1|Page
HESI PSYCHIATRIC MENTAL HEALTH EXAM 2025-
2026, 120 QUESTIONS WITH ANSWERS AND
RATIONALE, VERIFIED 100% CORRECT ALREADY
GRADED A+
1. A nurse is caring for a client with major depressive disorder. Which statement
indicates the client is improving?
A. “I wish I could just die.”
B. “I don’t want to get out of bed today.”
C. “I took a shower before breakfast.”
D. “Nothing makes sense anymore.”
Answer: C
Rationale: Engaging in self-care = positive progress.
2. A client with schizophrenia reports hearing voices saying, “You are worthless.”
What is the best response?
A. “The voices are not real.”
B. “What are the voices telling you?”
C. “Ignore them and focus on me.”
D. “You should not listen to that.”
Answer: B
Rationale: Assess content of hallucination for safety (command hallucinations).
3. Which activity is most therapeutic for a manic client?
A. Chess with peers
B. Group discussion
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C. Walking with staff
D. Reading a novel
Answer: C
Rationale: Simple, non-competitive, physical activity helps reduce excess energy.
4. A nurse is teaching a client starting lithium therapy. Which statement requires
intervention?
A. “I’ll drink 2–3 L of water daily.”
B. “I’ll avoid excessive sweating.”
C. “I’ll take ibuprofen if I get a headache.”
D. “I’ll keep my follow-up appointments.”
Answer: C
Rationale: NSAIDs ↑ lithium levels → toxicity risk.
5. A client with generalized anxiety disorder is pacing. What is the nurse’s
priority?
A. Offer PRN anxiolytic
B. Ask what triggered anxiety
C. Stay with client
D. Encourage relaxation techniques
Answer: C
Rationale: Safety and presence are priority during acute anxiety.
6. Which finding suggests a client with anorexia nervosa needs hospitalization?
A. BMI 18.5
B. HR 110
C. K+ 2.7 mEq/L
D. Reports poor appetite
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Answer: C
Rationale: Hypokalemia is life-threatening.
7. Which defense mechanism is a client using when stating, “I drink because my
spouse nags me all the time”?
A. Projection
B. Rationalization
C. Displacement
D. Denial
Answer: B
Rationale: Justifying behavior with excuses = rationalization.
8. During ECT, which nursing intervention is priority?
A. Provide reorientation post-procedure
B. Monitor gag reflex
C. Encourage fluids
D. Provide quiet environment
Answer: A
Rationale: Temporary memory loss/disorientation expected → reorient first.
9. A client with borderline personality disorder engages in self-harm. What is the
best initial response?
A. “Why did you do that?”
B. “You’re only trying to get attention.”
C. “Let’s talk about your feelings.”
D. “You need to stop this behavior.”
Answer: C
Rationale: Focus on feelings behind behavior, not judgment.
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10. A client with panic disorder is hyperventilating. Which action should the nurse
take?
A. Instruct slow, deep breathing
B. Leave the client alone
C. Explain that nothing is wrong
D. Ask about recent stressors
Answer: A
Rationale: Regulating breathing decreases panic symptoms.
11. Which intervention is priority for a client withdrawing from alcohol?
A. Provide IV fluids
B. Administer benzodiazepines
C. Encourage group therapy
D. Teach relapse prevention
Answer: B
Rationale: Benzodiazepines prevent seizures/DTs during withdrawal.
12. A client is prescribed clozapine. Which finding requires immediate action?
A. Weight gain
B. Constipation
C. WBC 2,000/mm³
D. Increased appetite
Answer: C
Rationale: Clozapine → risk of agranulocytosis. Low WBC = emergency.
13. Which is the priority nursing diagnosis for a client with paranoid delusions?
A. Risk for injury
B. Social isolation
C. Disturbed thought processes
D. Impaired communication
HESI PSYCHIATRIC MENTAL HEALTH EXAM 2025-
2026, 120 QUESTIONS WITH ANSWERS AND
RATIONALE, VERIFIED 100% CORRECT ALREADY
GRADED A+
1. A nurse is caring for a client with major depressive disorder. Which statement
indicates the client is improving?
A. “I wish I could just die.”
B. “I don’t want to get out of bed today.”
C. “I took a shower before breakfast.”
D. “Nothing makes sense anymore.”
Answer: C
Rationale: Engaging in self-care = positive progress.
2. A client with schizophrenia reports hearing voices saying, “You are worthless.”
What is the best response?
A. “The voices are not real.”
B. “What are the voices telling you?”
C. “Ignore them and focus on me.”
D. “You should not listen to that.”
Answer: B
Rationale: Assess content of hallucination for safety (command hallucinations).
3. Which activity is most therapeutic for a manic client?
A. Chess with peers
B. Group discussion
,2|Page
C. Walking with staff
D. Reading a novel
Answer: C
Rationale: Simple, non-competitive, physical activity helps reduce excess energy.
4. A nurse is teaching a client starting lithium therapy. Which statement requires
intervention?
A. “I’ll drink 2–3 L of water daily.”
B. “I’ll avoid excessive sweating.”
C. “I’ll take ibuprofen if I get a headache.”
D. “I’ll keep my follow-up appointments.”
Answer: C
Rationale: NSAIDs ↑ lithium levels → toxicity risk.
5. A client with generalized anxiety disorder is pacing. What is the nurse’s
priority?
A. Offer PRN anxiolytic
B. Ask what triggered anxiety
C. Stay with client
D. Encourage relaxation techniques
Answer: C
Rationale: Safety and presence are priority during acute anxiety.
6. Which finding suggests a client with anorexia nervosa needs hospitalization?
A. BMI 18.5
B. HR 110
C. K+ 2.7 mEq/L
D. Reports poor appetite
,3|Page
Answer: C
Rationale: Hypokalemia is life-threatening.
7. Which defense mechanism is a client using when stating, “I drink because my
spouse nags me all the time”?
A. Projection
B. Rationalization
C. Displacement
D. Denial
Answer: B
Rationale: Justifying behavior with excuses = rationalization.
8. During ECT, which nursing intervention is priority?
A. Provide reorientation post-procedure
B. Monitor gag reflex
C. Encourage fluids
D. Provide quiet environment
Answer: A
Rationale: Temporary memory loss/disorientation expected → reorient first.
9. A client with borderline personality disorder engages in self-harm. What is the
best initial response?
A. “Why did you do that?”
B. “You’re only trying to get attention.”
C. “Let’s talk about your feelings.”
D. “You need to stop this behavior.”
Answer: C
Rationale: Focus on feelings behind behavior, not judgment.
, 4|Page
10. A client with panic disorder is hyperventilating. Which action should the nurse
take?
A. Instruct slow, deep breathing
B. Leave the client alone
C. Explain that nothing is wrong
D. Ask about recent stressors
Answer: A
Rationale: Regulating breathing decreases panic symptoms.
11. Which intervention is priority for a client withdrawing from alcohol?
A. Provide IV fluids
B. Administer benzodiazepines
C. Encourage group therapy
D. Teach relapse prevention
Answer: B
Rationale: Benzodiazepines prevent seizures/DTs during withdrawal.
12. A client is prescribed clozapine. Which finding requires immediate action?
A. Weight gain
B. Constipation
C. WBC 2,000/mm³
D. Increased appetite
Answer: C
Rationale: Clozapine → risk of agranulocytosis. Low WBC = emergency.
13. Which is the priority nursing diagnosis for a client with paranoid delusions?
A. Risk for injury
B. Social isolation
C. Disturbed thought processes
D. Impaired communication
