ATI RN MENTAL HEALTH PROCTORED
EXAM 2026/2027 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
Questions 1-50: Foundations of Mental Health Nursing & Therapeutic
Communication
1. A nurse is planning care for a client who has a new diagnosis of major
depressive disorder. Which of the following actions should the nurse take
first?
A. Teach the client about antidepressant medications.
B. Encourage the client to participate in group therapy.
C. Perform a suicide risk assessment.
D. Refer the client to a support group.
Correct Answer: C
Rationale: The nurse's priority is client safety. A suicide risk assessment is the
most critical initial action when caring for a client with depression, as it
directly addresses the potential for self-harm.
2. A client tells the nurse, "I don't think I can go on anymore. Everyone would
be better off without me." Which of the following is the nurse's priority
response?
A. "You have so much to live for."
B. "Are you thinking of killing yourself?"
C. "I understand how you feel."
,D. "Let's talk about what is making you feel this way."
Correct Answer: B
Rationale: This is a direct, non-judgmental question that assesses for suicidal
ideation. It is the most therapeutic and essential question to ask when a client
makes a statement indicating hopelessness.
3. A nurse is using therapeutic communication with a client who is angry.
Which of the following statements is most appropriate?
A. "Why are you so angry right now?"
B. "You seem upset. Tell me more about what is bothering you."
C. "Calm down. Getting angry won't help."
D. "I think you are overreacting to the situation."
Correct Answer: B
Rationale: This statement uses the therapeutic technique of *offering general
leads* and *exploring*. It validates the client's feelings and encourages them
to express themselves without judgment.
4. A client diagnosed with schizophrenia tells the nurse, "The FBI is tapping
my phone because I know the secrets of the universe." Which of the following
is an appropriate therapeutic response?
A. "That sounds frightening. Tell me more about what you are experiencing."
B. "I know the FBI isn't tapping your phone. That is a delusion."
C. "Why would the FBI be interested in you?"
D. "Let's focus on something else."
Correct Answer: A
Rationale: This response validates the client's feelings (fear) without
confirming the delusion. It encourages the client to share their experience,
which builds rapport and provides the nurse with more assessment data.
,5. A nurse is caring for a client who is withdrawn and avoids eye contact.
Which of the following actions should the nurse take to promote
communication?
A. Sit close to the client and maintain constant eye contact.
B. Sit quietly with the client and allow them to initiate conversation.
C. Ask the client direct questions to encourage participation.
D. Tell the client that their behavior is unacceptable.
Correct Answer: B
Rationale: Sitting quietly with the client ( *being with* ) conveys acceptance
and reduces pressure. Allowing the client to initiate conversation when ready
respects their need for control and personal space.
6. A charge nurse is discussing mental status exams with a newly licensed
nurse. Which of the following components should the charge nurse include as
a part of the mental status exam?
A. Vital signs
B. Appearance and behavior
C. Medical history
D. Family history
Correct Answer: B
Rationale: The mental status exam (MSE) includes appearance, behavior,
speech, mood, affect, thought process, thought content, perceptual
disturbances, cognition, and insight/judgment.
7. A client says, "I feel like I'm losing my mind." Which of the following
responses by the nurse demonstrates the therapeutic technique of reflection?
A. "You feel like you're losing your mind?"
, B. "Many people feel that way sometimes."
C. "What makes you say that?"
D. "You are not losing your mind."
Correct Answer: A
Rationale: Reflection involves repeating the client's words back to them to
encourage them to elaborate. It shows the nurse is listening and helps the
client clarify their thoughts.
8. A nurse is caring for a client who is experiencing a panic attack. Which of
the following actions should the nurse take first?
A. Place the client in a seclusion room.
B. Administer a PRN antianxiety medication.
C. Stay with the client and speak in a calm, quiet voice.
D. Encourage the client to perform deep-breathing exercises.
Correct Answer: C
Rationale: The priority is to provide a calm, safe presence. Staying with the
client reduces anxiety and prevents feelings of abandonment. A calm voice
helps de-escalate the situation.
9. A client who is a recent immigrant is admitted to the psychiatric unit. The
client is hesitant to make eye contact with the nurse. Which of the following
actions should the nurse take?
