Adult Health HESI Exam 2026
High-Yield Questions with Correct Detailed
Answers & Rationales (A+)
Your Complete Study Guide for a Guaranteed Grade A+ Pass | NR 324 Adult Health | Updated 2026/2027
Covers: Mental Health Nursing • Psychiatric Pharmacology • Crisis Intervention • Substance Abuse •
Personality Disorders • Therapeutic Communication
Q1 A male client in the mental health unit is guarded and vaguely answers the nurse's
questions. He isolates in his room and sometimes opens the door to peek into the hall.
Which problem can the RN anticipate?
a. Visual hallucinations.
b. Auditory hallucinations.
c. Excessive motor activity.
d. Delusions of persecution.
✔ CORRECT ANSWER: D. Delusions of persecution.
RATIONALE
The client's guarded behavior, vague answers, isolation, and cautiously peeking into the hall all suggest
paranoid thinking and delusions of persecution — a belief that others are out to harm him. These are classic
behavioral cues of paranoid ideation rather than hallucinations or motor disturbances.
Q2 A female client with obsessive compulsive personality disorder is admitted for a cardiac
catheterization. The afternoon before the procedure, she begins to keep detailed notes of the
nursing care she is receiving and reports findings to the RN at bedtime. What action should
the nurse implement?
a. Explain to the client that her behavior invades the rights of the nursing staff.
b. Ask the client to explain why she is keeping a detailed record of her nursing care.
c. Teach the client strategies to control her obsessive compulsive behavior.
d. Encourage the client to express her feelings regarding the upcoming procedure.
✔procedure.
CORRECT ANSWER: D. Encourage the client to express her feelings regarding the upcoming
RATIONALE
The client's detailed note-taking is likely a coping mechanism for anxiety about the upcoming cardiac
catheterization. Encouraging the client to verbalize her fears and feelings is the most therapeutic approach.
Confronting the behavior or labeling it as invasive does not address the underlying anxiety driving it.
Q3 During admission to the psychiatric unit, a female client is extremely anxious and states
that she is worried about the sun coming up the next day. What intervention is most
important for the RN to implement during the admission process?
, a. Assist the client in developing alternative coping skills.
b. Remain calm and use a matter-of-fact approach.
c. Ask the client why she is so anxious.
d. Administer a PRN sedative to help relieve her anxiety.
✔ CORRECT ANSWER: A. Assist the client in developing alternative coping skills.
RATIONALE
During admission, helping the client develop alternative coping skills is the most important intervention as it
empowers the client to manage anxiety. Remaining calm is supportive but not the priority intervention. Asking
why she is anxious does not provide tools for managing it. Sedation should not be the first-line intervention
without exploring other options.
Q4 A female client is brought to the emergency department after being found disoriented,
disorganized, and confused. The RN determines the client is homeless and exhibiting
suspiciousness. What priority problem should be included in her plan of care?
a. Acute confusion.
b. Ineffective community coping.
c. Disturbed sensory perception.
d. Self-care deficit.
✔ CORRECT ANSWER: A. Acute confusion.
RATIONALE
Acute confusion is the priority problem because it represents an immediate safety risk. The client is disoriented,
disorganized, and confused — all hallmarks of acute confusion. Addressing confusion first ensures the client's
safety and allows for accurate assessment of other problems.
Q5 The occupational health nurse is working with a female employee just notified that her
child was involved in a MVA and taken to the hospital. The employee states, 'I can't believe
this. What should I do?' Which response is best for the RN to provide?
a. Tell me what you think should happen.
b. How serious was the collision?
c. What do you think you should do?
d. Call for transportation to the hospital.
✔ CORRECT ANSWER: D. Call for transportation to the hospital.
RATIONALE
In a crisis involving a child's safety, the priority is taking immediate action. The employee needs to get to the
hospital as quickly as possible. The other responses involve asking the employee to process or reflect during
an acute crisis, which is inappropriate when the most concrete, helpful action is arranging transportation.
Q6 A client tells the RN that he has an IQ of 400+ and is a genius and an inventor. He reports
being married to a female movie star and thinks his brother wants a sexual relationship with
her. What is the priority nursing problem for admission to the psychiatric unit?
a. Ineffective sexual patterns.
b. Impaired environmental interpretation.
c. Disturbed sensory perception.
, d. Compromised family coping.
✔ CORRECT ANSWER: A. Ineffective sexual patterns.
