Ultimate HESI Mental Health 2025-2026
Study Guide by Elsevier:150 Actual
Exam Questions & Detailed Answers .
**1. A patient with borderline personality disorder says, "You're the
only nurse who understands me. The others are all mean." Which
response by the nurse is most therapeutic?**
A. "Thank you, but you shouldn't talk badly about other nurses."
B. "I will share your concerns with the team. Let's focus on your
treatment goals."
C. "I'm glad we have a connection. Tell me more about the others."
D. "You're manipulating me by saying that."
**Answer: B**
**Rationale:** This response validates the patient's feelings without
engaging in "splitting" (idealizing one staff member while devaluing
others) . It maintains therapeutic boundaries and redirects the focus to
treatment goals.
**2. A patient with major depressive disorder tells the nurse, "There's
no point in anything. I just want to sleep forever." What is the nurse's
priority response?**
A. "Things will get better with treatment."
B. "Everyone feels sad sometimes."
,C. "Are you having thoughts of harming yourself?"
D. "Let's list three things you're grateful for."
**Answer: C**
**Rationale:** This statement expresses hopelessness, a key risk factor
for suicide. The nurse's priority is to directly assess for suicidal ideation
to ensure patient safety .
**3. During a group therapy session, a patient with paranoid
schizophrenia whispers to the nurse, "They're poisoning the coffee."
Which action should the nurse take first?**
A. Reassure the patient that the coffee is safe.
B. Privately ask the patient to explain the concern.
C. Announce to the group that the coffee is safe.
D. Ignore the comment to avoid reinforcing delusions.
**Answer: B**
**Rationale:** The nurse should first validate the patient's experience
without reinforcing the delusion. Privately asking the patient to explain
allows the nurse to assess the level of the patient's distress and gather
more information .
**4. The nurse is caring for a patient with anorexia nervosa who says, "I
feel so fat and ugly." Which response demonstrates empathy?**
,A. "You are not fat; you are dangerously underweight."
B. "Stop criticizing yourself; you need to eat."
C. "It sounds like you're feeling very distressed about your body."
D. "Let's look at your BMI chart together."
**Answer: C**
**Rationale:** Empathy involves reflecting the patient's feelings and
validating their experience without judgment. This response
acknowledges the patient's emotional distress .
**5. A patient with PTSD states, "I can't stop thinking about the
accident. It's like a movie in my head." The nurse should recognize this
as:**
A. Hallucination
B. Flashbulb memory
C. Intrusive re-experiencing
D. Dissociative fugue
**Answer: C**
**Rationale:** Intrusive re-experiencing, such as unwanted, distressing
memories or flashbacks of the traumatic event, is a core symptom of
PTSD .
, **6. A patient with bipolar disorder in a manic phase says, "I'm starting
a new business and going to marry the president next week." Which
nursing intervention is most appropriate initially?**
A. Ask the patient, "Do you really think the president will marry you?"
B. Tell the patient, "That's not possible."
C. Say, "Let's focus on planning your schedule for today."
D. Ignore the statement and walk away.
**Answer: C**
**Rationale:** The goal is to redirect the patient's grandiosity and high
energy to a concrete, reality-based task without directly challenging the
delusion .
**7. The nurse is preparing to discharge a patient with a new
prescription for lithium. Which statement by the patient indicates
effective teaching?**
A. "I can stop taking it if I feel my mood is stable."
B. "I will call my doctor if I have vomiting or severe tremors."
C. "I should take it on an empty stomach to absorb it better."
D. "I can keep taking my over-the-counter diuretic for my blood
pressure."
**Answer: B**
Study Guide by Elsevier:150 Actual
Exam Questions & Detailed Answers .
**1. A patient with borderline personality disorder says, "You're the
only nurse who understands me. The others are all mean." Which
response by the nurse is most therapeutic?**
A. "Thank you, but you shouldn't talk badly about other nurses."
B. "I will share your concerns with the team. Let's focus on your
treatment goals."
C. "I'm glad we have a connection. Tell me more about the others."
D. "You're manipulating me by saying that."
**Answer: B**
**Rationale:** This response validates the patient's feelings without
engaging in "splitting" (idealizing one staff member while devaluing
others) . It maintains therapeutic boundaries and redirects the focus to
treatment goals.
**2. A patient with major depressive disorder tells the nurse, "There's
no point in anything. I just want to sleep forever." What is the nurse's
priority response?**
A. "Things will get better with treatment."
B. "Everyone feels sad sometimes."
,C. "Are you having thoughts of harming yourself?"
D. "Let's list three things you're grateful for."
**Answer: C**
**Rationale:** This statement expresses hopelessness, a key risk factor
for suicide. The nurse's priority is to directly assess for suicidal ideation
to ensure patient safety .
**3. During a group therapy session, a patient with paranoid
schizophrenia whispers to the nurse, "They're poisoning the coffee."
Which action should the nurse take first?**
A. Reassure the patient that the coffee is safe.
B. Privately ask the patient to explain the concern.
C. Announce to the group that the coffee is safe.
D. Ignore the comment to avoid reinforcing delusions.
**Answer: B**
**Rationale:** The nurse should first validate the patient's experience
without reinforcing the delusion. Privately asking the patient to explain
allows the nurse to assess the level of the patient's distress and gather
more information .
**4. The nurse is caring for a patient with anorexia nervosa who says, "I
feel so fat and ugly." Which response demonstrates empathy?**
,A. "You are not fat; you are dangerously underweight."
B. "Stop criticizing yourself; you need to eat."
C. "It sounds like you're feeling very distressed about your body."
D. "Let's look at your BMI chart together."
**Answer: C**
**Rationale:** Empathy involves reflecting the patient's feelings and
validating their experience without judgment. This response
acknowledges the patient's emotional distress .
**5. A patient with PTSD states, "I can't stop thinking about the
accident. It's like a movie in my head." The nurse should recognize this
as:**
A. Hallucination
B. Flashbulb memory
C. Intrusive re-experiencing
D. Dissociative fugue
**Answer: C**
**Rationale:** Intrusive re-experiencing, such as unwanted, distressing
memories or flashbacks of the traumatic event, is a core symptom of
PTSD .
, **6. A patient with bipolar disorder in a manic phase says, "I'm starting
a new business and going to marry the president next week." Which
nursing intervention is most appropriate initially?**
A. Ask the patient, "Do you really think the president will marry you?"
B. Tell the patient, "That's not possible."
C. Say, "Let's focus on planning your schedule for today."
D. Ignore the statement and walk away.
**Answer: C**
**Rationale:** The goal is to redirect the patient's grandiosity and high
energy to a concrete, reality-based task without directly challenging the
delusion .
**7. The nurse is preparing to discharge a patient with a new
prescription for lithium. Which statement by the patient indicates
effective teaching?**
A. "I can stop taking it if I feel my mood is stable."
B. "I will call my doctor if I have vomiting or severe tremors."
C. "I should take it on an empty stomach to absorb it better."
D. "I can keep taking my over-the-counter diuretic for my blood
pressure."
**Answer: B**
