HESI RN Mental Health NGN ACTUAL
EXAM 2026/2027 | Complete Practice with
Answers | Package Deal | Verified Q&A |
Pass Guaranteed - A+ Graded
Section 1: Mood Disorders (Questions 1–15)
Q1: A 34-year-old female with major depressive disorder is admitted after stating, "I don't see the point
in living anymore." She has a plan to overdose on her prescribed medications. Which is the nurse's
priority action?
A. Encourage the patient to participate in group therapy today.
B. Remove all potentially harmful objects from the patient's room and place her on 1:1 observation.
[CORRECT]
C. Ask the patient to sign a no-suicide contract before bedtime.
D. Schedule a family meeting to discuss discharge planning.
Correct Answer: B
Rationale: A patient with active suicidal ideation and a specific plan requires immediate safety
interventions. Removing harmful objects and maintaining continuous observation prevents self-harm
during the acute crisis phase.
Q2: A 28-year-old male with bipolar I disorder, manic episode, has been sleeping 2 hours per night for 5
days. He is pacing the unit, speaking rapidly, and attempting to organize a "business venture" with other
patients. Which nursing intervention is most appropriate?
A. Provide a quiet environment and encourage rest in his room with decreased stimuli. [CORRECT]
B. Allow the patient to continue his business planning to promote self-esteem.
C. Confront the patient about the unrealistic nature of his business plans.
D. Encourage the patient to lead a group activity to channel his energy.
Correct Answer: A
Rationale: Patients in acute mania require a low-stimulus environment to prevent overstimulation and
promote rest. Decreasing environmental stimuli helps reduce agitation and supports gradual
stabilization.
,Q3: A 45-year-old patient with major depressive disorder is started on sertraline 50 mg daily. On day 7,
the patient asks the nurse, "When will I start feeling better?" Which response by the nurse is most
accurate?
A. "You should notice significant improvement within 24 to 48 hours."
B. "Most patients begin to notice mood improvement within 2 to 4 weeks." [CORRECT]
C. "It may take up to 6 months before you feel any different."
D. "The medication works immediately, but the effect is subtle at first."
Correct Answer: B
Rationale: SSRIs like sertraline typically require 2 to 4 weeks to produce noticeable antidepressant
effects. Setting realistic expectations helps the patient adhere to the medication regimen during the
initial treatment period.
Q4: A 52-year-old patient with bipolar disorder is prescribed lithium carbonate 300 mg three times daily.
Before administering the first dose, which laboratory value is most important for the nurse to verify?
A. Hemoglobin and hematocrit
B. Serum lithium level and serum creatinine [CORRECT]
C. Liver function tests
D. Thyroid-stimulating hormone (TSH) only
Correct Answer: B
Rationale: Lithium is renally excreted and can cause nephrotoxicity. Verifying baseline renal function
and ensuring no pre-existing therapeutic lithium level prevents toxicity and establishes safe monitoring
parameters.
Q5: A 19-year-old college student with newly diagnosed major depressive disorder is prescribed
fluoxetine. The nurse provides medication education. Which statement by the patient indicates
understanding of important safety information?
A. "I can stop taking this medication as soon as I feel better."
B. "I should report any thoughts of self-harm immediately because antidepressants can increase suicidal
thinking in young adults." [CORRECT]
C. "This medication will help me sleep better right away."
D. "I can take this with my herbal supplements without any problems."
Correct Answer: B
Rationale: The FDA black box warning indicates increased suicidal ideation risk in patients under 25
,years old during the first weeks of antidepressant therapy. Teaching the patient to report suicidal
thoughts immediately ensures timely intervention.
Q6: A 38-year-old patient with persistent depressive disorder (dysthymia) reports chronic low mood,
poor concentration, and fatigue for 2 years. The patient states, "I just force myself through each day."
Which therapeutic response by the nurse is most appropriate?
A. "You should try to think more positively about your situation."
B. "It sounds like you have been coping with significant challenges for a long time. Tell me more about
what a typical day looks like for you." [CORRECT]
C. "Many people feel this way, so you are not alone."
D. "Have you considered that this might just be your personality?"
Correct Answer: B
Rationale: A therapeutic, patient-centered response validates the patient's experience and invites
further exploration. This approach builds rapport and facilitates a comprehensive assessment of
functional impact.
Q7: A patient with bipolar II disorder is in a hypomanic episode. The patient has spent $3,000 on online
shopping in 2 days and has decreased need for sleep. Which nursing priority is most appropriate at this
time?