RATIONALE
The client's delusional belief that his brother wants a sexual relationship with his wife represents a dangerous
jealous delusion that poses risk for violence. Ineffective sexual patterns is the priority because the belief about
his brother's sexual intentions is the most potentially dangerous component and requires immediate attention to
prevent harm.
Q7 The RN is providing care for a client diagnosed with borderline personality disorder who
has self-inflicted lacerations on the abdomen. Which approach should the RN use when
changing this client's dressing?
a. Provide detailed thorough explanations when cleansing the wound.
b. Perform the dressing change in a non-judgmental manner.
c. Ask in a non-threatening manner why the client cut her own abdomen.
d. Request another staff member to assist with the dressing change.
✔ CORRECT ANSWER: B. Perform the dressing change in a non-judgmental manner.
RATIONALE
Clients with borderline personality disorder who self-harm are particularly sensitive to judgment and criticism.
Performing the dressing change in a non-judgmental manner maintains therapeutic trust and does not reinforce
or shame the self-harm behavior. Asking why during a dressing change is not the appropriate time and may be
perceived as accusatory.
Q8 While sitting in the day room, a male adolescent avoids eye contact, looks at the floor,
and talks softly when interacting with the RN. The two trade places and the RN demonstrates
the client's behaviors. What is the main goal of this therapeutic technique?
a. Initiate a non-threatening conversation with the client.
b. Dialog about the ineffectiveness of his interactions.
c. Allow the client to identify the way he interacts.
d. Discuss the client's feelings when he responds.
✔ CORRECT ANSWER: C. Allow the client to identify the way he interacts.
RATIONALE
By mirroring the client's behavior, the RN is using a role-reversal technique to help the client see himself from
an outside perspective. The goal is to increase self-awareness so the client can recognize how his
communication style may affect his relationships and social interactions.
Q9 An antidepressant medication is prescribed for a client who reports sleeping only 4
hours in the past 2 days and a weight loss of 9 lbs within the last month. Which client goal is
most important to achieve within the first three days of treatment?
a. Meet scheduled appointment with dietitian.
b. Sleep at least 6 hours a night.
c. Understands the purpose of the medication regimen.
d. Describes the reasons for hospitalization.
✔ CORRECT ANSWER: B. Sleep at least 6 hours a night.
High-Yield Questions with Correct Detailed
Answers & Rationales (A+)
Your Complete Study Guide for a Guaranteed Grade A+ Pass | NR 324 Adult Health | Updated 2026/2027
Covers: Mental Health Nursing • Psychiatric Pharmacology • Crisis Intervention • Substance Abuse •
Personality Disorders • Therapeutic Communication
Q1 A male client in the mental health unit is guarded and vaguely answers the nurse's
questions. He isolates in his room and sometimes opens the door to peek into the hall.
Which problem can the RN anticipate?
a. Visual hallucinations.
b. Auditory hallucinations.
c. Excessive motor activity.
d. Delusions of persecution.
✔ CORRECT ANSWER: D. Delusions of persecution.
RATIONALE
The client's guarded behavior, vague answers, isolation, and cautiously peeking into the hall all suggest
paranoid thinking and delusions of persecution — a belief that others are out to harm him. These are classic
behavioral cues of paranoid ideation rather than hallucinations or motor disturbances.
Q2 A female client with obsessive compulsive personality disorder is admitted for a cardiac
catheterization. The afternoon before the procedure, she begins to keep detailed notes of the
nursing care she is receiving and reports findings to the RN at bedtime. What action should
the nurse implement?
a. Explain to the client that her behavior invades the rights of the nursing staff.
b. Ask the client to explain why she is keeping a detailed record of her nursing care.
c. Teach the client strategies to control her obsessive compulsive behavior.
d. Encourage the client to express her feelings regarding the upcoming procedure.
✔procedure.
CORRECT ANSWER: D. Encourage the client to express her feelings regarding the upcoming
RATIONALE
The client's detailed note-taking is likely a coping mechanism for anxiety about the upcoming cardiac
catheterization. Encouraging the client to verbalize her fears and feelings is the most therapeutic approach.
Confronting the behavior or labeling it as invasive does not address the underlying anxiety driving it.
Q3 During admission to the psychiatric unit, a female client is extremely anxious and states
that she is worried about the sun coming up the next day. What intervention is most
important for the RN to implement during the admission process?
, a. Assist the client in developing alternative coping skills.
b. Remain calm and use a matter-of-fact approach.
c. Ask the client why she is so anxious.
d. Administer a PRN sedative to help relieve her anxiety.
