HESI Mental Health Exam 2 ACTUAL
EXAM 2026/2027 | HESI Psychiatric
Nursing | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1 – Therapeutic Communication & Therapeutic Relationship (Questions 1–15)
Q1: A patient with depression tells the nurse, "There's no point in trying anymore. Nothing ever gets
better." Which response by the nurse is most therapeutic?
A. "Things will get better soon. Just give it time."
B. "Why do you feel like nothing ever gets better?"
C. "You feel like nothing will ever get better?" [CORRECT]
D. "Everyone feels down sometimes. You'll be fine."
Correct Answer: C
Rationale: Restating the patient's feelings reflects empathy, validates the patient's experience, and
encourages further expression without judgment, which is a core therapeutic communication technique.
Q2: A nurse is admitting a patient with suicidal ideation. Which question is most important to ask first?
A. "Do you have a plan to harm yourself?" [CORRECT]
B. "How long have you felt this way?"
C. "Have you ever seen a psychiatrist before?"
D. "Do you have family support at home?"
Correct Answer: A
Rationale: Asking about a specific plan (method, access, timing) is the priority because it directly
assesses imminent risk and guides immediate safety interventions such as one-to-one observation or
removal of harmful objects.
Q3: A patient with bipolar disorder who is in a manic phase says, "I'm going to start a new business and
become a millionaire by next week." The patient has not slept or eaten in two days. What is the priority
nursing action?
A. Encourage the patient to rest in a quiet area. [CORRECT]
B. Discuss the realistic steps to start a business.
C. Ignore the grandiose statement to avoid reinforcing it.
D. Tell the patient the idea is unrealistic.
Correct Answer: A
,Rationale: Protecting the patient from physical exhaustion and injury is the priority; providing a low-
stimulation environment with rest periods helps conserve energy and prevent harm during acute mania.
Q4: A patient with schizophrenia tells the nurse, "The voices are telling me to hurt myself." Which
response by the nurse is most therapeutic?
A. "I don't hear any voices. You must be imagining things."
B. "What are the voices telling you to do?" [CORRECT]
C. "Don't listen to the voices. They aren't real."
D. "Just ignore them and take your medication."
Correct Answer: B
Rationale: Exploring the content of hallucinations assesses command hallucination risk and suicide
potential; this non-judgmental approach validates the patient's experience while gathering essential
safety information.
Q5: A nurse is caring for a patient with borderline personality disorder who says, "You're the only nurse
who understands me. The others are terrible." Which response is most therapeutic?
A. "I'm glad you feel that way about me."
B. "All the nurses here are skilled and care about you." [CORRECT]
C. "Why do you think the other nurses are terrible?"
D. "Let's focus on your treatment goals instead."
Correct Answer: B
Rationale: Maintaining consistent boundaries and avoiding splitting behaviors requires the nurse to
validate the nursing staff collectively; this prevents idealization/devaluation cycles and reinforces
therapeutic structure.
Q6: A patient with anxiety disorder states, "I can't breathe. My heart is racing. I think I'm dying." Which
nursing action is most therapeutic?
A. "You're not dying. It's just anxiety."
B. "Let's focus on your breathing together. Breathe in slowly through your nose." [CORRECT]
C. "Why do you think you're dying?"
D. "I'll get the doctor to check your heart."
Correct Answer: B
Rationale: Guiding slow, diaphragmatic breathing reduces hyperventilation and autonomic arousal; this
action-oriented technique empowers the patient with immediate symptom control during panic
episodes.
Q7: A patient tells the nurse, "I don't want to take my antidepressant because it makes me feel numb."
Which response is most therapeutic?
A. "The numbness is just in your head. Keep taking it."
B. "Tell me more about what 'numb' feels like for you." [CORRECT]
C. "Your doctor knows what's best. Don't stop the medication."
D. "Everyone feels that way at first. It will pass."
Correct Answer: B
, Rationale: Exploring the patient's subjective experience of medication side effects fosters trust,
identifies whether the symptom represents emotional blunting or physical numbness, and guides
appropriate intervention.
