HESI MENTAL HEALTH EXAM – PRACTICE QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains*
*Therapeutic Communication*
*Mood and Anxiety Disorders*
*Schizophrenia Spectrum Disorders*
*Personality Disorders*
*Substance Use and Addiction*
*Pediatric and Geriatric Psychiatry*
*Pharmacology and Medication Management*
*Legal and Ethical Nursing Practice*
*Crisis Intervention and Suicide Prevention*
*Introduction*
This comprehensive assessment is designed to evaluate a candidate's proficiency in psychiatric-
mental health nursing. The exam focuses on the application of the nursing process, therapeutic
communication techniques, and pharmacological interventions across various clinical settings.
Candidates are tested on their ability to assess, plan, and implement care for diverse patient
populations experiencing acute and chronic mental health challenges. The exam utilizes multiple-
choice and scenario-based questions to measure clinical judgment, critical thinking, and decision-
making skills. Emphasizing real-world application, this tool ensures nursing students are prepared
to provide safe, ethical, and evidence-based care while adhering to regulatory standards and
professional guidelines.
SECTION ONE: QUESTIONS 1–100
1. A patient with schizophrenia is hearing voices telling him that the food is poisoned. Which
response by the nurse is most therapeutic?
A. "No one is trying to poison you; the hospital food is safe."
B. "I don’t hear the voices, but I understand they are real to you."
,C. "Why do you think anyone would want to poison your food?"
D. "The voices are just a symptom of your illness."
🟢 B. "I don’t hear the voices, but I understand they are real to you."
🔴 RATIONALE: This response acknowledges the patient's reality without validating the
hallucination, a technique known as presenting reality and showing empathy.
2. A client is admitted to the unit for treatment of severe depression. Which nursing
intervention is the highest priority?
A. Encouraging the client to attend group therapy sessions.
B. Assessing the client’s nutritional intake and sleep patterns.
C. Implementing suicide precautions and monitoring the client's whereabouts.
D. Teaching the client about the side effects of antidepressant medications.
🟢 C. Implementing suicide precautions and monitoring the client's whereabouts.
🔴 RATIONALE: Safety is the primary concern for clients with severe depression due to the high
risk of self-harm or suicide.
3. Which medication is most commonly prescribed as a first-line treatment for a patient
experiencing an acute panic attack?
A. Fluoxetine
B. Lithium carbonate
C. Alprazolam
D. Haloperidol
🟢 C. Alprazolam
🔴 RATIONALE: Benzodiazepines like alprazolam have a rapid onset of action, making them
effective for the immediate relief of acute anxiety and panic symptoms.
, 4. A nurse is caring for a client with Bipolar I Disorder who is in a manic phase. Which meal
choice is most appropriate?
A. Spaghetti and meatballs with a side salad.
B. A turkey and cheese wrap with an apple.
C. Beef stew with mashed potatoes.
D. A bowl of chicken noodle soup and crackers.
🟢 B. A turkey and cheese wrap with an apple.
🔴 RATIONALE: Manic clients often cannot sit still to eat; "finger foods" that are high in protein
and calories allow them to eat while moving.
5. A client who was recently raped is brought to the emergency department. She is crying
and shaking. What is the nurse's priority action?
A. Asking the client to provide a detailed account of the event.
B. Providing a private, safe environment and staying with the client.
C. Contacting the client's family to provide emotional support.
D. Administering a sedative to help the client relax.
🟢 B. Providing a private, safe environment and staying with the client.
🔴 RATIONALE: Immediate care for a trauma victim focuses on establishing safety, security, and a
supportive presence.
6. A nurse is assessing a client for lithium toxicity. Which finding should the nurse report to
the provider immediately?
A. Fine hand tremors
B. Mild thirst
C. Blurred vision and ataxia
D. Polyuria
, 🟢 C. Blurred vision and ataxia
🔴 RATIONALE: Blurred vision, ataxia, and severe gastrointestinal upset are signs of moderate to
severe lithium toxicity that require immediate intervention.
7. Which defense mechanism is a client using when they state, "I only drink because my boss
is so hard on me"?
A. Displacement
B. Projection
C. Rationalization
D. Sublimation
🟢 C. Rationalization
🔴 RATIONALE: Rationalization involves creating logical-sounding excuses to justify unacceptable
behaviors or feelings.
8. A patient is scheduled for Electroconvulsive Therapy (ECT). Which medication should the
nurse expect to be held prior to the procedure?
A. Glycopyrrolate
B. Succinylcholine
C. Phenytoin
D. Methohexital
🟢 C. Phenytoin
🔴 RATIONALE: Anticonvulsants like phenytoin can increase the seizure threshold, potentially
making the ECT treatment ineffective.
9. A nurse is educating a client starting an MAOI (Monoamine Oxidase Inhibitor). Which food
choice indicates the client understands the dietary restrictions?
