ATI MENTAL HEALTH B
2026/2027 PROCTORED EXAM
Comprehensive Practice Examination
100 Questions | 12 Content Sections
Aligned with DSM-5-TR and Current Evidence-Based Practice
Format Multiple Choice (A-D)
Total Questions 100
Sections 12 (Foundations through Crisis Intervention)
Cognitive Levels 25% Recall | 55% Application | 20% Analysis
100 Questions | 12 Sections | Proctored Examination Format
,ATI Mental Health B 2026/2027 Proctored Exam Page 2
Section 1: Foundations of Psychiatric Nursing
Q1: A nurse is conducting the orientation phase of the nurse-client
relationship with a client who has major depressive disorder. The client says,
"I don't know why I'm here. Nobody cares about me anyway." Which response
by the nurse demonstrates therapeutic communication?
A. "Don't say that. Everyone here cares about you and wants to help you get better."
B. "Why do you feel like nobody cares about you?"
C. "You seem to be feeling like people around you don't care. Can you tell me
more about that?"
D. "I understand how you feel. I've felt that way before too."
Correct Answer: C
Rationale:
Option C uses reflection of feeling and an open-ended question, which are core therapeutic
communication techniques that encourage the client to explore emotions further. Option A
uses false reassurance, which dismisses the client's feelings and blocks further
communication. Option B uses a "why" question, which can feel interrogative and put the
client on the defensive. Option D uses a nontherapeutic technique of sharing personal
experiences, which redirects focus from the client to the nurse and is not appropriate
during the orientation phase of the relationship.
Q2: A nurse is caring for a client admitted to the psychiatric unit following a
suicide attempt. The client says, "Promise me you won't tell anyone what I
told you about my suicide plan." Which is the appropriate nursing response?
A. "I promise I won't tell anyone. Your secrets are safe with me."
B. "I can't make that promise. Your safety is my priority, and I may need to
share information with the treatment team to keep you safe."
C. "I won't tell anyone as long as you promise not to hurt yourself."
D. "Let me check with my supervisor first and get back to you."
Correct Answer: B
Rationale:
The nurse has a legal and ethical duty to warn and protect the client from self-harm. Option
B maintains the therapeutic relationship while being honest about the limits of
confidentiality, which is essential for building trust. Option A makes a promise the nurse
cannot ethically keep. Option C uses a conditional promise that undermines the treatment
relationship and could create liability. Option D delays the response and fails to address the
immediate concern directly, which is inappropriate in a crisis situation involving client
safety.
Q3: A client on the psychiatric unit tells the nurse, "The CIA is monitoring
my phone calls and tracking my movements." The nurse notes the client
appears anxious but is not in acute distress. Which nursing intervention is
the priority?
ATI MENTAL HEALTH B 2026/2027 PROCTORED EXAM
,ATI Mental Health B 2026/2027 Proctored Exam Page 3
A. Confront the client and explain that their beliefs are not real
B. Acknowledge the client's feelings without validating the delusion
C. Call the provider immediately to request an increase in antipsychotic medication
D. Redirect the conversation to a more reality-based topic immediately
Correct Answer: B
Rationale:
When a client expresses a delusional belief, the nurse should acknowledge the underlying
emotion (anxiety, fear) without reinforcing the delusional content. This approach builds
trust while maintaining a reality-based foundation for the therapeutic relationship. Option A
is confrontational and will damage the therapeutic alliance. Option C is premature without
a full assessment and provider collaboration. Option D uses avoidance, which can make the
client feel dismissed and escalate anxiety. ATI prioritization frameworks emphasize that the
nurse should address the client's emotional experience as a safety-first approach using
Maslow's hierarchy.
Q4: A nurse is preparing to obtain informed consent from a client scheduled
to receive electroconvulsive therapy (ECT). The client has been diagnosed
with major depressive disorder and has capacity to consent. Which action by
the nurse is most important?
A. Ensure the client understands the purpose, risks, benefits, and
alternatives of ECT
B. Obtain the signature on the consent form and place it in the chart
C. Ask the client's family to verify the client's understanding of the procedure
D. Provide written materials about ECT and allow 24 hours before obtaining consent
Correct Answer: A
Rationale:
Informed consent requires that the client receives and comprehends information about the
procedure's purpose, potential risks, expected benefits, and available alternatives. The
nurse's role is to verify understanding, not merely obtain a signature. Option B is a
mechanical step that does not address the substance of informed consent. Option C is
unnecessary because the client has decision-making capacity; involving family shifts
responsibility inappropriately. Option D describes a process step but does not identify the
most important nursing action, which is ensuring comprehension of all key elements of
informed consent.
Q5: A nurse is caring for a client from a Southeast Asian cultural background
who is exhibiting signs of depression. The client's family insists that the
client's symptoms are due to "imbalance of spiritual forces" and wants to use
traditional healing methods instead of prescribed medications. Which
response by the nurse is best?