A. Ask the client why they won't make eye contact.
B. Respect the client's cultural norms and avoid forcing eye contact.
C. Tell the client that making eye contact is a sign of respect in this country.
D. Document that the client is non-compliant with treatment.
Correct Answer: B
EXAM 2026/2027 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
Questions 1-50: Foundations of Mental Health Nursing & Therapeutic
Communication
1. A nurse is planning care for a client who has a new diagnosis of major
depressive disorder. Which of the following actions should the nurse take
first?
A. Teach the client about antidepressant medications.
B. Encourage the client to participate in group therapy.
C. Perform a suicide risk assessment.
D. Refer the client to a support group.
Correct Answer: C
Rationale: The nurse's priority is client safety. A suicide risk assessment is the
most critical initial action when caring for a client with depression, as it
directly addresses the potential for self-harm.
2. A client tells the nurse, "I don't think I can go on anymore. Everyone would
be better off without me." Which of the following is the nurse's priority
response?
A. "You have so much to live for."
B. "Are you thinking of killing yourself?"
C. "I understand how you feel."
,D. "Let's talk about what is making you feel this way."
Correct Answer: B
Rationale: This is a direct, non-judgmental question that assesses for suicidal
ideation. It is the most therapeutic and essential question to ask when a client
makes a statement indicating hopelessness.
3. A nurse is using therapeutic communication with a client who is angry.
Which of the following statements is most appropriate?
A. "Why are you so angry right now?"
B. "You seem upset. Tell me more about what is bothering you."
C. "Calm down. Getting angry won't help."
D. "I think you are overreacting to the situation."
Correct Answer: B
Rationale: This statement uses the therapeutic technique of *offering general
leads* and *exploring*. It validates the client's feelings and encourages them
to express themselves without judgment.
4. A client diagnosed with schizophrenia tells the nurse, "The FBI is tapping
my phone because I know the secrets of the universe." Which of the following
is an appropriate therapeutic response?
A. "That sounds frightening. Tell me more about what you are experiencing."
B. "I know the FBI isn't tapping your phone. That is a delusion."
C. "Why would the FBI be interested in you?"
D. "Let's focus on something else."
Correct Answer: A
Rationale: This response validates the client's feelings (fear) without
confirming the delusion. It encourages the client to share their experience,
which builds rapport and provides the nurse with more assessment data.
,5. A nurse is caring for a client who is withdrawn and avoids eye contact.
Which of the following actions should the nurse take to promote
communication?
A. Sit close to the client and maintain constant eye contact.
B. Sit quietly with the client and allow them to initiate conversation.
C. Ask the client direct questions to encourage participation.
D. Tell the client that their behavior is unacceptable.
Correct Answer: B
Rationale: Sitting quietly with the client ( *being with* ) conveys acceptance
and reduces pressure. Allowing the client to initiate conversation when ready
respects their need for control and personal space.
6. A charge nurse is discussing mental status exams with a newly licensed
nurse. Which of the following components should the charge nurse include as
a part of the mental status exam?
A. Vital signs
B. Appearance and behavior
C. Medical history
D. Family history
Correct Answer: B
Rationale: The mental status exam (MSE) includes appearance, behavior,
speech, mood, affect, thought process, thought content, perceptual
disturbances, cognition, and insight/judgment.
7. A client says, "I feel like I'm losing my mind." Which of the following
responses by the nurse demonstrates the therapeutic technique of reflection?
A. "You feel like you're losing your mind?"
, B. "Many people feel that way sometimes."
C. "What makes you say that?"
D. "You are not losing your mind."
Correct Answer: A
Rationale: Reflection involves repeating the client's words back to them to
encourage them to elaborate. It shows the nurse is listening and helps the
client clarify their thoughts.
8. A nurse is caring for a client who is experiencing a panic attack. Which of
the following actions should the nurse take first?
A. Place the client in a seclusion room.
B. Administer a PRN antianxiety medication.
C. Stay with the client and speak in a calm, quiet voice.
D. Encourage the client to perform deep-breathing exercises.
Correct Answer: C
Rationale: The priority is to provide a calm, safe presence. Staying with the
client reduces anxiety and prevents feelings of abandonment. A calm voice
helps de-escalate the situation.
9. A client who is a recent immigrant is admitted to the psychiatric unit. The
client is hesitant to make eye contact with the nurse. Which of the following
actions should the nurse take?
A. Ask the client why they won't make eye contact.
B. Respect the client's cultural norms and avoid forcing eye contact.
C. Tell the client that making eye contact is a sign of respect in this country.
D. Document that the client is non-compliant with treatment.
Correct Answer: B
