1
HESI Mental Health Exam 2 Actual Exam
2026/2027 – Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
[SECTION 1: Psychiatric Disorders & Therapeutic Communication — Questions 1-20]
Q1: A patient diagnosed with schizophrenia exhibits flat affect, poverty of speech, and social
withdrawal. These symptoms are best described as:
A. Positive symptoms
B. Prodromal symptoms
C. Residual symptoms
D. Negative symptoms
Correct Answer: D
Rationale: Negative symptoms of schizophrenia reflect a diminution or loss of normal functions,
such as flat affect (reduced emotional expression), alogia (poverty of speech), avolition (lack of
motivation), and social withdrawal. Positive symptoms involve an excess or distortion of normal
functions, such as hallucinations and delusions. Prodromal symptoms occur before the full onset
of the illness.
Q2: Which nursing intervention is most appropriate for a patient in the acute manic phase of
Bipolar I Disorder?
A. Encouraging the patient to lead a group activity
B. Placing the patient in a quiet, low-stimulus environment
C. Confronting the patient about their grandiose delusions
D. Providing detailed information about their diagnosis
Correct Answer: B
,2
Rationale: During acute mania, patients are easily overstimulated and have a decreased need for
sleep. A quiet, low-stimulus environment helps reduce agitation and prevent exhaustion.
Confronting delusions is non-therapeutic and increases agitation, and leading a group may be too
overwhelming for the patient.
Q3: A nurse is caring for a patient with Major Depressive Disorder (MDD). Which statement by
the patient indicates an understanding of the discharge plan regarding medication?
A. "I will stop taking my medication as soon as I feel better."
B. "I will double my dose if I have a bad day."
C. "I understand that it may take 2-4 weeks to feel the full effect of the medication."
D. "I can drink alcohol while taking this medication because it helps me relax."
Correct Answer: C
Rationale: Antidepressants typically take 2-4 weeks to reach therapeutic effect, and patients must
be educated to adhere to the regimen despite not feeling immediate relief. Stopping early leads to
relapse, and alcohol should be avoided due to interactions and increased depression risk.
Q4: When interacting with a patient experiencing a panic attack, which action by the nurse is
most therapeutic?
A. Reassuring the patient that nothing bad will happen
B. Encouraging the patient to sit down and take slow, deep breaths
C. Leaving the patient alone to "calm down" in private
D. Asking the patient to explain why they are panicking
Correct Answer: B
Rationale: During a panic attack, the physiological arousal is high. Slow, deep breathing helps
activate the parasympathetic nervous system to reduce symptoms. Leaving the patient is unsafe,
and asking "why" can be overwhelming or impossible for the patient to articulate in the moment.
,3
Q5: A patient with Obsessive-Compulsive Disorder (OCD) spends 2 hours washing their hands.
The nurse should:
A. Hide the soap to force the patient to stop
B. Interrupt the ritual immediately to save time
C. Allow the ritual but set limits on the time spent
D. Ignore the behavior completely
Correct Answer: C
Rationale: Treatment for OCD often involves exposure and response prevention (ERP).
However, abruptly stopping a ritual can cause extreme anxiety. Nurses should initially allow the
ritual while gradually working with the treatment team to set limits and reduce the time spent on
the compulsion.
Q6: Which defense mechanism involves unconsciously attributing one's own unacceptable
feelings to another person?
A. Repression
B. Projection
C. Displacement
D. Sublimation
Correct Answer: B
Rationale: Projection is a defense mechanism where a person denies their own unacceptable
thoughts or feelings and attributes them to others. For example, a patient who is angry might
accuse the nurse of being angry.
Q7: A patient with Post-Traumatic Stress Disorder (PTSD) reports recurring nightmares and
flashbacks of a car accident. These symptoms are categorized as:
A. Avoidance
B. Hyperarousal
C. Negative cognitions
, 4
D. Re-experiencing
Correct Answer: D
Rationale: Re-experiencing symptoms involve reliving the traumatic event, which includes
flashbacks, nightmares, and intrusive thoughts. Avoidance involves steering clear of triggers, and
hyperarousal refers to heightened startle response and hypervigilance.
Q8: When a patient states, "The voices are telling me to hurt myself," the nurse's priority action
is to:
A. Ask the patient what the voices are saying
B. Ensure the patient's immediate safety and initiate suicide precautions
C. Administer PRN antipsychotic medication
D. Document the statement in the chart
Correct Answer: B
Rationale: Safety is always the priority. Command hallucinations telling a patient to hurt
themselves or others are a medical emergency. The nurse must ensure the environment is safe
(remove dangerous objects) and initiate constant observation protocols.