A. "Your cultural beliefs are respected, but your family member needs to take the
prescribed medication to get better."
B. "I understand your beliefs are important. Let's discuss how we can
incorporate traditional healing alongside the treatment plan."
ATI MENTAL HEALTH B 2026/2027 PROCTORED EXAM
, ATI Mental Health B 2026/2027 Proctored Exam Page 4
C. "Those traditional methods won't work for this condition. We need to follow the
medical treatment plan."
D. "I will refer you to a different facility that can accommodate your cultural
preferences."
Correct Answer: B
Rationale:
Cultural competence in psychiatric nursing requires respecting the client's cultural beliefs
while ensuring safe and effective care. Option B demonstrates cultural humility and opens
dialogue for collaborative care planning that can integrate traditional practices with
evidence-based treatment. Option A pays lip service to cultural respect but ultimately
dismisses the family's wishes. Option C is culturally insensitive and rigid, which will
damage the therapeutic relationship and reduce treatment adherence. Option D abandons
the nurse's responsibility to provide culturally responsive care and inappropriately refers
the client elsewhere.
Q6: A psychiatric nurse is documenting client information in the electronic
health record. Which action violates HIPAA regulations?
A. Discussing a client's diagnosis with the treatment team during a closed-door
interdisciplinary meeting
B. Logging out of the electronic health record before leaving the nurses' station
C. Sharing a client's treatment plan with a family member who is not the
designated healthcare proxy
D. Using a secure messaging system to communicate lab results to the provider
Correct Answer: C
Rationale:
HIPAA prohibits disclosure of protected health information (PHI) to any person who is not
authorized to receive it. Only the client, the client's legal representative, or individuals the
client has designated may access PHI. Option A is appropriate because treatment team
discussions are covered under the treatment, payment, and healthcare operations
exception. Option B demonstrates proper HIPAA compliance with security measures.
Option D uses an approved secure communication method. Option C violates HIPAA
because the family member lacks authorization, and sharing information without consent is
a breach of confidentiality.
Q7: During a mental status examination, a nurse asks a client to interpret
the proverb "People who live in glass houses shouldn't throw stones." The
client responds, "It means you shouldn't throw rocks at windows because
they will break." Which cognitive finding does the nurse document?
A. Concrete thinking
B. Abstract thinking
C. Loose associations
D. Tangential thinking
Correct Answer: A
Rationale:
ATI MENTAL HEALTH B 2026/2027 PROCTORED EXAM
2026/2027 PROCTORED EXAM
Comprehensive Practice Examination
100 Questions | 12 Content Sections
Aligned with DSM-5-TR and Current Evidence-Based Practice
Format Multiple Choice (A-D)
Total Questions 100
Sections 12 (Foundations through Crisis Intervention)
Cognitive Levels 25% Recall | 55% Application | 20% Analysis
100 Questions | 12 Sections | Proctored Examination Format
,ATI Mental Health B 2026/2027 Proctored Exam Page 2
Section 1: Foundations of Psychiatric Nursing
Q1: A nurse is conducting the orientation phase of the nurse-client
relationship with a client who has major depressive disorder. The client says,
"I don't know why I'm here. Nobody cares about me anyway." Which response
by the nurse demonstrates therapeutic communication?
A. "Don't say that. Everyone here cares about you and wants to help you get better."
B. "Why do you feel like nobody cares about you?"
C. "You seem to be feeling like people around you don't care. Can you tell me
more about that?"
D. "I understand how you feel. I've felt that way before too."
Correct Answer: C
Rationale:
Option C uses reflection of feeling and an open-ended question, which are core therapeutic
communication techniques that encourage the client to explore emotions further. Option A
uses false reassurance, which dismisses the client's feelings and blocks further
communication. Option B uses a "why" question, which can feel interrogative and put the
client on the defensive. Option D uses a nontherapeutic technique of sharing personal
experiences, which redirects focus from the client to the nurse and is not appropriate
during the orientation phase of the relationship.
Q2: A nurse is caring for a client admitted to the psychiatric unit following a
suicide attempt. The client says, "Promise me you won't tell anyone what I
told you about my suicide plan." Which is the appropriate nursing response?
A. "I promise I won't tell anyone. Your secrets are safe with me."
B. "I can't make that promise. Your safety is my priority, and I may need to
share information with the treatment team to keep you safe."
C. "I won't tell anyone as long as you promise not to hurt yourself."
D. "Let me check with my supervisor first and get back to you."
Correct Answer: B
Rationale:
The nurse has a legal and ethical duty to warn and protect the client from self-harm. Option
B maintains the therapeutic relationship while being honest about the limits of
confidentiality, which is essential for building trust. Option A makes a promise the nurse
cannot ethically keep. Option C uses a conditional promise that undermines the treatment
relationship and could create liability. Option D delays the response and fails to address the
immediate concern directly, which is inappropriate in a crisis situation involving client
safety.
