HESI EXIT MENTAL HEALTH PRACTICE
EXAMINATION STUDY GUIDE 2026
DETAILED QUESTIONS WITH PRECISE
CORRECT ANSWERS GRADED A+
⩥ A client with a diagnosis of major depression who has attempted
suicide says to the nurse, "I should have died. I've always been a failure.
Nothing ever goes right for me." Which response demonstrates
therapeutic communication?
1. "You have everything to live for."
2. "Why do you see yourself as a failure?"
3. "Feeling like this is all part of being depressed."
4. "You've been feeling like a failure for a while?". Answer: 4. "You've
been feeling like a failure for a while?"
Rationale:
Responding to the feelings expressed by a client is an effective
therapeutic communication technique. The correct option is an example
of the use of restating. The remaining options block communication
because they minimize the client's experience and do not facilitate
exploration of the client's expressed feelings. In addition, use of the
word "why" is nontherapeutic.
,⩥ When the mental health nurse visits a client at home, the client states,
"I haven't slept at all the last couple of nights." Which response by the
nurse illustrates a therapeutic communication response to this client?
1. "I see."
2. "Really?"
3. "You're having difficulty sleeping?"
4. "Sometimes, I have trouble sleeping too.". Answer: 3. "You're having
difficulty sleeping?"
Rationale:
The correct option uses the therapeutic communication technique of
restatement. Although restatement is a technique that has a prompting
component to it, it repeats the client's major theme, which assists the
nurse to obtain a more specific perception of the problem from the
client. The remaining options are not therapeutic responses since none
encourage the client to expand on the problem. Offering personal
experiences moves the focus away from the client and onto the nurse.
⩥ A client experiencing disturbed thought processes believes that his
food is being poisoned. Which communication technique should the
nurse use to encourage the client to eat?
1. Using open-ended questions and silence
2. Sharing personal preference regarding food choices
,3. Documenting reasons why the client does not want to eat
4. Offering opinions about the necessity of adequate nutrition. Answer:
1. Using open-ended questions and silence
Rationale:
Open-ended questions and silence are strategies used to encourage
clients to discuss their problems. Sharing personal food preferences is
not a client-centered intervention. The remaining options are not helpful
to the client because they do not encourage the client to express feelings.
The nurse should not offer opinions and should encourage the client to
identify the reasons for the behavior.
⩥ A client admitted to a mental health unit for treatment of psychotic
behavior spends hours at the locked exit door shouting, "Let me out.
There's nothing wrong with me. I don't belong here." What defense
mechanism is the client implementing?
1. Denial
2. Projection
3. Regression
4. Rationalization. Answer: 1. Denial
Rationale:
Denial is refusal to admit to a painful reality, which is treated as if it
does not exist. In projection, a person unconsciously rejects emotionally
, unacceptable features and attributes them to other persons, objects, or
situations. Regression allows the client to return to an earlier, more
comforting, although less mature, way of behaving. Rationalization is
justifying illogical or unreasonable ideas, actions, or feelings by
developing acceptable explanations that satisfy the teller and the listener.
⩥ A client diagnosed with terminal cancer says to the nurse, "I'm going
to die, and I wish my family would stop hoping for a cure! I get so angry
when they carry on like this. After all, I'm the one who's dying." Which
response by the nurse is therapeutic?
1. "Have you shared your feelings with your family?"
2. "I think we should talk more about your anger with your family."
3. "You're feeling angry that your family continues to hope for you to be
cured?"
4. "You are probably very depressed, which is understandable with such
a diagnosis.". Answer: 3. "You're feeling angry that your family
continues to hope for you to be cured?"
Rationale:
Restating is a therapeutic communication technique in which the nurse
repeats what the client says to show understanding and to review what
was said. While it is appropriate for the nurse to attempt to assess the
client's ability to discuss feelings openly with family members, it does
not help the client discuss the feelings causing the anger. The nurse's
attempt to focus on the central issue of anger is premature. The nurse
EXAMINATION STUDY GUIDE 2026
DETAILED QUESTIONS WITH PRECISE
CORRECT ANSWERS GRADED A+
⩥ A client with a diagnosis of major depression who has attempted
suicide says to the nurse, "I should have died. I've always been a failure.
