HERZING UNIVERSITY HESI MENTAL HEALTH
EXAM STUDY GUIDE 2026 | COMPLETE
QUESTIONS & DETAILED VERIFIED ANSWERS |
LATEST PASS-FOCUSED PREP
HERZING UNIVERSITY HESI MENTAL HEALTH EXAM STUDY GUIDE 2026
COMPLETE QUESTIONS & DETAILED VERIFIED ANSWERS | LATEST PASS-
FOCUSED PREP
OVERVIEW: This material contains carefully crafted multiple-choice questions designed
to sharpen your clinical reasoning and test-taking confidence for the Mental Health
HESI. Read each EXPERT RATIONALE thoroughly — understanding why an answer is
correct matters more than memorizing the answer itself.
QUESTION 1. A nurse is caring for a client diagnosed with major depressive disorder.
Which statement by the client should the nurse prioritize as most concerning?
A. "I feel tired all the time and sleep too much."
B. "I no longer enjoy spending time with my grandchildren."
C. "I have been thinking about ending my life and have a plan."
D. "I haven't had much of an appetite lately."
E. "I feel worthless and like a burden to everyone."
CORRECT ANSWER: C. "I have been thinking about ending my life and have
a plan."
EXPERT RATIONALE: A client who expresses suicidal ideation with a specific plan is at
the highest risk for self-harm. This is a psychiatric emergency requiring immediate
intervention, including safety assessment and notification of the treatment team. All
other options reflect symptoms of depression but do not carry the same level of
immediate danger.
QUESTION 2. A nurse is using therapeutic communication with a client experiencing
anxiety. Which response by the nurse is most therapeutic?
A. "Don't worry, everything will be fine."
,B. "Why do you feel so anxious all the time?"
C. "I understand exactly what you're going through."
D. "Tell me more about what you are experiencing."
E. "You should try to think more positively."
CORRECT ANSWER: D. "Tell me more about what you are experiencing."
EXPERT RATIONALE: Open-ended statements like "tell me more" encourage the client
to express feelings freely and show the nurse is engaged and interested. Option A offers
false reassurance, option B uses "why" which can feel judgmental, option C implies the
nurse fully understands without adequate information, and option E gives unsolicited
advice.
QUESTION 3. A client with schizophrenia tells the nurse, "The television is sending me
secret messages about my mission." The nurse recognizes this as which type of
symptom?
A. Hallucination
B. Illusion
C. Delusion of reference
D. Thought broadcasting
E. Depersonalization
CORRECT ANSWER: C. Delusion of reference
EXPERT RATIONALE: A delusion of reference occurs when a client believes that
neutral objects or events (such as a television) are sending personal, meaningful
messages directed specifically at them. This is a positive symptom of schizophrenia.
Hallucinations involve sensory perceptions without external stimuli. Thought
broadcasting is the belief that one's thoughts are heard by others.
QUESTION 4. A nurse is preparing to administer lithium carbonate to a client with
bipolar disorder. Which laboratory value should the nurse review before administration?
A. Blood glucose level
B. Serum sodium level
,C. Serum lithium level
D. Complete blood count
E. Liver function tests
CORRECT ANSWER: C. Serum lithium level
EXPERT RATIONALE: Lithium has a narrow therapeutic index (0.6–1.2 mEq/L for
maintenance). Levels above 1.5 mEq/L can cause toxicity. The nurse must check the
serum lithium level before administration to prevent toxicity. Although sodium levels
affect lithium excretion, the most direct pre-administration check is the serum lithium
level.
QUESTION 5. Which intervention is the nurse's priority when a client is experiencing a
panic attack?
A. Teach the client progressive muscle relaxation techniques.
B. Encourage the client to discuss the cause of the anxiety.
C. Stay with the client and speak in a calm, reassuring manner.
D. Administer a prescribed anxiolytic and leave to allow privacy.
E. Ask the client to complete a feelings journal entry.
CORRECT ANSWER: C. Stay with the client and speak in a calm, reassuring
manner.
EXPERT RATIONALE: During a panic attack, the client is overwhelmed and terrified.
