# 2022 – 2023 HESI MENTAL HEALTH RN V1-V3 TEST BANKS
(ALL TOGETHER) UPDATED 2023
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**01.** A client with bipolar disorder is in the manic phase. Which intervention is most appropriate?
A) Place the client in a quiet room with low lighting and few stimuli
B) Allow the client to stay up all night to use excess energy
C) Engage the client in a competitive group activity
D) Offer large, heavy meals three times daily
🔍 RATIONALE💡-- Clients in a manic phase are easily overstimulated. A low‑stimulus environment
(quiet, dim lighting, few people) helps reduce agitation. Competitive activities and large meals are not
appropriate; frequent high‑calorie finger foods are better.
ANSWER💫✔️-- A) Place the client in a quiet room with low lighting and few stimuli
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**02.** A nurse is caring for a client with major depressive disorder who has been prescribed
fluoxetine. Which statement by the client indicates understanding?
A) “I will stop taking the medication when I feel better.”
B) “It may take several weeks before I notice improvement.”
C) “I can take St. John’s wort to enhance the effect.”
D) “I will take the medication only when I feel depressed.”
🔍 RATIONALE💡-- Fluoxetine (SSRI) typically takes 2‑4 weeks to achieve therapeutic effect. It should be
taken daily, not PRN, and not stopped abruptly. St. John’s wort can cause serotonin syndrome.
,ANSWER💫✔️-- B) “It may take several weeks before I notice improvement.”
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**03.** A nurse is assessing a client with schizophrenia who has a flat affect and social withdrawal.
Which term best describes these symptoms?
A) Positive symptoms
B) Negative symptoms
C) Cognitive symptoms
D) Affective symptoms
🔍 RATIONALE💡-- Negative symptoms of schizophrenia include flat affect, anhedonia, social
withdrawal, and avolition. Positive symptoms include hallucinations, delusions, and disorganized speech.
ANSWER💫✔️-- B) Negative symptoms
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**04.** A nurse is caring for a client who is experiencing alcohol withdrawal. The client has a CIWA
score of 22. Which medication should the nurse anticipate administering?
A) Haloperidol
B) Lorazepam
C) Disulfiram
D) Naltrexone
🔍 RATIONALE💡-- A CIWA score >20 indicates severe withdrawal. Benzodiazepines (lorazepam) are
first‑line to prevent seizures and delirium tremens. Disulfiram and naltrexone are for relapse prevention,
not acute withdrawal.
ANSWER💫✔️-- B) Lorazepam
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**05.** A nurse is reinforcing teaching with a client who has a new prescription for lithium. Which
statement indicates a need for further teaching?
A) “I will have my blood levels checked regularly.”
B) “I will drink at least 8‑10 glasses of water every day.”
C) “I can take ibuprofen for my headaches.”
D) “I will notify my provider if I have vomiting or diarrhea.”
🔍 RATIONALE💡-- NSAIDs (ibuprofen) increase lithium levels and risk of toxicity. Acetaminophen is
safer. The other statements are correct: lithium requires monitoring, adequate hydration, and reporting
signs of dehydration.
ANSWER💫✔️-- C) “I can take ibuprofen for my headaches.”
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**06.** A nurse is caring for a client who is taking clozapine for schizophrenia. Which laboratory test
must be monitored regularly?
A) Absolute neutrophil count (ANC)
B) Liver function tests
C) Serum creatinine
D) Thyroid‑stimulating hormone
🔍 RATIONALE💡-- Clozapine causes agranulocytosis (severe neutropenia). ANC must be monitored
weekly or bi‑weekly per FDA requirements.
ANSWER💫✔️-- A) Absolute neutrophil count (ANC)
, ---
**07.** A nurse is assessing a client with post‑traumatic stress disorder (PTSD). Which finding is
characteristic?
A) Euphoria and grandiosity
B) Flashbacks and hypervigilance
C) Disorganized speech
D) Compulsive hand washing
🔍 RATIONALE💡-- PTSD is characterized by re‑experiencing (flashbacks, nightmares), avoidance,
hyperarousal (hypervigilance, startle response), and negative mood. Euphoria/grandiosity is bipolar;
disorganized speech is schizophrenia; compulsive hand washing is OCD.
ANSWER💫✔️-- B) Flashbacks and hypervigilance
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**08.** A nurse is caring for a client who has overdosed on a benzodiazepine. Which medication should
the nurse anticipate administering?
A) Naloxone
B) Flumazenil
C) Activated charcoal
D) Atropine
🔍 RATIONALE💡-- Flumazenil is a benzodiazepine antagonist that reverses sedation. It is used with
caution due to risk of seizures in chronic benzodiazepine users or those who also took tricyclic
antidepressants. Naloxone reverses opioids.
