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ATI RN Mental Health 2027 Updated – Complete
Practice Questions & Answers
QUESTION 1
The nurse receives handoff report on 4 clients. Which client should the nurse see FIRST?
A. A client with schizophrenia who is hearing voices telling them to "hurt the nurse"
B. A client with major depression who states "I have a plan but not the means"
C. A client with bipolar mania who hasn't slept for 72 hours
D. A client with borderline PD who made superficial cuts on both forearms 2 hours ago
Correct Answer: A
Rationale: Command hallucinations to harm others represent an immediate danger to
others and require priority intervention. While B (plan, high risk), C (exhaustion/psychosis
risk), and D (superficial, not current bleeding → stable) are concerning, A poses the most
immediate safety threat to staff and others.
QUESTION 2
Which clinical findings indicate IMMINENT suicide risk? (Select all that apply)
A. Giving away prized possessions
B. Sudden calmness after severe depression
C. Writing a suicide note
D. Asking to donate organs
E. Saying "I just want the pain to stop"
Correct Answer: A, B, C, D, E
Rationale: All of the above are red flags. A, C, D = concrete planning. B = energy to act
(paradoxical improvement). E = suicidal ideation with distress. When a severely depressed
patient suddenly becomes calm and begins giving away possessions, they may have made
the decision to complete suicide and now have the energy to act.
Sure pass
,2
QUESTION 3
Which clients meet criteria for involuntary psychiatric hold (danger to self/others/gravely
disabled)? (Select all that apply)
A. Homeless with schizophrenia, refuses shelter, eating from trash cans in winter
B. PTSD client with a knife, threatening to kill ex-partner
C. Bipolar client who stopped lithium, now spending $10,000 daily
D. Anorexia nervosa, BMI 14, refuses treatment, says "I feel fine"
E. Social anxiety disorder who refuses to attend group therapy
Correct Answer: A, B, C, D
Rationale: A (gravely disabled), B (danger to others), C (grossly impaired judgment), D
(medical danger). E does not meet hold criteria. Involuntary commitment requires clear
evidence of danger to self, danger to others, or grave disability (inability to provide for
basic needs).
QUESTION 4
A client with alcohol withdrawal has a CIWA-Ar score of 28. Which interventions are
required? (Select all that apply)
A. Frequent vital signs (q15-30 min)
B. Seizure precautions
C. PRN lorazepam administration
D. One-to-one observation
E. Encourage oral fluids
Correct Answer: A, B, C, D, E
Rationale: CIWA-Ar > 20 indicates severe withdrawal requiring aggressive management:
frequent monitoring, seizure precautions, benzodiazepines, close observation, and
hydration support. CIWA-Ar stands for Clinical Institute Withdrawal Assessment for
Alcohol. Severe withdrawal can progress to delirium tremens, which is life-threatening.
Sure pass
,3
QUESTION 5
Which clients are at highest risk for serotonin syndrome? (Select all that apply)
A. Taking fluoxetine + tramadol
B. Taking duloxetine + St. John's wort
C. Taking venlafaxine + linezolid
D. Taking sertraline + acetaminophen
E. Taking citalopram + donepezil
Correct Answer: A, B, C
Rationale: A, B, C → serotonergic combinations. D/E minimal interaction. Serotonin
syndrome is a life-threatening condition caused by excessive serotonergic activity in the
CNS. Symptoms include agitation, confusion, diaphoresis, tremors, hyperthermia, and
autonomic instability.
QUESTION 6
Which findings indicate neuroleptic malignant syndrome (NMS)? (Select all that apply)
A. Muscle rigidity
B. Hyperthermia
C. Autonomic instability (BP fluctuations, tachycardia)
D. Drooling and tongue protrusion
E. Altered mental status
Correct Answer: A, B, C, E
Rationale: A, B, C, E = diagnostic criteria for NMS. D = acute dystonia, not NMS. NMS is a
life-threatening complication of antipsychotic medications characterized by "lead pipe"
rigidity, hyperthermia, autonomic dysfunction, and altered consciousness. Treatment
includes stopping the antipsychotic, supportive care, and possibly dantrolene or
bromocriptine.
QUESTION 7
A client on clozapine reports sore throat and fever. Which lab abnormalities require
holding the next dose? (Select all that apply)
Sure pass
, 4
A. WBC 2,100/μL
B. Absolute neutrophil count 400/μL
C. Hemoglobin 12 g/dL
D. Platelets 150,000/μL
E. Neutrophils 30% with normal WBC
Correct Answer: A, B
Rationale: A (WBC < 3000), B (ANC < 500) = severe neutropenia. C/D normal. E not
severe alone. Clozapine carries a black box warning for agranulocytosis (severe
neutropenia). Patients must have regular WBC and ANC monitoring. Fever and sore throat
may be the first signs of infection from neutropenia.
QUESTION 8
Which PRN medications are appropriate for acute agitation in a 70-kg adult? (Select all
that apply)
A. Lorazepam 2 mg IM
B. Haloperidol 5 mg IM
C. Diphenhydramine 50 mg IM
D. Olanzapine 10 mg orally disintegrating tablet
E. Quetiapine 300 mg PO
Correct Answer: A, B, D
Rationale: A+B (classic combo) or D alone appropriate. C treats dystonia, not agitation. E
too slow. The B52 protocol (haloperidol 5 mg + lorazepam 2 mg + diphenhydramine 50
mg) is commonly used for acute agitation. Olanzapine ODT is a rapid-acting atypical
antipsychotic suitable for agitation.
QUESTION 9
Which clinical findings indicate imminent medical emergency? (Select all that apply)
A. Depressed client with glucose 52 mg/dL
B. Hallucinating client with O2 sat 88%
C. Depressed client with HR 38 bpm
Sure pass
ATI RN Mental Health 2027 Updated – Complete
Practice Questions & Answers
QUESTION 1
The nurse receives handoff report on 4 clients. Which client should the nurse see FIRST?