✔ CORRECT ANSWER: A. Assist the client in developing alternative coping skills.
RATIONALE
During admission, helping the client develop alternative coping skills is the most important intervention as it
empowers the client to manage anxiety. Remaining calm is supportive but not the priority intervention. Asking
why she is anxious does not provide tools for managing it. Sedation should not be the first-line intervention
without exploring other options.
Q4 A female client is brought to the emergency department after being found disoriented,
disorganized, and confused. The RN determines the client is homeless and exhibiting
suspiciousness. What priority problem should be included in her plan of care?
a. Acute confusion.
b. Ineffective community coping.
c. Disturbed sensory perception.
d. Self-care deficit.
✔ CORRECT ANSWER: A. Acute confusion.
RATIONALE
Acute confusion is the priority problem because it represents an immediate safety risk. The client is disoriented,
disorganized, and confused — all hallmarks of acute confusion. Addressing confusion first ensures the client's
safety and allows for accurate assessment of other problems.
Q5 The occupational health nurse is working with a female employee just notified that her
child was involved in a MVA and taken to the hospital. The employee states, 'I can't believe
this. What should I do?' Which response is best for the RN to provide?
a. Tell me what you think should happen.
b. How serious was the collision?
c. What do you think you should do?
d. Call for transportation to the hospital.
✔ CORRECT ANSWER: D. Call for transportation to the hospital.
RATIONALE
In a crisis involving a child's safety, the priority is taking immediate action. The employee needs to get to the
hospital as quickly as possible. The other responses involve asking the employee to process or reflect during
an acute crisis, which is inappropriate when the most concrete, helpful action is arranging transportation.
Q6 A client tells the RN that he has an IQ of 400+ and is a genius and an inventor. He reports
being married to a female movie star and thinks his brother wants a sexual relationship with
her. What is the priority nursing problem for admission to the psychiatric unit?
a. Ineffective sexual patterns.
b. Impaired environmental interpretation.
c. Disturbed sensory perception.
, d. Compromised family coping.
✔ CORRECT ANSWER: A. Ineffective sexual patterns.
RATIONALE
The client's delusional belief that his brother wants a sexual relationship with his wife represents a dangerous
jealous delusion that poses risk for violence. Ineffective sexual patterns is the priority because the belief about
his brother's sexual intentions is the most potentially dangerous component and requires immediate attention to
prevent harm.
Q7 The RN is providing care for a client diagnosed with borderline personality disorder who
has self-inflicted lacerations on the abdomen. Which approach should the RN use when
changing this client's dressing?
a. Provide detailed thorough explanations when cleansing the wound.
b. Perform the dressing change in a non-judgmental manner.
c. Ask in a non-threatening manner why the client cut her own abdomen.
d. Request another staff member to assist with the dressing change.
✔ CORRECT ANSWER: B. Perform the dressing change in a non-judgmental manner.
RATIONALE
Clients with borderline personality disorder who self-harm are particularly sensitive to judgment and criticism.
Performing the dressing change in a non-judgmental manner maintains therapeutic trust and does not reinforce
or shame the self-harm behavior. Asking why during a dressing change is not the appropriate time and may be
perceived as accusatory.
Q8 While sitting in the day room, a male adolescent avoids eye contact, looks at the floor,
and talks softly when interacting with the RN. The two trade places and the RN demonstrates
the client's behaviors. What is the main goal of this therapeutic technique?
a. Initiate a non-threatening conversation with the client.
b. Dialog about the ineffectiveness of his interactions.
c. Allow the client to identify the way he interacts.
d. Discuss the client's feelings when he responds.
✔ CORRECT ANSWER: C. Allow the client to identify the way he interacts.
RATIONALE
By mirroring the client's behavior, the RN is using a role-reversal technique to help the client see himself from
an outside perspective. The goal is to increase self-awareness so the client can recognize how his
communication style may affect his relationships and social interactions.
Q9 An antidepressant medication is prescribed for a client who reports sleeping only 4
hours in the past 2 days and a weight loss of 9 lbs within the last month. Which client goal is
most important to achieve within the first three days of treatment?
a. Meet scheduled appointment with dietitian.
b. Sleep at least 6 hours a night.
c. Understands the purpose of the medication regimen.
d. Describes the reasons for hospitalization.
✔ CORRECT ANSWER: B. Sleep at least 6 hours a night.