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains*
*Therapeutic Communication*
*Mood and Anxiety Disorders*
*Schizophrenia Spectrum Disorders*
*Personality Disorders*
*Substance Use and Addiction*
*Pediatric and Geriatric Psychiatry*
*Pharmacology and Medication Management*
*Legal and Ethical Nursing Practice*
*Crisis Intervention and Suicide Prevention*
*Introduction*
This comprehensive assessment is designed to evaluate a candidate's proficiency in psychiatric-
mental health nursing. The exam focuses on the application of the nursing process, therapeutic
communication techniques, and pharmacological interventions across various clinical settings.
Candidates are tested on their ability to assess, plan, and implement care for diverse patient
populations experiencing acute and chronic mental health challenges. The exam utilizes multiple-
choice and scenario-based questions to measure clinical judgment, critical thinking, and decision-
making skills. Emphasizing real-world application, this tool ensures nursing students are prepared
to provide safe, ethical, and evidence-based care while adhering to regulatory standards and
professional guidelines.
SECTION ONE: QUESTIONS 1–100
1. A patient with schizophrenia is hearing voices telling him that the food is poisoned. Which
response by the nurse is most therapeutic?
A. "No one is trying to poison you; the hospital food is safe."
B. "I don’t hear the voices, but I understand they are real to you."
,C. "Why do you think anyone would want to poison your food?"
D. "The voices are just a symptom of your illness."
🟢 B. "I don’t hear the voices, but I understand they are real to you."
🔴 RATIONALE: This response acknowledges the patient's reality without validating the
hallucination, a technique known as presenting reality and showing empathy.
2. A client is admitted to the unit for treatment of severe depression. Which nursing
intervention is the highest priority?
A. Encouraging the client to attend group therapy sessions.
B. Assessing the client’s nutritional intake and sleep patterns.
C. Implementing suicide precautions and monitoring the client's whereabouts.
D. Teaching the client about the side effects of antidepressant medications.
🟢 C. Implementing suicide precautions and monitoring the client's whereabouts.
🔴 RATIONALE: Safety is the primary concern for clients with severe depression due to the high
risk of self-harm or suicide.
3. Which medication is most commonly prescribed as a first-line treatment for a patient
experiencing an acute panic attack?
A. Fluoxetine
B. Lithium carbonate
C. Alprazolam
D. Haloperidol
🟢 C. Alprazolam
🔴 RATIONALE: Benzodiazepines like alprazolam have a rapid onset of action, making them
effective for the immediate relief of acute anxiety and panic symptoms.
, 4. A nurse is caring for a client with Bipolar I Disorder who is in a manic phase. Which meal
choice is most appropriate?
A. Spaghetti and meatballs with a side salad.
B. A turkey and cheese wrap with an apple.
C. Beef stew with mashed potatoes.
D. A bowl of chicken noodle soup and crackers.
🟢 B. A turkey and cheese wrap with an apple.
🔴 RATIONALE: Manic clients often cannot sit still to eat; "finger foods" that are high in protein
and calories allow them to eat while moving.
5. A client who was recently raped is brought to the emergency department. She is crying
and shaking. What is the nurse's priority action?
A. Asking the client to provide a detailed account of the event.
B. Providing a private, safe environment and staying with the client.
C. Contacting the client's family to provide emotional support.
D. Administering a sedative to help the client relax.
🟢 B. Providing a private, safe environment and staying with the client.
🔴 RATIONALE: Immediate care for a trauma victim focuses on establishing safety, security, and a
supportive presence.
6. A nurse is assessing a client for lithium toxicity. Which finding should the nurse report to
the provider immediately?
A. Fine hand tremors
B. Mild thirst
C. Blurred vision and ataxia
D. Polyuria
, 🟢 C. Blurred vision and ataxia
🔴 RATIONALE: Blurred vision, ataxia, and severe gastrointestinal upset are signs of moderate to
severe lithium toxicity that require immediate intervention.
7. Which defense mechanism is a client using when they state, "I only drink because my boss
is so hard on me"?
A. Displacement
B. Projection
C. Rationalization
D. Sublimation
🟢 C. Rationalization
🔴 RATIONALE: Rationalization involves creating logical-sounding excuses to justify unacceptable
behaviors or feelings.
8. A patient is scheduled for Electroconvulsive Therapy (ECT). Which medication should the
nurse expect to be held prior to the procedure?
A. Glycopyrrolate
B. Succinylcholine
C. Phenytoin
D. Methohexital
🟢 C. Phenytoin
🔴 RATIONALE: Anticonvulsants like phenytoin can increase the seizure threshold, potentially
making the ECT treatment ineffective.
9. A nurse is educating a client starting an MAOI (Monoamine Oxidase Inhibitor). Which food
choice indicates the client understands the dietary restrictions?
