: B
Rationale: Grounding and relaxation techniques help reduce symptoms and
improve coping without avoidance or isolation.
,5. A patient with generalized anxiety disorder asks for PRN medication. The
nurse should first:
A. Administer the medication immediately.
B. Ask the patient to describe current symptoms and coping strategies.
C. Refuse because anxiety is not dangerous.
D. Tell the patient to “calm down.”
Answer: B
Rationale: Assessing symptoms and coping strategies helps determine if
medication is needed and supports therapeutic intervention.
6. A patient is experiencing an acute panic attack. The most appropriate
nursing action is:
A. Encourage deep breathing and stay with the patient.
B. Provide a detailed explanation of anxiety.
C. Leave the patient alone to calm down.
D. Tell the patient to “stop being irrational.”
Answer: A
Rationale: Remaining with the patient and using breathing techniques helps
reduce panic symptoms and promotes safety.
7. A patient with anorexia nervosa refuses meals. The nurse’s best response is:
A. “If you don’t eat, you will be placed on a feeding tube.”
B. “You must eat to gain control of your health.”
C. “I understand this is difficult. Let’s talk about what you are feeling.”
D. “You can skip meals as long as you exercise.”
Answer: C
Rationale: Therapeutic communication explores feelings and supports motivation
without threats or judgment.
, 8. A patient with borderline personality disorder becomes angry and
threatens staff. The nurse should:
A. Ignore the behavior.
B. Set clear limits and maintain a calm, firm tone.
C. Argue with the patient.
D. Use physical restraints immediately.
Answer: B
Rationale: Setting limits maintains safety and structure while reducing escalation.
Restraints are last resort.
9. A patient with alcohol withdrawal is tremulous, anxious, and diaphoretic.
The nurse should prioritize:
A. Encouraging oral fluids.
B. Assessing for delirium tremens and initiating CIWA protocol.
C. Providing relaxation music.
D. Scheduling group therapy.
Answer: B
Rationale: Alcohol withdrawal can progress to delirium tremens; CIWA
assessment and intervention are priority for safety.
10. A patient with dementia is confused and wandering. The nurse’s best
intervention is:
A. Restrain the patient to prevent wandering.
B. Provide a safe, structured environment and frequent orientation.
C. Tell the patient to stay in bed.
D. Ignore the behavior.
Answer: B
Rationale: A safe environment and orientation reduce confusion and wandering
without using restraints.
