HESI Mental Health

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Sample questions from HESI Mental Health

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 22-year-old client in an emergency department reports depression and says, "I bought a bottle of pills so I can end this tonight." The client is alert, with BP 118/72 mm Hg and pulse 88/min. Which action should the nurse take first?

   • A.Ask the client to sign an agreement not to attempt suicide
   • B.Maintain direct observation and activate suicide safety precautions
   • C.Explore the events that contributed to the client's depression
   • D.Ask the client's family to secure medications at home

   Rationale: A stated plan, available means, and imminent intent require immediate protection and direct observation. A safety agreement does not reliably prevent suicide. Exploring stressors and securing home medications are appropriate later but do not address the immediate danger. The priority is safety before extended assessment or discharge planning.

2. 2.A 34-year-old client on an inpatient psychiatric unit says, "The voice says I should stab my roommate." The client is pacing with clenched fists; pulse is 112/min. Which response by the nurse is best?

   • A."The voice cannot actually make you do anything."
   • B."Try listening to music until the voice stops."
   • C."Do you intend to act on the voice, and do you have anything you could use to hurt someone?"
   • D."Why do you think the voice chose your roommate?"

   Rationale: Command hallucinations require direct assessment of intent, access to weapons, and ability to resist while the nurse maintains safety. Telling the client the voice has no control minimizes the experience and does not establish risk. Music may help later, while asking why invites speculation rather than assessing danger. Threatening commands must be evaluated directly and promptly.

3. 3.A 41-year-old client in an outpatient clinic suddenly reports intense fear, tingling fingers, and difficulty breathing after a distressing phone call. Pulse is 120/min, respirations are 30/min, and oxygen saturation is 99% on room air; an initial medical assessment identifies no acute cardiopulmonary problem. Which nursing action is best?

   • A.Remain with the client and coach slow breathing using brief instructions
   • B.Ask the client to describe childhood experiences associated with anxiety
   • C.Have the client breathe into a paper bag
   • D.Provide a detailed explanation of the physiology of panic

   Rationale: Calm presence and simple breathing instructions reduce stimulation and support control during panic. Exploring childhood experiences and giving detailed teaching exceed the client's immediate capacity to process information. Paper-bag breathing can cause hypoxia and is not recommended. During severe anxiety, use brief communication and address physiologic safety.

4. 4.A 29-year-old client admitted for acute mania sleeps 2 hours nightly, interrupts every conversation, and has lost 2 kg in a week. Vital signs are stable. Which nursing plan best addresses the client's immediate needs?

   • A.Schedule competitive group activities to use excess energy
   • B.Encourage three large meals in the crowded dining room
   • C.Allow unlimited social interaction until the client becomes tired
   • D.Offer high-calorie finger foods and scheduled rest in a low-stimulation area

   Answer and rationale are in the full material.

5. 5.A 46-year-old client taking lithium arrives at an urgent care clinic after 2 days of vomiting and diarrhea. The client has a coarse tremor, unsteady gait, and slurred speech; BP is 96/60 mm Hg. Which action should the nurse take?

   • A.Administer the scheduled lithium with food
   • B.Withhold lithium and arrange urgent medical evaluation with lithium and renal testing
   • C.Encourage sodium restriction until the gastrointestinal symptoms resolve
   • D.Reassure the client that tremor is an expected effect requiring no intervention

   Answer and rationale are in the full material.