A. Encourage the patient to return the purchased items immediately.
B. Assess the patient's insight into their behavior and implement financial safeguards with family
involvement. [CORRECT]
C. Tell the patient that their shopping behavior is inappropriate and must stop.
D. Restrict all visitors to prevent further stimulation.
Correct Answer: B
Rationale: During hypomania, patients often have impaired judgment with preserved insight. Assessing
insight and collaborating with family to establish financial protections minimizes harm while maintaining
therapeutic alliance.
Q8: A 67-year-old patient with major depressive disorder and comorbid Parkinson's disease is prescribed
an antidepressant. Which medication is most appropriate for this patient?
A. Amitriptyline
B. Bupropion
, C. Mirtazapine [CORRECT]
D. Venlafaxine
Correct Answer: C
Rationale: Mirtazapine has minimal effects on dopamine and minimal anticholinergic properties, making
it safer for patients with Parkinson's disease. It also addresses the appetite and sleep disturbances
common in geriatric depression.
Q9: A patient with seasonal affective disorder (SAD) asks the nurse about non-pharmacological
treatments. Which intervention does the nurse recommend?
A. Increasing caffeine intake during winter months
B. Light therapy with 10,000 lux for 30 minutes each morning [CORRECT]
C. Staying indoors to avoid cold weather stress
D. Taking high-dose vitamin D supplements only
Correct Answer: B
Rationale: Bright light therapy is a first-line non-pharmacological treatment for seasonal affective
disorder. Morning exposure helps regulate circadian rhythms and melatonin secretion, improving mood
and energy levels.
Q10: A patient with major depressive disorder is receiving electroconvulsive therapy (ECT). The nurse is
preparing the patient for the first treatment. Which statement by the nurse is most accurate?
A. "You will be awake during the procedure and can talk to us."
B. "You will receive general anesthesia and a muscle relaxant, and the treatment lasts only a few
minutes." [CORRECT]
C. "The procedure is painful, but we will give you pain medication afterward."
D. "You will need to stop all your antidepressant medications before starting ECT."
Correct Answer: B
Rationale: Modern ECT is performed under general anesthesia with a muscle relaxant to prevent injury.
The actual seizure lasts 30 to 60 seconds, and the entire procedure is brief and painless for the patient.
Q11: A 41-year-old patient with bipolar disorder is taking valproic acid. The nurse reviews laboratory
results before the patient's appointment. Which finding requires immediate follow-up?
A. Platelet count of 180,000/mm³
B. Serum valproic level of 65 mcg/mL
EXAM 2026/2027 | Complete Practice with
Answers | Package Deal | Verified Q&A |
Pass Guaranteed - A+ Graded
Section 1: Mood Disorders (Questions 1–15)
Q1: A 34-year-old female with major depressive disorder is admitted after stating, "I don't see the point
in living anymore." She has a plan to overdose on her prescribed medications. Which is the nurse's
priority action?
A. Encourage the patient to participate in group therapy today.
B. Remove all potentially harmful objects from the patient's room and place her on 1:1 observation.
[CORRECT]
C. Ask the patient to sign a no-suicide contract before bedtime.
D. Schedule a family meeting to discuss discharge planning.
Correct Answer: B
Rationale: A patient with active suicidal ideation and a specific plan requires immediate safety
interventions. Removing harmful objects and maintaining continuous observation prevents self-harm
during the acute crisis phase.
Q2: A 28-year-old male with bipolar I disorder, manic episode, has been sleeping 2 hours per night for 5
days. He is pacing the unit, speaking rapidly, and attempting to organize a "business venture" with other
patients. Which nursing intervention is most appropriate?
A. Provide a quiet environment and encourage rest in his room with decreased stimuli. [CORRECT]
B. Allow the patient to continue his business planning to promote self-esteem.
C. Confront the patient about the unrealistic nature of his business plans.
D. Encourage the patient to lead a group activity to channel his energy.
Correct Answer: A
Rationale: Patients in acute mania require a low-stimulus environment to prevent overstimulation and
promote rest. Decreasing environmental stimuli helps reduce agitation and supports gradual
stabilization.
,Q3: A 45-year-old patient with major depressive disorder is started on sertraline 50 mg daily. On day 7,
the patient asks the nurse, "When will I start feeling better?" Which response by the nurse is most
accurate?
A. "You should notice significant improvement within 24 to 48 hours."
B. "Most patients begin to notice mood improvement within 2 to 4 weeks." [CORRECT]
C. "It may take up to 6 months before you feel any different."
D. "The medication works immediately, but the effect is subtle at first."
Correct Answer: B
Rationale: SSRIs like sertraline typically require 2 to 4 weeks to produce noticeable antidepressant
effects. Setting realistic expectations helps the patient adhere to the medication regimen during the
initial treatment period.
