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HESI Mental Health Nursing Test Bank 2025 |
Psychiatric NCLEX-Style Qs with Rationales | A+
Prep Guide
1. Schizophrenia – Positive Symptom Identification
Question:
Which of the following is considered a positive symptom of schizophrenia?
A. Flat affect
B. Anhedonia
C. Auditory hallucinations
D. Avolition
✅ Answer: C. Auditory hallucinations
Rationale:
Positive symptoms are additions to normal behavior, such as hallucinations, delusions, and
disorganized speech
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2. Depression – Suicide Risk
Question:
Which client is at highest risk for suicide?
A. 45-year-old female with seasonal affective disorder
B. 20-year-old male with history of substance abuse
C. 68-year-old widower recently diagnosed with terminal illness
D. 33-year-old with postpartum depression
✅ Answer: C. 68-year-old widower recently diagnosed with terminal illness
Rationale:
Elderly men with recent loss or terminal illness are among the highest risk groups for suicide.
3. Bipolar Disorder – Manic Episode
Question:
Which behavior is most characteristic of a manic episode?
A. Fatigue and guilt
B. Grandiosity and pressured speech
C. Tearfulness and self-blame
D. Apathy and poor concentration
✅ Answer: B. Grandiosity and pressured speech
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Rationale:
Mania is marked by elevated mood, inflated self-esteem, rapid speech, and decreased need for sleep.
4. Therapeutic Communication – Schizophrenia
Question:
A client says, “The voices are telling me to hurt myself.” What is the nurse’s best response?
A. “You know the voices aren't real.”
B. “Let’s ignore the voices right now.”
C. “Do you feel like acting on what they say?”
D. “Try to focus on happier thoughts.”
✅ Answer: C. “Do you feel like acting on what they say?”
Rationale:
This is a direct, therapeutic response that assesses risk for harm, which is the priority.
5. OCD – Behavior Understanding
Question:
A client repeatedly checks the stove to prevent a fire. This behavior is best described as:
A. A delusion
B. A compulsion
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C. A hallucination
D. A flashback
✅ Answer: B. A compulsion
Rationale:
Compulsions are repetitive behaviors performed to reduce anxiety associated with obsessive
thoughts.
6. Anorexia Nervosa – Priority Assessment
Question:
What is the most important physical assessment for a client with anorexia nervosa?
A. Blood glucose levels
B. BMI and electrolyte balance
C. Abdominal distention
D. Lung sounds
✅ Answer: B. BMI and electrolyte balance
Rationale:
Malnutrition and electrolyte imbalances (especially hypokalemia) can be life-threatening in
anorexia.
HESI Mental Health Nursing Test Bank 2025 |
Psychiatric NCLEX-Style Qs with Rationales | A+
Prep Guide
1. Schizophrenia – Positive Symptom Identification
Question:
Which of the following is considered a positive symptom of schizophrenia?
A. Flat affect
B. Anhedonia
C. Auditory hallucinations
D. Avolition
✅ Answer: C. Auditory hallucinations
Rationale:
Positive symptoms are additions to normal behavior, such as hallucinations, delusions, and
disorganized speech
,2
2. Depression – Suicide Risk
Question:
Which client is at highest risk for suicide?
A. 45-year-old female with seasonal affective disorder
B. 20-year-old male with history of substance abuse
C. 68-year-old widower recently diagnosed with terminal illness
D. 33-year-old with postpartum depression
✅ Answer: C. 68-year-old widower recently diagnosed with terminal illness
Rationale:
Elderly men with recent loss or terminal illness are among the highest risk groups for suicide.
3. Bipolar Disorder – Manic Episode
Question:
Which behavior is most characteristic of a manic episode?
A. Fatigue and guilt
B. Grandiosity and pressured speech
C. Tearfulness and self-blame
D. Apathy and poor concentration
✅ Answer: B. Grandiosity and pressured speech
,3
Rationale:
Mania is marked by elevated mood, inflated self-esteem, rapid speech, and decreased need for sleep.
4. Therapeutic Communication – Schizophrenia
Question:
A client says, “The voices are telling me to hurt myself.” What is the nurse’s best response?
A. “You know the voices aren't real.”
B. “Let’s ignore the voices right now.”
C. “Do you feel like acting on what they say?”
D. “Try to focus on happier thoughts.”
✅ Answer: C. “Do you feel like acting on what they say?”
Rationale:
This is a direct, therapeutic response that assesses risk for harm, which is the priority.
5. OCD – Behavior Understanding
Question:
A client repeatedly checks the stove to prevent a fire. This behavior is best described as:
A. A delusion
B. A compulsion
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C. A hallucination
D. A flashback
✅ Answer: B. A compulsion
Rationale:
Compulsions are repetitive behaviors performed to reduce anxiety associated with obsessive
thoughts.
6. Anorexia Nervosa – Priority Assessment
Question:
What is the most important physical assessment for a client with anorexia nervosa?
A. Blood glucose levels
B. BMI and electrolyte balance
C. Abdominal distention
D. Lung sounds
✅ Answer: B. BMI and electrolyte balance
Rationale:
Malnutrition and electrolyte imbalances (especially hypokalemia) can be life-threatening in
anorexia.