ANSWER💫✔️-- B) Flumazenil
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(ALL TOGETHER) UPDATED 2023
---
**01.** A client with bipolar disorder is in the manic phase. Which intervention is most appropriate?
A) Place the client in a quiet room with low lighting and few stimuli
B) Allow the client to stay up all night to use excess energy
C) Engage the client in a competitive group activity
D) Offer large, heavy meals three times daily
🔍 RATIONALE💡-- Clients in a manic phase are easily overstimulated. A low‑stimulus environment
(quiet, dim lighting, few people) helps reduce agitation. Competitive activities and large meals are not
appropriate; frequent high‑calorie finger foods are better.
ANSWER💫✔️-- A) Place the client in a quiet room with low lighting and few stimuli
---
**02.** A nurse is caring for a client with major depressive disorder who has been prescribed
fluoxetine. Which statement by the client indicates understanding?
A) “I will stop taking the medication when I feel better.”
B) “It may take several weeks before I notice improvement.”
C) “I can take St. John’s wort to enhance the effect.”
D) “I will take the medication only when I feel depressed.”
🔍 RATIONALE💡-- Fluoxetine (SSRI) typically takes 2‑4 weeks to achieve therapeutic effect. It should be
taken daily, not PRN, and not stopped abruptly. St. John’s wort can cause serotonin syndrome.
,ANSWER💫✔️-- B) “It may take several weeks before I notice improvement.”
---
**03.** A nurse is assessing a client with schizophrenia who has a flat affect and social withdrawal.
Which term best describes these symptoms?
A) Positive symptoms
B) Negative symptoms
C) Cognitive symptoms
D) Affective symptoms
🔍 RATIONALE💡-- Negative symptoms of schizophrenia include flat affect, anhedonia, social
withdrawal, and avolition. Positive symptoms include hallucinations, delusions, and disorganized speech.
ANSWER💫✔️-- B) Negative symptoms
---
**04.** A nurse is caring for a client who is experiencing alcohol withdrawal. The client has a CIWA
score of 22. Which medication should the nurse anticipate administering?
A) Haloperidol
B) Lorazepam
C) Disulfiram
D) Naltrexone
🔍 RATIONALE💡-- A CIWA score >20 indicates severe withdrawal. Benzodiazepines (lorazepam) are
first‑line to prevent seizures and delirium tremens. Disulfiram and naltrexone are for relapse prevention,
not acute withdrawal.
ANSWER💫✔️-- B) Lorazepam
,---
**05.** A nurse is reinforcing teaching with a client who has a new prescription for lithium. Which
statement indicates a need for further teaching?
A) “I will have my blood levels checked regularly.”
B) “I will drink at least 8‑10 glasses of water every day.”
C) “I can take ibuprofen for my headaches.”
D) “I will notify my provider if I have vomiting or diarrhea.”
🔍 RATIONALE💡-- NSAIDs (ibuprofen) increase lithium levels and risk of toxicity. Acetaminophen is
safer. The other statements are correct: lithium requires monitoring, adequate hydration, and reporting
signs of dehydration.
ANSWER💫✔️-- C) “I can take ibuprofen for my headaches.”
---
**06.** A nurse is caring for a client who is taking clozapine for schizophrenia. Which laboratory test
must be monitored regularly?
A) Absolute neutrophil count (ANC)
B) Liver function tests
C) Serum creatinine
D) Thyroid‑stimulating hormone
🔍 RATIONALE💡-- Clozapine causes agranulocytosis (severe neutropenia). ANC must be monitored
weekly or bi‑weekly per FDA requirements.
ANSWER💫✔️-- A) Absolute neutrophil count (ANC)
, ---
**07.** A nurse is assessing a client with post‑traumatic stress disorder (PTSD). Which finding is
characteristic?
A) Euphoria and grandiosity
B) Flashbacks and hypervigilance
C) Disorganized speech
D) Compulsive hand washing
🔍 RATIONALE💡-- PTSD is characterized by re‑experiencing (flashbacks, nightmares), avoidance,
hyperarousal (hypervigilance, startle response), and negative mood. Euphoria/grandiosity is bipolar;
disorganized speech is schizophrenia; compulsive hand washing is OCD.
ANSWER💫✔️-- B) Flashbacks and hypervigilance
---
**08.** A nurse is caring for a client who has overdosed on a benzodiazepine. Which medication should
the nurse anticipate administering?
A) Naloxone
B) Flumazenil
C) Activated charcoal
D) Atropine
🔍 RATIONALE💡-- Flumazenil is a benzodiazepine antagonist that reverses sedation. It is used with
caution due to risk of seizures in chronic benzodiazepine users or those who also took tricyclic
antidepressants. Naloxone reverses opioids.
ANSWER💫✔️-- B) Flumazenil
---