Q9: A patient with Borderline Personality Disorder is manipulative and splits staff into "good"
and "bad" categories. The best nursing approach is to:
A. Agree with the patient to avoid conflict
B. Ask the patient why they behave this way
C. Maintain consistent boundaries among all staff members
D. Ignore the patient when they are acting out
Correct Answer: C
Rationale: Patients with Borderline Personality Disorder often "split" staff to manipulate
situations. Consistency among staff is crucial to prevent this manipulation and provide a stable,
HESI Mental Health Exam 2 Actual Exam
2026/2027 – Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
[SECTION 1: Psychiatric Disorders & Therapeutic Communication — Questions 1-20]
Q1: A patient diagnosed with schizophrenia exhibits flat affect, poverty of speech, and social
withdrawal. These symptoms are best described as:
A. Positive symptoms
B. Prodromal symptoms
C. Residual symptoms
D. Negative symptoms
Correct Answer: D
Rationale: Negative symptoms of schizophrenia reflect a diminution or loss of normal functions,
such as flat affect (reduced emotional expression), alogia (poverty of speech), avolition (lack of
motivation), and social withdrawal. Positive symptoms involve an excess or distortion of normal
functions, such as hallucinations and delusions. Prodromal symptoms occur before the full onset
of the illness.
Q2: Which nursing intervention is most appropriate for a patient in the acute manic phase of
Bipolar I Disorder?
A. Encouraging the patient to lead a group activity
B. Placing the patient in a quiet, low-stimulus environment
C. Confronting the patient about their grandiose delusions
D. Providing detailed information about their diagnosis
Correct Answer: B
,2
Rationale: During acute mania, patients are easily overstimulated and have a decreased need for
sleep. A quiet, low-stimulus environment helps reduce agitation and prevent exhaustion.
Confronting delusions is non-therapeutic and increases agitation, and leading a group may be too
overwhelming for the patient.
Q3: A nurse is caring for a patient with Major Depressive Disorder (MDD). Which statement by
the patient indicates an understanding of the discharge plan regarding medication?
A. "I will stop taking my medication as soon as I feel better."
B. "I will double my dose if I have a bad day."
C. "I understand that it may take 2-4 weeks to feel the full effect of the medication."
D. "I can drink alcohol while taking this medication because it helps me relax."
Correct Answer: C
Rationale: Antidepressants typically take 2-4 weeks to reach therapeutic effect, and patients must
be educated to adhere to the regimen despite not feeling immediate relief. Stopping early leads to
relapse, and alcohol should be avoided due to interactions and increased depression risk.
Q4: When interacting with a patient experiencing a panic attack, which action by the nurse is
most therapeutic?
A. Reassuring the patient that nothing bad will happen
B. Encouraging the patient to sit down and take slow, deep breaths
C. Leaving the patient alone to "calm down" in private
D. Asking the patient to explain why they are panicking
Correct Answer: B
Rationale: During a panic attack, the physiological arousal is high. Slow, deep breathing helps
activate the parasympathetic nervous system to reduce symptoms. Leaving the patient is unsafe,
and asking "why" can be overwhelming or impossible for the patient to articulate in the moment.
,3
Q5: A patient with Obsessive-Compulsive Disorder (OCD) spends 2 hours washing their hands.
The nurse should:
A. Hide the soap to force the patient to stop
B. Interrupt the ritual immediately to save time
C. Allow the ritual but set limits on the time spent
D. Ignore the behavior completely
Correct Answer: C
Rationale: Treatment for OCD often involves exposure and response prevention (ERP).
However, abruptly stopping a ritual can cause extreme anxiety. Nurses should initially allow the
ritual while gradually working with the treatment team to set limits and reduce the time spent on
the compulsion.
Q6: Which defense mechanism involves unconsciously attributing one's own unacceptable
feelings to another person?
A. Repression
B. Projection
C. Displacement
D. Sublimation
Correct Answer: B
Rationale: Projection is a defense mechanism where a person denies their own unacceptable
thoughts or feelings and attributes them to others. For example, a patient who is angry might
accuse the nurse of being angry.
Q7: A patient with Post-Traumatic Stress Disorder (PTSD) reports recurring nightmares and
flashbacks of a car accident. These symptoms are categorized as:
A. Avoidance
B. Hyperarousal
C. Negative cognitions
, 4
D. Re-experiencing
Correct Answer: D
Rationale: Re-experiencing symptoms involve reliving the traumatic event, which includes
flashbacks, nightmares, and intrusive thoughts. Avoidance involves steering clear of triggers, and
hyperarousal refers to heightened startle response and hypervigilance.
Q8: When a patient states, "The voices are telling me to hurt myself," the nurse's priority action
is to:
A. Ask the patient what the voices are saying
B. Ensure the patient's immediate safety and initiate suicide precautions
C. Administer PRN antipsychotic medication
D. Document the statement in the chart
Correct Answer: B
Rationale: Safety is always the priority. Command hallucinations telling a patient to hurt
themselves or others are a medical emergency. The nurse must ensure the environment is safe
(remove dangerous objects) and initiate constant observation protocols.
Q9: A patient with Borderline Personality Disorder is manipulative and splits staff into "good"
and "bad" categories. The best nursing approach is to:
A. Agree with the patient to avoid conflict
B. Ask the patient why they behave this way
C. Maintain consistent boundaries among all staff members
D. Ignore the patient when they are acting out
Correct Answer: C
Rationale: Patients with Borderline Personality Disorder often "split" staff to manipulate
situations. Consistency among staff is crucial to prevent this manipulation and provide a stable,