Q4: A 52-year-old patient with bipolar disorder is prescribed lithium carbonate 300 mg three times daily.
Before administering the first dose, which laboratory value is most important for the nurse to verify?
A. Hemoglobin and hematocrit
B. Serum lithium level and serum creatinine [CORRECT]
C. Liver function tests
D. Thyroid-stimulating hormone (TSH) only
Correct Answer: B
Rationale: Lithium is renally excreted and can cause nephrotoxicity. Verifying baseline renal function
and ensuring no pre-existing therapeutic lithium level prevents toxicity and establishes safe monitoring
parameters.
Q5: A 19-year-old college student with newly diagnosed major depressive disorder is prescribed
fluoxetine. The nurse provides medication education. Which statement by the patient indicates
understanding of important safety information?
A. "I can stop taking this medication as soon as I feel better."
B. "I should report any thoughts of self-harm immediately because antidepressants can increase suicidal
thinking in young adults." [CORRECT]
C. "This medication will help me sleep better right away."
D. "I can take this with my herbal supplements without any problems."
Correct Answer: B
Rationale: The FDA black box warning indicates increased suicidal ideation risk in patients under 25
,years old during the first weeks of antidepressant therapy. Teaching the patient to report suicidal
thoughts immediately ensures timely intervention.
Q6: A 38-year-old patient with persistent depressive disorder (dysthymia) reports chronic low mood,
poor concentration, and fatigue for 2 years. The patient states, "I just force myself through each day."
Which therapeutic response by the nurse is most appropriate?
A. "You should try to think more positively about your situation."
B. "It sounds like you have been coping with significant challenges for a long time. Tell me more about
what a typical day looks like for you." [CORRECT]
C. "Many people feel this way, so you are not alone."
D. "Have you considered that this might just be your personality?"
Correct Answer: B
Rationale: A therapeutic, patient-centered response validates the patient's experience and invites
further exploration. This approach builds rapport and facilitates a comprehensive assessment of
functional impact.
Q7: A patient with bipolar II disorder is in a hypomanic episode. The patient has spent $3,000 on online
shopping in 2 days and has decreased need for sleep. Which nursing priority is most appropriate at this
time?
A. Encourage the patient to return the purchased items immediately.
B. Assess the patient's insight into their behavior and implement financial safeguards with family
involvement. [CORRECT]
C. Tell the patient that their shopping behavior is inappropriate and must stop.
D. Restrict all visitors to prevent further stimulation.
Correct Answer: B
Rationale: During hypomania, patients often have impaired judgment with preserved insight. Assessing
insight and collaborating with family to establish financial protections minimizes harm while maintaining
therapeutic alliance.
Q8: A 67-year-old patient with major depressive disorder and comorbid Parkinson's disease is prescribed
an antidepressant. Which medication is most appropriate for this patient?
A. Amitriptyline
B. Bupropion
, C. Mirtazapine [CORRECT]
D. Venlafaxine
Correct Answer: C
Rationale: Mirtazapine has minimal effects on dopamine and minimal anticholinergic properties, making
it safer for patients with Parkinson's disease. It also addresses the appetite and sleep disturbances
common in geriatric depression.
Q9: A patient with seasonal affective disorder (SAD) asks the nurse about non-pharmacological
treatments. Which intervention does the nurse recommend?
A. Increasing caffeine intake during winter months
B. Light therapy with 10,000 lux for 30 minutes each morning [CORRECT]
C. Staying indoors to avoid cold weather stress
D. Taking high-dose vitamin D supplements only
Correct Answer: B
Rationale: Bright light therapy is a first-line non-pharmacological treatment for seasonal affective
disorder. Morning exposure helps regulate circadian rhythms and melatonin secretion, improving mood
and energy levels.
Q10: A patient with major depressive disorder is receiving electroconvulsive therapy (ECT). The nurse is
preparing the patient for the first treatment. Which statement by the nurse is most accurate?
A. "You will be awake during the procedure and can talk to us."
B. "You will receive general anesthesia and a muscle relaxant, and the treatment lasts only a few
minutes." [CORRECT]
C. "The procedure is painful, but we will give you pain medication afterward."
D. "You will need to stop all your antidepressant medications before starting ECT."
Correct Answer: B
Rationale: Modern ECT is performed under general anesthesia with a muscle relaxant to prevent injury.
The actual seizure lasts 30 to 60 seconds, and the entire procedure is brief and painless for the patient.
Q11: A 41-year-old patient with bipolar disorder is taking valproic acid. The nurse reviews laboratory
results before the patient's appointment. Which finding requires immediate follow-up?
A. Platelet count of 180,000/mm³
B. Serum valproic level of 65 mcg/mL
