ATI RN Mental Health 2023/2026
NGN: Practice Questions with
Answers & Rationales
Q1. A nurse is establishing a therapeutic relationship with a client
newly admitted to the inpatient psychiatric unit. During the
orientation phase, which action is the nurse's priority?
A) Explore the client's deep-seated emotional conflicts
B) Establish rapport, define the purpose and duration of the relationship,
and set boundaries regarding confidentiality
C) Encourage the client to express all negative feelings immediately
D) Plan for termination of the relationship
Answer: B) Establish rapport, define the purpose and duration of the
relationship, and set boundaries regarding confidentiality
Rationale: The orientation phase is foundational. Key tasks include building
trust, defining the relationship's purpose, setting boundaries, and clarifying
confidentiality limits. Deep exploration occurs during the working phase.
Q2. A nurse is using therapeutic communication with a client
experiencing a crisis. Which technique demonstrates active listening?
,A) Offering advice about how to solve the client's problems
B) Using open-ended questions, paraphrasing, and reflecting the client's
feelings
C) Changing the subject when the client becomes emotional
D) Providing false reassurance that everything will be fine
Answer: B) Using open-ended questions, paraphrasing, and reflecting
the client's feelings
Rationale: Active listening involves techniques that encourage the client to
express feelings and thoughts. Open-ended questions, paraphrasing, and
reflection facilitate communication. Offering advice, changing the subject,
and false reassurance are nontherapeutic.
Q3. A client tells the nurse, "I am a spy, a spy for the FBI. I am an I, an
eye for an eye in the sky. Sky is up high." The nurse should document
this as which speech alteration?
A) Echolalia
B) Word salad
C) Neologism
D) Clang association
Answer: D) Clang association
Rationale: Clang association is a speech pattern in which words are chosen
based on sound rather than meaning, often involving rhyming or punning.
Echolalia is repeating others' words; word salad is incoherent mixing of
words; neologism is making up new words.
,Q4. A client with bipolar disorder tells the nurse, "I'm the most
important person in this hospital. You should all bow when I walk by."
Which therapeutic response is most appropriate?
A) "That kind of thinking will not help you get better."
B) "You seem to be feeling very important today."
C) "Why do you think you are more important than others?"
D) "Let's talk about something else."
Answer: B) "You seem to be feeling very important today."
Rationale: This response uses reflection and validation without challenging
the delusion of grandeur. It acknowledges the client's feeling while
remaining neutral. "Why" questions are judgmental; confrontation is
nontherapeutic; dismissing the concern avoids addressing the client's
experience.
Q5. A nurse is using a communication technique that restates the
client's message in the nurse's own words. Which technique is this?
A) Clarification
B) Reflection
C) Restating
D) Paraphrasing
Answer: D) Paraphrasing
, Rationale: Paraphrasing involves rewording the client's message to confirm
understanding. Restating repeats exact words; reflection focuses on
feelings; clarification asks for more detail.
Q6. A nurse hears a newly licensed nurse discussing a client's
hallucinations in the hallway with another nurse. Which action should
the nurse take first?
A) Notify the nurse manager
B) Tell the nurse to stop discussing the behavior
C) Provide an in-service program about confidentiality
D) Complete an incident report
Answer: B) Tell the nurse to stop discussing the behavior
Rationale: The immediate action is to stop the breach of confidentiality.
Notification and education follow as secondary actions.
Q7. A client is upset about a new diagnosis. Which response is most
therapeutic?
A) "I think your son is getting better. What have you noticed?"
B) "I'm sure everything will be okay. It just takes time to heal."
C) "I'm not sure what's wrong. Have you asked the doctor?"
D) "I understand you're concerned. Let's discuss what concerns you
specifically."
NGN: Practice Questions with
Answers & Rationales
Q1. A nurse is establishing a therapeutic relationship with a client
newly admitted to the inpatient psychiatric unit. During the
orientation phase, which action is the nurse's priority?
A) Explore the client's deep-seated emotional conflicts
B) Establish rapport, define the purpose and duration of the relationship,
and set boundaries regarding confidentiality
C) Encourage the client to express all negative feelings immediately
D) Plan for termination of the relationship
Answer: B) Establish rapport, define the purpose and duration of the
relationship, and set boundaries regarding confidentiality
Rationale: The orientation phase is foundational. Key tasks include building
trust, defining the relationship's purpose, setting boundaries, and clarifying
confidentiality limits. Deep exploration occurs during the working phase.
Q2. A nurse is using therapeutic communication with a client
experiencing a crisis. Which technique demonstrates active listening?
,A) Offering advice about how to solve the client's problems
B) Using open-ended questions, paraphrasing, and reflecting the client's
feelings
C) Changing the subject when the client becomes emotional
D) Providing false reassurance that everything will be fine
Answer: B) Using open-ended questions, paraphrasing, and reflecting
the client's feelings
Rationale: Active listening involves techniques that encourage the client to
express feelings and thoughts. Open-ended questions, paraphrasing, and
reflection facilitate communication. Offering advice, changing the subject,
and false reassurance are nontherapeutic.
Q3. A client tells the nurse, "I am a spy, a spy for the FBI. I am an I, an
eye for an eye in the sky. Sky is up high." The nurse should document
this as which speech alteration?
A) Echolalia
B) Word salad
C) Neologism
D) Clang association
Answer: D) Clang association
Rationale: Clang association is a speech pattern in which words are chosen
based on sound rather than meaning, often involving rhyming or punning.
Echolalia is repeating others' words; word salad is incoherent mixing of
words; neologism is making up new words.
,Q4. A client with bipolar disorder tells the nurse, "I'm the most
important person in this hospital. You should all bow when I walk by."
Which therapeutic response is most appropriate?
A) "That kind of thinking will not help you get better."
B) "You seem to be feeling very important today."
C) "Why do you think you are more important than others?"
D) "Let's talk about something else."
Answer: B) "You seem to be feeling very important today."
Rationale: This response uses reflection and validation without challenging
the delusion of grandeur. It acknowledges the client's feeling while
remaining neutral. "Why" questions are judgmental; confrontation is
nontherapeutic; dismissing the concern avoids addressing the client's
experience.
Q5. A nurse is using a communication technique that restates the
client's message in the nurse's own words. Which technique is this?
A) Clarification
B) Reflection
C) Restating
D) Paraphrasing
Answer: D) Paraphrasing
, Rationale: Paraphrasing involves rewording the client's message to confirm
understanding. Restating repeats exact words; reflection focuses on
feelings; clarification asks for more detail.
Q6. A nurse hears a newly licensed nurse discussing a client's
hallucinations in the hallway with another nurse. Which action should
the nurse take first?
A) Notify the nurse manager
B) Tell the nurse to stop discussing the behavior
C) Provide an in-service program about confidentiality
D) Complete an incident report
Answer: B) Tell the nurse to stop discussing the behavior
Rationale: The immediate action is to stop the breach of confidentiality.
Notification and education follow as secondary actions.
Q7. A client is upset about a new diagnosis. Which response is most
therapeutic?
A) "I think your son is getting better. What have you noticed?"
B) "I'm sure everything will be okay. It just takes time to heal."
C) "I'm not sure what's wrong. Have you asked the doctor?"
D) "I understand you're concerned. Let's discuss what concerns you
specifically."