The nurse's priority is to remain present, maintain a calm environment, use short simple
sentences, and provide reassurance. Leaving the client alone is unsafe. Teaching and
journaling are not appropriate during an acute panic attack, as the client's cognitive
ability is impaired.
QUESTION 6. A nurse is admitting a client who is severely depressed. Which is the
priority nursing action?
A. Assess nutritional status and recent food intake.
B. Conduct a thorough suicide risk assessment.
C. Review the client's past psychiatric history.
, D. Orient the client to the unit environment.
E. Obtain a complete medication history.
CORRECT ANSWER: B. Conduct a thorough suicide risk assessment.
EXPERT RATIONALE: Safety is always the priority. A client with severe depression is
at elevated risk for suicidal ideation and self-harm. Conducting a thorough suicide risk
assessment (ideation, plan, means, intent) ensures the nurse can take appropriate
safety measures immediately. Other assessments are important but secondary to
safety.
QUESTION 7. A client on the psychiatric unit is prescribed haloperidol (Haldol). The
nurse observes the client's neck twisted to one side, eyes deviated upward, and muscle
rigidity. The nurse should first:
A. Document the findings and monitor the client.
B. Administer a PRN anxiolytic medication.
C. Prepare to administer diphenhydramine (Benadryl) or benztropine (Cogentin).
D. Notify the physician and hold the next dose of haloperidol.
E. Apply a warm compress to the affected neck muscles.
CORRECT ANSWER: C. Prepare to administer diphenhydramine (Benadryl)
or benztropine (Cogentin).
EXPERT RATIONALE: The client is experiencing an acute dystonic reaction, a
common extrapyramidal side effect of typical antipsychotics like haloperidol. This
involves sudden, involuntary muscle contractions. The immediate treatment is an
anticholinergic agent such as benztropine or diphenhydramine administered IM/IV. The
physician should also be notified, but treating the acute reaction takes priority.
QUESTION 8. Which statement best reflects the nurse's understanding of the
therapeutic relationship?
A. "I share personal experiences with clients to help build trust."
B. "The therapeutic relationship is centered on the client's needs and goals."
C. "I try to be friends with my clients to help them open up."
D. "I tell clients what decisions to make to help them recover faster."
EXAM STUDY GUIDE 2026 | COMPLETE
QUESTIONS & DETAILED VERIFIED ANSWERS |
LATEST PASS-FOCUSED PREP
HERZING UNIVERSITY HESI MENTAL HEALTH EXAM STUDY GUIDE 2026
COMPLETE QUESTIONS & DETAILED VERIFIED ANSWERS | LATEST PASS-
FOCUSED PREP
OVERVIEW: This material contains carefully crafted multiple-choice questions designed
to sharpen your clinical reasoning and test-taking confidence for the Mental Health
HESI. Read each EXPERT RATIONALE thoroughly — understanding why an answer is
correct matters more than memorizing the answer itself.
QUESTION 1. A nurse is caring for a client diagnosed with major depressive disorder.
Which statement by the client should the nurse prioritize as most concerning?
A. "I feel tired all the time and sleep too much."
B. "I no longer enjoy spending time with my grandchildren."
C. "I have been thinking about ending my life and have a plan."
D. "I haven't had much of an appetite lately."
E. "I feel worthless and like a burden to everyone."
CORRECT ANSWER: C. "I have been thinking about ending my life and have
a plan."
EXPERT RATIONALE: A client who expresses suicidal ideation with a specific plan is at
the highest risk for self-harm. This is a psychiatric emergency requiring immediate
intervention, including safety assessment and notification of the treatment team. All
other options reflect symptoms of depression but do not carry the same level of
immediate danger.
QUESTION 2. A nurse is using therapeutic communication with a client experiencing
anxiety. Which response by the nurse is most therapeutic?
A. "Don't worry, everything will be fine."
,B. "Why do you feel so anxious all the time?"
C. "I understand exactly what you're going through."
D. "Tell me more about what you are experiencing."
E. "You should try to think more positively."
CORRECT ANSWER: D. "Tell me more about what you are experiencing."
EXPERT RATIONALE: Open-ended statements like "tell me more" encourage the client
to express feelings freely and show the nurse is engaged and interested. Option A offers
false reassurance, option B uses "why" which can feel judgmental, option C implies the
nurse fully understands without adequate information, and option E gives unsolicited
advice.
