1
ATI RN MENTAL HEALTH PROCTORED
EXAM WITH NGN
EXAM STRUCTURE
This practice exam is designed to mirror the ATI RN Mental Health Proctored
Exam incorporating Next Generation NCLEX (NGN) item types, including:
• Multiple Choice (MC)
• Select All That Apply (SATA)
• Bowtie Questions
• Matrix/Grid Questions
• Drag and Drop / Ordered Response
• Case Studies with Extended Multiple Response
Total Questions: 180 covering all major content areas in psychiatric-mental health
nursing.
SECTION 1: THERAPEUTIC COMMUNICATION & THE NURSE-PATIENT
RELATIONSHIP (Questions 1-20)
1. A nurse is caring for a client with major depressive disorder. The client says,
“There’s no point in going on.” Which of the following is the most therapeutic
response?
A) “You have so much to live for. Think about your family.”
B) “Why do you feel that way?”
C) “You are feeling hopeless right now. I am here with you.”
D) “Everyone feels sad sometimes. You’ll feel better soon.”
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✔✔ Correct Answer✔✔ C
Rationale: This response validates the client’s feelings and offers presence. It is a
therapeutic communication technique that uses restating and reflecting. Option A
is false reassurance; Option B is a “why” question that can put the client on the
defensive; Option D minimizes the client’s feelings.
2. A nurse is working with a client who has posttraumatic stress disorder (PTSD).
The client begins to describe a traumatic event in detail and becomes visibly
agitated. Which of the following actions should the nurse take first?
A) Ask the client to continue describing the event to process the trauma.
B) Redirect the client to a neutral topic.
C) Sit quietly and allow the client to express emotions.
D) Help the client use grounding techniques to return to the present moment.
✔✔ Correct Answer✔✔ D
Rationale: When a client becomes overwhelmed during trauma recall, the priority
is to help them re-establish a sense of safety and return to the present moment.
Grounding techniques (e.g., naming objects in the room, deep breathing) are
appropriate first steps before further processing.
3. A client with schizophrenia tells the nurse, “I hear voices telling me I am evil.”
Which of the following is the most therapeutic response?
A) “The voices are not real. Try to ignore them.”
B) “I don’t hear anything. Tell me what the voices are saying.”
C) “It must be frightening to hear those voices. Are they telling you to hurt
yourself or others?”
D) “If you ignore them, they will go away.”
✔✔ Correct Answer✔✔ C
Rationale: This response validates the client’s experience and assesses for
command hallucinations (voices that tell the person to harm self or others), which
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is a safety priority. Denying the voices (option A) is not therapeutic; option B may
be appropriate but does not assess safety; option D is dismissive.
4. A nurse is sitting with a client who is crying. The client says, “I just feel so
alone.” Which of the following responses uses the therapeutic technique of
“reflection”?
A) “You feel alone right now.”
B) “Why do you feel alone?”
C) “I understand. I get lonely too sometimes.”
D) “Would you like to talk about it?”
✔✔ Correct Answer✔✔ A
Rationale: Reflection involves repeating the client’s own words or paraphrasing to
encourage further expression. Option A reflects the client’s statement. Option B is
a nontherapeutic “why” question; Option C is self-disclosure; Option D is an
open-ended question but not reflection.
5. A nurse is assessing a client with generalized anxiety disorder. The client
paces the room and says, “I can’t sit still. My heart is racing.” Which of the
following is the best action?
A) Tell the client to sit down and relax.
B) Stay with the client and offer a quiet environment.
C) Ask the client to identify the cause of the anxiety.
D) Administer a PRN anxiolytic immediately.
✔✔ Correct Answer✔✔ B
Rationale: During acute anxiety, the nurse should remain with the client, provide
a calm environment, and use a calm, reassuring voice. Asking the client to identify
the cause or telling them to relax is not effective when anxiety is high. Medication
may be needed but is not the first intervention.
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6. A nurse is caring for a client who is very withdrawn and speaks in a flat tone.
Which technique should the nurse use to encourage communication?
A) Sit close to the client and use a loud voice.
B) Use open-ended questions and allow silence.
C) Confront the client about lack of participation.
D) Ask “yes or no” questions to obtain simple answers.
✔✔ Correct Answer✔✔ B
Rationale: Open-ended questions and allowing silence give the client time to
respond without pressure. Yes-no questions may be used initially but do not
encourage elaboration. Confrontation is not therapeutic.
7. A client tells the nurse, “My wife is having an affair with my brother.” The
nurse has no evidence of this. Which of the following is the best response?
A) “That must be very upsetting for you.”
B) “Are you sure you’re not imagining that?”
C) “Tell me more about why you think that.”
D) “I find that hard to believe.”
✔✔ Correct Answer✔✔ A
Rationale: This response validates the client’s feelings without agreeing or
disagreeing with the content. It is a therapeutic technique that focuses on the
emotional impact. Arguing or questioning the client’s reality is nontherapeutic.
8. A nurse is providing education to a client who is about to be discharged.
Which of the following statements demonstrates the nurse’s use of the
teach-back method?
A) “Do you understand what I told you?”
B) “Tell me in your own words how you will take your medication.”
C) “I will give you a pamphlet with all the information.”
D) “You should be fine; call if you have questions.”
