HESI RN 2025 Mega Test Bank | 550+ Verified
Questions – Mental Health, Pharmacology,
Fundamentals
✅ Question 001
The RN is preparing medications for a client diagnosed with bipolar I disorder. During
medication reconciliation, the nurse discovers that the client has self-discontinued risperidone, an
antipsychotic, for the past four days. The medication administration record shows that the client
is due for their scheduled dose of lithium carbonate. What is the nurse’s most appropriate action?
A. Continue administering lithium to maintain serum levels
B. Withhold lithium and notify the healthcare provider immediately
C. Resume risperidone administration along with lithium
D. Administer lithium and increase fluid intake to prevent toxicity
Correct Answer: B
Rationale: In clients taking lithium for bipolar disorder, co-administered antipsychotics help
manage mania and psychosis. Stopping antipsychotics destabilizes treatment and increases the
risk of lithium toxicity. Lithium should be withheld, and the provider must reassess the regimen.
,✅ Question 002
A client with schizophrenia is prescribed clozapine 100 mg PO BID. During the morning shift,
the nurse reviews the latest laboratory results and notes that the client’s absolute neutrophil count
(ANC) is 950/mm³. What is the nurse’s priority action?
A. Hold the dose and notify the healthcare provider immediately
B. Administer the dose and monitor for infection
C. Encourage fluid intake and administer the medication
D. Delay the dose until the next scheduled lab draw
Correct Answer: A
Rationale: Clozapine must be withheld if the ANC is below 1,000/mm³ due to the risk of
agranulocytosis. The nurse’s priority is to hold the dose and alert the provider to prevent severe
immunosuppression and infection.
✅ Question 003
A client with acute mania is admitted to the psychiatric unit. The nurse notes the client is pacing,
hyperverbal, and attempts to engage other clients disruptively. What is the nurse’s most
appropriate initial intervention?
A. Place the client in seclusion to reduce stimulation
B. Offer finger foods and encourage fluid intake
,C. Redirect the client to a quiet area with structured activity
D. Administer prescribed PRN lorazepam immediately
Correct Answer: C
Rationale: Clients in manic states benefit from redirection to low-stimulation environments.
Structured activity helps reduce excessive energy while promoting safety and engagement. This
is a therapeutic and non-restrictive first-line intervention.
✅ Question 004
The nurse is caring for a client with schizoaffective disorder who reports hearing voices telling
them to harm themselves. Which nursing action is the highest priority?
A. Validate the client’s feelings and explore the content of the voices
B. Administer prescribed antipsychotic medication
C. Place the client on one-to-one observation
D. Notify the healthcare provider for possible medication adjustment
Correct Answer: C
Rationale: Auditory hallucinations with self-harm content are a psychiatric emergency.
Immediate one-to-one observation ensures client safety. While validation and medication are
important, suicide prevention is the top priority.
✅ Question 005
, A client with major depressive disorder has been prescribed fluoxetine. The nurse provides
discharge education. Which client statement indicates a need for further teaching?
A. “I may not feel better right away, and that’s okay.”
B. “If I feel better in a week, I can stop taking it.”
C. “I’ll let my provider know if I have any unusual thoughts.”
D. “I need to take this every day even if I feel fine.”
Correct Answer: B
Rationale: SSRIs like fluoxetine require several weeks to reach full therapeutic effect.
Discontinuing medication early increases relapse risk and may cause withdrawal symptoms.
Education should stress medication adherence.
✅ Question 006
The nurse is teaching a client about olanzapine. Which instruction is most important to reduce a
common side effect?
A. “Avoid exposure to sunlight while taking this medication.”
B. “Drink plenty of fluids and increase fiber in your diet.”
C. “Take the medication with food to reduce stomach upset.”
D. “Avoid alcohol while on this medication.”
Correct Answer: B
Rationale: Olanzapine often causes anticholinergic effects like constipation. Encouraging
Questions – Mental Health, Pharmacology,
Fundamentals
✅ Question 001
The RN is preparing medications for a client diagnosed with bipolar I disorder. During
medication reconciliation, the nurse discovers that the client has self-discontinued risperidone, an
antipsychotic, for the past four days. The medication administration record shows that the client
is due for their scheduled dose of lithium carbonate. What is the nurse’s most appropriate action?
A. Continue administering lithium to maintain serum levels
B. Withhold lithium and notify the healthcare provider immediately
C. Resume risperidone administration along with lithium
D. Administer lithium and increase fluid intake to prevent toxicity
Correct Answer: B
Rationale: In clients taking lithium for bipolar disorder, co-administered antipsychotics help
manage mania and psychosis. Stopping antipsychotics destabilizes treatment and increases the
risk of lithium toxicity. Lithium should be withheld, and the provider must reassess the regimen.
,✅ Question 002
A client with schizophrenia is prescribed clozapine 100 mg PO BID. During the morning shift,
the nurse reviews the latest laboratory results and notes that the client’s absolute neutrophil count
(ANC) is 950/mm³. What is the nurse’s priority action?
A. Hold the dose and notify the healthcare provider immediately
B. Administer the dose and monitor for infection
C. Encourage fluid intake and administer the medication
D. Delay the dose until the next scheduled lab draw
Correct Answer: A
Rationale: Clozapine must be withheld if the ANC is below 1,000/mm³ due to the risk of
agranulocytosis. The nurse’s priority is to hold the dose and alert the provider to prevent severe
immunosuppression and infection.
✅ Question 003
A client with acute mania is admitted to the psychiatric unit. The nurse notes the client is pacing,
hyperverbal, and attempts to engage other clients disruptively. What is the nurse’s most
appropriate initial intervention?
A. Place the client in seclusion to reduce stimulation
B. Offer finger foods and encourage fluid intake
,C. Redirect the client to a quiet area with structured activity
D. Administer prescribed PRN lorazepam immediately
Correct Answer: C
Rationale: Clients in manic states benefit from redirection to low-stimulation environments.
Structured activity helps reduce excessive energy while promoting safety and engagement. This
is a therapeutic and non-restrictive first-line intervention.
✅ Question 004
The nurse is caring for a client with schizoaffective disorder who reports hearing voices telling
them to harm themselves. Which nursing action is the highest priority?
A. Validate the client’s feelings and explore the content of the voices
B. Administer prescribed antipsychotic medication
C. Place the client on one-to-one observation
D. Notify the healthcare provider for possible medication adjustment
Correct Answer: C
Rationale: Auditory hallucinations with self-harm content are a psychiatric emergency.
Immediate one-to-one observation ensures client safety. While validation and medication are
important, suicide prevention is the top priority.
✅ Question 005
, A client with major depressive disorder has been prescribed fluoxetine. The nurse provides
discharge education. Which client statement indicates a need for further teaching?
A. “I may not feel better right away, and that’s okay.”
B. “If I feel better in a week, I can stop taking it.”
C. “I’ll let my provider know if I have any unusual thoughts.”
D. “I need to take this every day even if I feel fine.”
Correct Answer: B
Rationale: SSRIs like fluoxetine require several weeks to reach full therapeutic effect.
Discontinuing medication early increases relapse risk and may cause withdrawal symptoms.
Education should stress medication adherence.
✅ Question 006
The nurse is teaching a client about olanzapine. Which instruction is most important to reduce a
common side effect?
A. “Avoid exposure to sunlight while taking this medication.”
B. “Drink plenty of fluids and increase fiber in your diet.”
C. “Take the medication with food to reduce stomach upset.”
D. “Avoid alcohol while on this medication.”
Correct Answer: B
Rationale: Olanzapine often causes anticholinergic effects like constipation. Encouraging