Q8: A nurse is caring for a patient who has been silent for 10 minutes during a therapeutic session.
Which action is most appropriate?
A. Fill the silence with conversation to reduce discomfort.
B. Allow the silence to continue; it may indicate the patient is processing thoughts. [CORRECT]
C. Ask the patient why they are not talking.
D. End the session early since the patient is uncooperative.
Correct Answer: B
Rationale: Therapeutic silence allows patients time to organize thoughts and feelings; interrupting with
questions or conversation can disrupt the therapeutic process and increase patient anxiety.
Q9: A patient with PTSD says, "I keep reliving the accident over and over. I can't make it stop." Which
response is most therapeutic?
A. "That must be terrifying. Grounding techniques can help bring you back to the present." [CORRECT]
B. "You need to stop thinking about it. It's in the past."
C. "Why haven't you been able to move on yet?"
D. "At least you survived the accident."
Correct Answer: A
Rationale: Validating the distress of intrusive memories while offering grounding techniques (5-4-3-2-1
method) provides immediate coping strategies that anchor the patient in present reality during
flashbacks.
Q10: A patient with anorexia nervosa tells the nurse, "I'm fat and ugly. I don't deserve to eat." Which
response is most therapeutic?
A. "You are not fat. You are underweight."
B. "It sounds like you have strong negative feelings about your body." [CORRECT]
C. "Why do you think you don't deserve to eat?"
D. "If you don't eat, you'll end up in the hospital longer."
Correct Answer: B
Rationale: Reflecting the patient's emotional experience without arguing about body image distortions
maintains therapeutic alliance; challenging delusional body image directly often increases resistance and
defensiveness.
Q11: A nurse is caring for a patient with substance use disorder who says, "I can quit anytime I want. I
just don't want to right now." Which response is most therapeutic?
A. "You're in denial about your addiction."
B. "What would need to change for you to want to quit?" [CORRECT]
C. "Your liver enzymes show you need to quit now."
D. "Why don't you want to quit if it's hurting you?"
Correct Answer: B
EXAM 2026/2027 | HESI Psychiatric
Nursing | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1 – Therapeutic Communication & Therapeutic Relationship (Questions 1–15)
Q1: A patient with depression tells the nurse, "There's no point in trying anymore. Nothing ever gets
better." Which response by the nurse is most therapeutic?
A. "Things will get better soon. Just give it time."
B. "Why do you feel like nothing ever gets better?"
C. "You feel like nothing will ever get better?" [CORRECT]
D. "Everyone feels down sometimes. You'll be fine."
Correct Answer: C
Rationale: Restating the patient's feelings reflects empathy, validates the patient's experience, and
encourages further expression without judgment, which is a core therapeutic communication technique.
Q2: A nurse is admitting a patient with suicidal ideation. Which question is most important to ask first?
A. "Do you have a plan to harm yourself?" [CORRECT]
B. "How long have you felt this way?"
C. "Have you ever seen a psychiatrist before?"
D. "Do you have family support at home?"
Correct Answer: A
Rationale: Asking about a specific plan (method, access, timing) is the priority because it directly
assesses imminent risk and guides immediate safety interventions such as one-to-one observation or
removal of harmful objects.
Q3: A patient with bipolar disorder who is in a manic phase says, "I'm going to start a new business and
become a millionaire by next week." The patient has not slept or eaten in two days. What is the priority
nursing action?
A. Encourage the patient to rest in a quiet area. [CORRECT]
B. Discuss the realistic steps to start a business.
C. Ignore the grandiose statement to avoid reinforcing it.
D. Tell the patient the idea is unrealistic.
Correct Answer: A
,Rationale: Protecting the patient from physical exhaustion and injury is the priority; providing a low-
stimulation environment with rest periods helps conserve energy and prevent harm during acute mania.
Q4: A patient with schizophrenia tells the nurse, "The voices are telling me to hurt myself." Which
response by the nurse is most therapeutic?