QUESTION 3. A client with schizophrenia tells the nurse, "The television is sending me
secret messages about my mission." The nurse recognizes this as which type of
symptom?
A. Hallucination
B. Illusion
C. Delusion of reference
D. Thought broadcasting
E. Depersonalization
CORRECT ANSWER: C. Delusion of reference
EXPERT RATIONALE: A delusion of reference occurs when a client believes that
neutral objects or events (such as a television) are sending personal, meaningful
messages directed specifically at them. This is a positive symptom of schizophrenia.
Hallucinations involve sensory perceptions without external stimuli. Thought
broadcasting is the belief that one's thoughts are heard by others.
QUESTION 4. A nurse is preparing to administer lithium carbonate to a client with
bipolar disorder. Which laboratory value should the nurse review before administration?
A. Blood glucose level
B. Serum sodium level
,C. Serum lithium level
D. Complete blood count
E. Liver function tests
CORRECT ANSWER: C. Serum lithium level
EXPERT RATIONALE: Lithium has a narrow therapeutic index (0.6–1.2 mEq/L for
maintenance). Levels above 1.5 mEq/L can cause toxicity. The nurse must check the
serum lithium level before administration to prevent toxicity. Although sodium levels
affect lithium excretion, the most direct pre-administration check is the serum lithium
level.
QUESTION 5. Which intervention is the nurse's priority when a client is experiencing a
panic attack?
A. Teach the client progressive muscle relaxation techniques.
B. Encourage the client to discuss the cause of the anxiety.
C. Stay with the client and speak in a calm, reassuring manner.
D. Administer a prescribed anxiolytic and leave to allow privacy.
E. Ask the client to complete a feelings journal entry.
CORRECT ANSWER: C. Stay with the client and speak in a calm, reassuring
manner.
EXPERT RATIONALE: During a panic attack, the client is overwhelmed and terrified.
The nurse's priority is to remain present, maintain a calm environment, use short simple
sentences, and provide reassurance. Leaving the client alone is unsafe. Teaching and
journaling are not appropriate during an acute panic attack, as the client's cognitive
ability is impaired.
QUESTION 6. A nurse is admitting a client who is severely depressed. Which is the
priority nursing action?
A. Assess nutritional status and recent food intake.
B. Conduct a thorough suicide risk assessment.
C. Review the client's past psychiatric history.
, D. Orient the client to the unit environment.
E. Obtain a complete medication history.
CORRECT ANSWER: B. Conduct a thorough suicide risk assessment.
EXPERT RATIONALE: Safety is always the priority. A client with severe depression is
at elevated risk for suicidal ideation and self-harm. Conducting a thorough suicide risk
assessment (ideation, plan, means, intent) ensures the nurse can take appropriate
safety measures immediately. Other assessments are important but secondary to
safety.
QUESTION 7. A client on the psychiatric unit is prescribed haloperidol (Haldol). The
nurse observes the client's neck twisted to one side, eyes deviated upward, and muscle
rigidity. The nurse should first:
A. Document the findings and monitor the client.
B. Administer a PRN anxiolytic medication.
C. Prepare to administer diphenhydramine (Benadryl) or benztropine (Cogentin).
D. Notify the physician and hold the next dose of haloperidol.
E. Apply a warm compress to the affected neck muscles.
CORRECT ANSWER: C. Prepare to administer diphenhydramine (Benadryl)
or benztropine (Cogentin).
EXPERT RATIONALE: The client is experiencing an acute dystonic reaction, a
common extrapyramidal side effect of typical antipsychotics like haloperidol. This
involves sudden, involuntary muscle contractions. The immediate treatment is an
anticholinergic agent such as benztropine or diphenhydramine administered IM/IV. The
physician should also be notified, but treating the acute reaction takes priority.
QUESTION 8. Which statement best reflects the nurse's understanding of the
therapeutic relationship?
A. "I share personal experiences with clients to help build trust."
B. "The therapeutic relationship is centered on the client's needs and goals."
C. "I try to be friends with my clients to help them open up."
D. "I tell clients what decisions to make to help them recover faster."