ATI RN MENTAL HEALTH PROCTORED
EXAM WITH NGN
EXAM STRUCTURE
This practice exam is designed to mirror the ATI RN Mental Health Proctored
Exam incorporating Next Generation NCLEX (NGN) item types, including:
• Multiple Choice (MC)
• Select All That Apply (SATA)
• Bowtie Questions
• Matrix/Grid Questions
• Drag and Drop / Ordered Response
• Case Studies with Extended Multiple Response
Total Questions: 180 covering all major content areas in psychiatric-mental health
nursing.
SECTION 1: THERAPEUTIC COMMUNICATION & THE NURSE-PATIENT
RELATIONSHIP (Questions 1-20)
1. A nurse is caring for a client with major depressive disorder. The client says,
“There’s no point in going on.” Which of the following is the most therapeutic
response?
A) “You have so much to live for. Think about your family.”
B) “Why do you feel that way?”
C) “You are feeling hopeless right now. I am here with you.”
D) “Everyone feels sad sometimes. You’ll feel better soon.”
,2
✔✔ Correct Answer✔✔ C
Rationale: This response validates the client’s feelings and offers presence. It is a
therapeutic communication technique that uses restating and reflecting. Option A
is false reassurance; Option B is a “why” question that can put the client on the
defensive; Option D minimizes the client’s feelings.
2. A nurse is working with a client who has posttraumatic stress disorder (PTSD).
The client begins to describe a traumatic event in detail and becomes visibly
agitated. Which of the following actions should the nurse take first?
A) Ask the client to continue describing the event to process the trauma.
B) Redirect the client to a neutral topic.
C) Sit quietly and allow the client to express emotions.
D) Help the client use grounding techniques to return to the present moment.
✔✔ Correct Answer✔✔ D
Rationale: When a client becomes overwhelmed during trauma recall, the priority
is to help them re-establish a sense of safety and return to the present moment.
Grounding techniques (e.g., naming objects in the room, deep breathing) are
appropriate first steps before further processing.
3. A client with schizophrenia tells the nurse, “I hear voices telling me I am evil.”
Which of the following is the most therapeutic response?
A) “The voices are not real. Try to ignore them.”
B) “I don’t hear anything. Tell me what the voices are saying.”
C) “It must be frightening to hear those voices. Are they telling you to hurt
yourself or others?”
D) “If you ignore them, they will go away.”
✔✔ Correct Answer✔✔ C
Rationale: This response validates the client’s experience and assesses for
command hallucinations (voices that tell the person to harm self or others), which
,3
is a safety priority. Denying the voices (option A) is not therapeutic; option B may
be appropriate but does not assess safety; option D is dismissive.
4. A nurse is sitting with a client who is crying. The client says, “I just feel so
alone.” Which of the following responses uses the therapeutic technique of
“reflection”?
A) “You feel alone right now.”
B) “Why do you feel alone?”
C) “I understand. I get lonely too sometimes.”
D) “Would you like to talk about it?”
✔✔ Correct Answer✔✔ A
Rationale: Reflection involves repeating the client’s own words or paraphrasing to
encourage further expression. Option A reflects the client’s statement. Option B is
a nontherapeutic “why” question; Option C is self-disclosure; Option D is an
open-ended question but not reflection.
5. A nurse is assessing a client with generalized anxiety disorder. The client
paces the room and says, “I can’t sit still. My heart is racing.” Which of the
following is the best action?
A) Tell the client to sit down and relax.
B) Stay with the client and offer a quiet environment.
C) Ask the client to identify the cause of the anxiety.
D) Administer a PRN anxiolytic immediately.
✔✔ Correct Answer✔✔ B
Rationale: During acute anxiety, the nurse should remain with the client, provide
a calm environment, and use a calm, reassuring voice. Asking the client to identify
the cause or telling them to relax is not effective when anxiety is high. Medication
may be needed but is not the first intervention.
, 4
6. A nurse is caring for a client who is very withdrawn and speaks in a flat tone.
Which technique should the nurse use to encourage communication?
A) Sit close to the client and use a loud voice.
B) Use open-ended questions and allow silence.
C) Confront the client about lack of participation.
D) Ask “yes or no” questions to obtain simple answers.
✔✔ Correct Answer✔✔ B
Rationale: Open-ended questions and allowing silence give the client time to
respond without pressure. Yes-no questions may be used initially but do not
encourage elaboration. Confrontation is not therapeutic.
7. A client tells the nurse, “My wife is having an affair with my brother.” The
nurse has no evidence of this. Which of the following is the best response?
A) “That must be very upsetting for you.”
B) “Are you sure you’re not imagining that?”
C) “Tell me more about why you think that.”
D) “I find that hard to believe.”
✔✔ Correct Answer✔✔ A
Rationale: This response validates the client’s feelings without agreeing or
disagreeing with the content. It is a therapeutic technique that focuses on the
emotional impact. Arguing or questioning the client’s reality is nontherapeutic.
8. A nurse is providing education to a client who is about to be discharged.
Which of the following statements demonstrates the nurse’s use of the
teach-back method?
A) “Do you understand what I told you?”
B) “Tell me in your own words how you will take your medication.”
C) “I will give you a pamphlet with all the information.”
D) “You should be fine; call if you have questions.”