Nothing ever goes right for me." Which response demonstrates
therapeutic communication?
1. "You have everything to live for."
2. "Why do you see yourself as a failure?"
3. "Feeling like this is all part of being depressed."
4. "You've been feeling like a failure for a while?". Answer: 4. "You've
been feeling like a failure for a while?"
Rationale:
Responding to the feelings expressed by a client is an effective
therapeutic communication technique. The correct option is an example
of the use of restating. The remaining options block communication
because they minimize the client's experience and do not facilitate
exploration of the client's expressed feelings. In addition, use of the
word "why" is nontherapeutic.
,⩥ When the mental health nurse visits a client at home, the client states,
"I haven't slept at all the last couple of nights." Which response by the
nurse illustrates a therapeutic communication response to this client?
1. "I see."
2. "Really?"
3. "You're having difficulty sleeping?"
4. "Sometimes, I have trouble sleeping too.". Answer: 3. "You're having
difficulty sleeping?"
Rationale:
The correct option uses the therapeutic communication technique of
restatement. Although restatement is a technique that has a prompting
component to it, it repeats the client's major theme, which assists the
nurse to obtain a more specific perception of the problem from the
client. The remaining options are not therapeutic responses since none
encourage the client to expand on the problem. Offering personal
experiences moves the focus away from the client and onto the nurse.
⩥ A client experiencing disturbed thought processes believes that his
food is being poisoned. Which communication technique should the
nurse use to encourage the client to eat?
1. Using open-ended questions and silence
2. Sharing personal preference regarding food choices
,3. Documenting reasons why the client does not want to eat
4. Offering opinions about the necessity of adequate nutrition. Answer:
1. Using open-ended questions and silence
Rationale:
Open-ended questions and silence are strategies used to encourage
clients to discuss their problems. Sharing personal food preferences is
not a client-centered intervention. The remaining options are not helpful
to the client because they do not encourage the client to express feelings.
The nurse should not offer opinions and should encourage the client to
identify the reasons for the behavior.
⩥ A client admitted to a mental health unit for treatment of psychotic
behavior spends hours at the locked exit door shouting, "Let me out.
There's nothing wrong with me. I don't belong here." What defense
mechanism is the client implementing?
1. Denial
2. Projection
3. Regression
4. Rationalization. Answer: 1. Denial
Rationale:
Denial is refusal to admit to a painful reality, which is treated as if it
does not exist. In projection, a person unconsciously rejects emotionally
, unacceptable features and attributes them to other persons, objects, or
situations. Regression allows the client to return to an earlier, more
comforting, although less mature, way of behaving. Rationalization is
justifying illogical or unreasonable ideas, actions, or feelings by
developing acceptable explanations that satisfy the teller and the listener.
⩥ A client diagnosed with terminal cancer says to the nurse, "I'm going
to die, and I wish my family would stop hoping for a cure! I get so angry
when they carry on like this. After all, I'm the one who's dying." Which
response by the nurse is therapeutic?
1. "Have you shared your feelings with your family?"
2. "I think we should talk more about your anger with your family."
3. "You're feeling angry that your family continues to hope for you to be
cured?"
4. "You are probably very depressed, which is understandable with such
a diagnosis.". Answer: 3. "You're feeling angry that your family
continues to hope for you to be cured?"
Rationale:
Restating is a therapeutic communication technique in which the nurse
repeats what the client says to show understanding and to review what
was said. While it is appropriate for the nurse to attempt to assess the
client's ability to discuss feelings openly with family members, it does
not help the client discuss the feelings causing the anger. The nurse's
attempt to focus on the central issue of anger is premature. The nurse