A. "I don't hear any voices. You must be imagining things."
B. "What are the voices telling you to do?" [CORRECT]
C. "Don't listen to the voices. They aren't real."
D. "Just ignore them and take your medication."
Correct Answer: B
Rationale: Exploring the content of hallucinations assesses command hallucination risk and suicide
potential; this non-judgmental approach validates the patient's experience while gathering essential
safety information.
Q5: A nurse is caring for a patient with borderline personality disorder who says, "You're the only nurse
who understands me. The others are terrible." Which response is most therapeutic?
A. "I'm glad you feel that way about me."
B. "All the nurses here are skilled and care about you." [CORRECT]
C. "Why do you think the other nurses are terrible?"
D. "Let's focus on your treatment goals instead."
Correct Answer: B
Rationale: Maintaining consistent boundaries and avoiding splitting behaviors requires the nurse to
validate the nursing staff collectively; this prevents idealization/devaluation cycles and reinforces
therapeutic structure.
Q6: A patient with anxiety disorder states, "I can't breathe. My heart is racing. I think I'm dying." Which
nursing action is most therapeutic?
A. "You're not dying. It's just anxiety."
B. "Let's focus on your breathing together. Breathe in slowly through your nose." [CORRECT]
C. "Why do you think you're dying?"
D. "I'll get the doctor to check your heart."
Correct Answer: B
Rationale: Guiding slow, diaphragmatic breathing reduces hyperventilation and autonomic arousal; this
action-oriented technique empowers the patient with immediate symptom control during panic
episodes.
Q7: A patient tells the nurse, "I don't want to take my antidepressant because it makes me feel numb."
Which response is most therapeutic?
A. "The numbness is just in your head. Keep taking it."
B. "Tell me more about what 'numb' feels like for you." [CORRECT]
C. "Your doctor knows what's best. Don't stop the medication."
D. "Everyone feels that way at first. It will pass."
Correct Answer: B
, Rationale: Exploring the patient's subjective experience of medication side effects fosters trust,
identifies whether the symptom represents emotional blunting or physical numbness, and guides
appropriate intervention.
Q8: A nurse is caring for a patient who has been silent for 10 minutes during a therapeutic session.
Which action is most appropriate?
A. Fill the silence with conversation to reduce discomfort.
B. Allow the silence to continue; it may indicate the patient is processing thoughts. [CORRECT]
C. Ask the patient why they are not talking.
D. End the session early since the patient is uncooperative.
Correct Answer: B
Rationale: Therapeutic silence allows patients time to organize thoughts and feelings; interrupting with
questions or conversation can disrupt the therapeutic process and increase patient anxiety.
Q9: A patient with PTSD says, "I keep reliving the accident over and over. I can't make it stop." Which
response is most therapeutic?
A. "That must be terrifying. Grounding techniques can help bring you back to the present." [CORRECT]
B. "You need to stop thinking about it. It's in the past."
C. "Why haven't you been able to move on yet?"
D. "At least you survived the accident."
Correct Answer: A
Rationale: Validating the distress of intrusive memories while offering grounding techniques (5-4-3-2-1
method) provides immediate coping strategies that anchor the patient in present reality during
flashbacks.
Q10: A patient with anorexia nervosa tells the nurse, "I'm fat and ugly. I don't deserve to eat." Which
response is most therapeutic?
A. "You are not fat. You are underweight."
B. "It sounds like you have strong negative feelings about your body." [CORRECT]
C. "Why do you think you don't deserve to eat?"
D. "If you don't eat, you'll end up in the hospital longer."
Correct Answer: B
Rationale: Reflecting the patient's emotional experience without arguing about body image distortions
maintains therapeutic alliance; challenging delusional body image directly often increases resistance and
defensiveness.
Q11: A nurse is caring for a patient with substance use disorder who says, "I can quit anytime I want. I
just don't want to right now." Which response is most therapeutic?
A. "You're in denial about your addiction."
B. "What would need to change for you to want to quit?" [CORRECT]
C. "Your liver enzymes show you need to quit now."
D. "Why don't you want to quit if it's hurting you?"
Correct Answer: B