A. A client with schizophrenia who is hearing voices telling them to "hurt the nurse"
B. A client with major depression who states "I have a plan but not the means"
C. A client with bipolar mania who hasn't slept for 72 hours
D. A client with borderline PD who made superficial cuts on both forearms 2 hours ago
Correct Answer: A
Rationale: Command hallucinations to harm others represent an immediate danger to
others and require priority intervention. While B (plan, high risk), C (exhaustion/psychosis
risk), and D (superficial, not current bleeding → stable) are concerning, A poses the most
immediate safety threat to staff and others.
QUESTION 2
Which clinical findings indicate IMMINENT suicide risk? (Select all that apply)
A. Giving away prized possessions
B. Sudden calmness after severe depression
C. Writing a suicide note
D. Asking to donate organs
E. Saying "I just want the pain to stop"
Correct Answer: A, B, C, D, E
Rationale: All of the above are red flags. A, C, D = concrete planning. B = energy to act
(paradoxical improvement). E = suicidal ideation with distress. When a severely depressed
patient suddenly becomes calm and begins giving away possessions, they may have made
the decision to complete suicide and now have the energy to act.
Sure pass
,2
QUESTION 3
Which clients meet criteria for involuntary psychiatric hold (danger to self/others/gravely
disabled)? (Select all that apply)
A. Homeless with schizophrenia, refuses shelter, eating from trash cans in winter
B. PTSD client with a knife, threatening to kill ex-partner
C. Bipolar client who stopped lithium, now spending $10,000 daily
D. Anorexia nervosa, BMI 14, refuses treatment, says "I feel fine"
E. Social anxiety disorder who refuses to attend group therapy
Correct Answer: A, B, C, D
Rationale: A (gravely disabled), B (danger to others), C (grossly impaired judgment), D
(medical danger). E does not meet hold criteria. Involuntary commitment requires clear
evidence of danger to self, danger to others, or grave disability (inability to provide for
basic needs).
QUESTION 4
A client with alcohol withdrawal has a CIWA-Ar score of 28. Which interventions are
required? (Select all that apply)
A. Frequent vital signs (q15-30 min)
B. Seizure precautions
C. PRN lorazepam administration
D. One-to-one observation
E. Encourage oral fluids
Correct Answer: A, B, C, D, E
Rationale: CIWA-Ar > 20 indicates severe withdrawal requiring aggressive management:
frequent monitoring, seizure precautions, benzodiazepines, close observation, and
hydration support. CIWA-Ar stands for Clinical Institute Withdrawal Assessment for
Alcohol. Severe withdrawal can progress to delirium tremens, which is life-threatening.
Sure pass
,3
QUESTION 5
Which clients are at highest risk for serotonin syndrome? (Select all that apply)
A. Taking fluoxetine + tramadol
B. Taking duloxetine + St. John's wort
C. Taking venlafaxine + linezolid
D. Taking sertraline + acetaminophen
E. Taking citalopram + donepezil
Correct Answer: A, B, C
Rationale: A, B, C → serotonergic combinations. D/E minimal interaction. Serotonin
syndrome is a life-threatening condition caused by excessive serotonergic activity in the
CNS. Symptoms include agitation, confusion, diaphoresis, tremors, hyperthermia, and
autonomic instability.
QUESTION 6
Which findings indicate neuroleptic malignant syndrome (NMS)? (Select all that apply)
A. Muscle rigidity
B. Hyperthermia
C. Autonomic instability (BP fluctuations, tachycardia)
D. Drooling and tongue protrusion
E. Altered mental status
Correct Answer: A, B, C, E
Rationale: A, B, C, E = diagnostic criteria for NMS. D = acute dystonia, not NMS. NMS is a
life-threatening complication of antipsychotic medications characterized by "lead pipe"
rigidity, hyperthermia, autonomic dysfunction, and altered consciousness. Treatment
includes stopping the antipsychotic, supportive care, and possibly dantrolene or
bromocriptine.
QUESTION 7
A client on clozapine reports sore throat and fever. Which lab abnormalities require
holding the next dose? (Select all that apply)
Sure pass
, 4
A. WBC 2,100/μL
B. Absolute neutrophil count 400/μL
C. Hemoglobin 12 g/dL
D. Platelets 150,000/μL
E. Neutrophils 30% with normal WBC
Correct Answer: A, B
Rationale: A (WBC < 3000), B (ANC < 500) = severe neutropenia. C/D normal. E not
severe alone. Clozapine carries a black box warning for agranulocytosis (severe
neutropenia). Patients must have regular WBC and ANC monitoring. Fever and sore throat
may be the first signs of infection from neutropenia.
QUESTION 8
Which PRN medications are appropriate for acute agitation in a 70-kg adult? (Select all
that apply)
A. Lorazepam 2 mg IM
B. Haloperidol 5 mg IM
C. Diphenhydramine 50 mg IM
D. Olanzapine 10 mg orally disintegrating tablet
E. Quetiapine 300 mg PO
Correct Answer: A, B, D
Rationale: A+B (classic combo) or D alone appropriate. C treats dystonia, not agitation. E
too slow. The B52 protocol (haloperidol 5 mg + lorazepam 2 mg + diphenhydramine 50
mg) is commonly used for acute agitation. Olanzapine ODT is a rapid-acting atypical
antipsychotic suitable for agitation.
QUESTION 9
Which clinical findings indicate imminent medical emergency? (Select all that apply)
A. Depressed client with glucose 52 mg/dL
B. Hallucinating client with O2 sat 88%
C. Depressed client with HR 38 bpm
Sure pass