Q3: A client on the psychiatric unit tells the nurse, "The CIA is monitoring
my phone calls and tracking my movements." The nurse notes the client
appears anxious but is not in acute distress. Which nursing intervention is
the priority?
ATI MENTAL HEALTH B 2026/2027 PROCTORED EXAM
,ATI Mental Health B 2026/2027 Proctored Exam Page 3
A. Confront the client and explain that their beliefs are not real
B. Acknowledge the client's feelings without validating the delusion
C. Call the provider immediately to request an increase in antipsychotic medication
D. Redirect the conversation to a more reality-based topic immediately
Correct Answer: B
Rationale:
When a client expresses a delusional belief, the nurse should acknowledge the underlying
emotion (anxiety, fear) without reinforcing the delusional content. This approach builds
trust while maintaining a reality-based foundation for the therapeutic relationship. Option A
is confrontational and will damage the therapeutic alliance. Option C is premature without
a full assessment and provider collaboration. Option D uses avoidance, which can make the
client feel dismissed and escalate anxiety. ATI prioritization frameworks emphasize that the
nurse should address the client's emotional experience as a safety-first approach using
Maslow's hierarchy.
Q4: A nurse is preparing to obtain informed consent from a client scheduled
to receive electroconvulsive therapy (ECT). The client has been diagnosed
with major depressive disorder and has capacity to consent. Which action by
the nurse is most important?
A. Ensure the client understands the purpose, risks, benefits, and
alternatives of ECT
B. Obtain the signature on the consent form and place it in the chart
C. Ask the client's family to verify the client's understanding of the procedure
D. Provide written materials about ECT and allow 24 hours before obtaining consent
Correct Answer: A
Rationale:
Informed consent requires that the client receives and comprehends information about the
procedure's purpose, potential risks, expected benefits, and available alternatives. The
nurse's role is to verify understanding, not merely obtain a signature. Option B is a
mechanical step that does not address the substance of informed consent. Option C is
unnecessary because the client has decision-making capacity; involving family shifts
responsibility inappropriately. Option D describes a process step but does not identify the
most important nursing action, which is ensuring comprehension of all key elements of
informed consent.
Q5: A nurse is caring for a client from a Southeast Asian cultural background
who is exhibiting signs of depression. The client's family insists that the
client's symptoms are due to "imbalance of spiritual forces" and wants to use
traditional healing methods instead of prescribed medications. Which
response by the nurse is best?
A. "Your cultural beliefs are respected, but your family member needs to take the
prescribed medication to get better."
B. "I understand your beliefs are important. Let's discuss how we can
incorporate traditional healing alongside the treatment plan."
ATI MENTAL HEALTH B 2026/2027 PROCTORED EXAM
, ATI Mental Health B 2026/2027 Proctored Exam Page 4
C. "Those traditional methods won't work for this condition. We need to follow the
medical treatment plan."
D. "I will refer you to a different facility that can accommodate your cultural
preferences."
Correct Answer: B
Rationale:
Cultural competence in psychiatric nursing requires respecting the client's cultural beliefs
while ensuring safe and effective care. Option B demonstrates cultural humility and opens
dialogue for collaborative care planning that can integrate traditional practices with
evidence-based treatment. Option A pays lip service to cultural respect but ultimately
dismisses the family's wishes. Option C is culturally insensitive and rigid, which will
damage the therapeutic relationship and reduce treatment adherence. Option D abandons
the nurse's responsibility to provide culturally responsive care and inappropriately refers
the client elsewhere.
Q6: A psychiatric nurse is documenting client information in the electronic
health record. Which action violates HIPAA regulations?
A. Discussing a client's diagnosis with the treatment team during a closed-door
interdisciplinary meeting
B. Logging out of the electronic health record before leaving the nurses' station
C. Sharing a client's treatment plan with a family member who is not the
designated healthcare proxy
D. Using a secure messaging system to communicate lab results to the provider
Correct Answer: C
Rationale:
HIPAA prohibits disclosure of protected health information (PHI) to any person who is not
authorized to receive it. Only the client, the client's legal representative, or individuals the
client has designated may access PHI. Option A is appropriate because treatment team
discussions are covered under the treatment, payment, and healthcare operations
exception. Option B demonstrates proper HIPAA compliance with security measures.
Option D uses an approved secure communication method. Option C violates HIPAA
because the family member lacks authorization, and sharing information without consent is
a breach of confidentiality.
Q7: During a mental status examination, a nurse asks a client to interpret
the proverb "People who live in glass houses shouldn't throw stones." The
client responds, "It means you shouldn't throw rocks at windows because
they will break." Which cognitive finding does the nurse document?
A. Concrete thinking
B. Abstract thinking
C. Loose associations
D. Tangential thinking
Correct Answer: A
Rationale:
ATI MENTAL HEALTH B 2026/2027 PROCTORED EXAM
