Prof. Star (2026/2027)
Psychiatric-Mental Health Nursing (ATI Focus) | Key Domains: Therapeutic Communication &
Relationships, Major Psychiatric Disorders, Psychopharmacology, Crisis Intervention & Suicide,
Legal & Ethical Issues, and Milieu Management | Expert-Aligned Structure | ATI Practice Format
Introduction
This structured ATI Mental Health Practice set for 2026/2027 provides a comprehensive set of
exam-style questions with correct answers and rationales. It is designed to simulate the ATI Mental
Health proctored exam, emphasizing the application of nursing knowledge to psychiatric scenarios,
therapeutic communication, medication management, and safe, ethical practice.
Practice Structure:
• Comprehensive ATI Practice Bank: (80 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the therapeutic communication technique, the mechanism of action or key side effect of a
psychotropic medication, the priority nursing intervention for a psychiatric crisis, the legal or
ethical standard, and why alternative options are non-therapeutic, unsafe, or violate ATI exam
standards of care.
1. A client diagnosed with schizophrenia tells the nurse, “The FBI has implanted a chip in my brain
to control my thoughts.” Which response by the nurse is most therapeutic?
A. “That’s not possible. The FBI doesn’t do things like that.”
B. “I understand you feel frightened by this. Can you tell me more about what you’re
experiencing?”
C. “Let’s focus on something more realistic right now.”
D. “You should talk to your psychiatrist about stopping your medication.”
B. “I understand you feel frightened by this. Can you tell me more about what you’re
experiencing?”
, This response uses empathy and open-ended inquiry, validating the client’s feelings without
reinforcing delusional content. Option A denies the client’s reality and may damage trust. Option C
dismisses the client’s concern. Option D is inappropriate and potentially dangerous advice.
2. A nurse is caring for a client who has been prescribed clozapine. Which laboratory value should
the nurse monitor weekly?
A. Liver enzymes
B. Serum sodium
C. Absolute neutrophil count (ANC)
D. Blood glucose
C. Absolute neutrophil count (ANC)
Clozapine carries a risk of agranulocytosis, a life-threatening drop in white blood cells. Weekly
monitoring of ANC is required, especially during the first 6 months of therapy. Liver enzymes (A)
are monitored with some antipsychotics but not as critically as ANC with clozapine. Sodium (B) and
glucose (D) are relevant for other medications (e.g., lithium, second-generation antipsychotics) but
not the priority for clozapine.
3. During a mental health assessment, a client states, “I just want it all to end.” What is the nurse’s
priority action?
A. Ask the client if they have a plan to harm themselves.
B. Reassure the client that things will get better.
C. Notify the charge nurse immediately.
D. Document the statement and continue the assessment.
A. Ask the client if they have a plan to harm themselves.
Assessing for suicidal ideation, intent, and plan is the immediate priority when a client expresses
hopelessness or passive suicidal thoughts. This guides risk level and interventions. Reassurance (B)
is non-therapeutic and minimizes distress. Notification (C) may be needed later but assessment
comes first. Documentation (D) without action is unsafe.
,4. Which behavior by a nurse demonstrates adherence to ethical principles when caring for a client
who refuses antipsychotic medication?
A. Administering the medication covertly in food
B. Respecting the client’s right to refuse and documenting the refusal
C. Telling the client they will be secluded if they don’t comply
D. Calling the provider to request an involuntary hold
B. Respecting the client’s right to refuse and documenting the refusal
Competent clients have the legal and ethical right to refuse treatment. Covert administration (A)
violates autonomy and informed consent. Threats (C) are coercive and unethical. Involuntary holds
(D) require specific legal criteria (e.g., danger to self/others), not mere noncompliance.
5. A client with bipolar disorder in the manic phase is pacing rapidly, speaking loudly, and
interrupting others. What is the most appropriate milieu intervention?
A. Place the client in seclusion immediately
B. Offer a quiet space and simple, one-step directions
C. Engage the client in a group discussion to redirect energy
D. Ignore the behavior to avoid reinforcement
B. Offer a quiet space and simple, one-step directions
Clients in mania are overstimulated; reducing environmental stimuli and using clear, concise
communication helps decrease agitation. Seclusion (A) is a last resort for imminent danger. Group
activities (C) may increase stimulation. Ignoring (D) neglects safety and de-escalation needs.
6. A client with major depressive disorder says, “Nothing matters anymore.” The nurse recognizes
this as a sign of:
A. Anhedonia
, B. Hopelessness
C. Guilt
D. Psychomotor retardation
B. Hopelessness
Hopelessness is a core symptom of depression and a significant risk factor for suicide. Anhedonia
(A) is loss of pleasure. Guilt (C) involves excessive self-blame. Psychomotor retardation (D) refers to
slowed movement and speech.
7. Which medication requires regular monitoring of thyroid function?
A. Fluoxetine
B. Lithium
C. Risperidone
D. Lorazepam
B. Lithium
Lithium can cause hypothyroidism; therefore, thyroid-stimulating hormone (TSH) levels should be
monitored periodically. Fluoxetine (A) is an SSRI with no direct thyroid effect. Risperidone (C) may
affect prolactin but not thyroid. Lorazepam (D) is a benzodiazepine unrelated to thyroid function.
8. A nurse is leading a group therapy session. A client begins to cry while discussing childhood
trauma. What is the most therapeutic response?
A. “It’s okay—everyone here has been through something.”
B. “Would you like to take a break and step outside?”
C. “I see this is very painful for you. Would you like to continue or pause?”
D. “Try to focus on how strong you’ve become since then.”