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ATI RN MENTAL HEALTH PROCTORED EXAM
2026/2027 | NEXT GENERATION NCLEX (NGN) |
EXPERT VERIFIED | 200 QUESTIONS & COMPLETE
RATIONALES | PASS GUARANTEED - A+ GRADED
SECTION 1: THERAPEUTIC COMMUNICATION & THE NURSE-CLIENT RELATIONSHIP (Questions 1-25)
Q1: A nurse is establishing a therapeutic relationship with a client diagnosed with major depressive
disorder. Which action by the nurse demonstrates the principle of genuineness?
A. Using a standardized greeting for all clients
B. Responding authentically and congruently while maintaining professional boundaries
C. Sharing personal experiences to build rapport
D. Avoiding eye contact to reduce pressure on the client
Correct Answer: B
Rationale: Genuineness involves being authentic, open, and honest with the client while maintaining
professional boundaries. It helps build trust and rapport in the therapeutic relationship. Option A is a
routine behavior, not genuineness. Option C violates professional boundaries. Option D is a barrier
to communication . Key teaching point: Genuineness is being authentic and honest with clients
within professional boundaries; it is a core component of the therapeutic relationship.
Q2: A nurse is in the working phase of a therapeutic relationship with a client who has
methamphetamine use disorder. Which client behavior indicates transference?
A. The client asks the nurse whether she will go out to dinner with him
B. The client accuses the nurses of telling him what to do just like his ex-girlfriend
C. The client reminds the nurse of a friend who died from a substance overdose
D. The client becomes angry and threatens to harm himself
Correct Answer: B
Rationale: Transference is the client's unconscious redirection of feelings from a significant person
(often a parent or former partner) onto the nurse. The client is transferring feelings about his ex-
girlfriend onto the nursing staff. Option A describes boundary crossing. Option C describes
countertransference (the nurse's feelings). Option D describes a safety concern . Key teaching
point: Transference = client unconsciously redirects feelings from past relationships onto the nurse;
countertransference = nurse's emotional response to the client.
Q3: A client on an inpatient unit tells the nurse, "I want to leave right now. You can't keep me here."
The client was voluntarily admitted 2 days ago. What is the nurse's best response?
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A. "You are correct; you can leave whenever you want."
B. "I understand you want to leave. Let's discuss your concerns with the treatment team."
C. "If you leave, we will have to call security."
D. "You signed a voluntary admission form, so you cannot leave."
Correct Answer: B
Rationale: A voluntary client has the right to request discharge. The nurse should acknowledge the
client's feelings and facilitate discussion with the treatment team rather than using threats or
coercion. Option A is legally incorrect; the provider must evaluate the client before discharge.
Options C and D are coercive and nontherapeutic . Key teaching point: Voluntary clients have the
right to request discharge; the nurse should facilitate discussion with the treatment team.
Q4: A client with major depressive disorder tells the nurse, "I don't have anything to live for
anymore." What is the nurse's best response?
A. "Everything will be fine."
B. "You have so much to live for."
C. "Are you thinking of hurting yourself?"
D. "Don't say that."
Correct Answer: C
Rationale: Direct questioning about suicidal ideation is essential and does not increase suicide risk.
The nurse must assess for intent, plan, and means. False reassurance or minimizing the statement is
not therapeutic. The most important action is to perform a suicide risk assessment by asking directly
about suicidal thoughts and plans . Key teaching point: Always directly assess for suicidal ideation;
direct questioning does not increase suicide risk.
Q5: A nurse is caring for a client who gave birth to a stillborn baby. Which statement should the
nurse make?
A. "Everything happens for a reason."
B. "You can have another baby."
C. "I'll stay with you just in case you want to talk."
D. "I know how you feel."
Correct Answer: C
Rationale: Offering presence without pressure to talk is therapeutic. Statements A, B, and D are
nontherapeutic—they minimize the client's pain, offer false reassurance, or presume to understand.
Silence and presence are often most therapeutic in grief situations . Key teaching point: Offering
presence without pressure to talk is therapeutic in grief situations; avoid platitudes and false
reassurance.
Q6: A nurse overhears a newly licensed nurse discussing a client's hallucinations in the hallway with
another nurse. Which action should the nurse take first?
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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
Correct Answer: B
Rationale: The nurse should first directly address the breach of confidentiality by telling the nurse to
stop discussing client information in a public area. This immediate intervention protects client
privacy. Follow-up actions (notifying manager, providing education, completing an incident report)
should occur after the immediate safety concern is addressed . Key teaching point: Directly address
confidentiality breaches immediately; follow-up actions should occur after the immediate concern is
resolved.
Q7: A client says, "Nobody cares about me; I'm all alone." Which response by the nurse is most
therapeutic?
A. "That's not true; your family visits every day."
B. "Why do you feel alone when people care?"
C. "It sounds like you are feeling very lonely right now."
D. "You need to focus on the positive relationships you have."
Correct Answer: C
Rationale: Reflecting feelings validates the client's emotional experience without arguing or
dismissing. It opens communication. Responses A, B, and D are nontherapeutic—they argue,
question in a judgmental way, or dismiss the client's feelings . Key teaching point: Reflecting feelings
validates the client's experience and opens communication; avoid arguing, questioning in a
judgmental way, or dismissing feelings.
Q8: A charge nurse is discussing mental status exams with a newly licensed nurse. Which statements
indicate an understanding of the teaching? (Select all that apply)
A. "To assess cognitive ability, I should ask the client to count backward by sevens."
B. "To assess affect, I should observe the client's facial expression."
C. "To assess language ability, I should instruct the client to write a sentence."
D. "To assess remote memory, I should have the client repeat a list of objects."
E. "To assess abstract thinking, I should ask the client to identify our most recent presidents."
Correct Answers: A, B, C, E
Rationale: Counting backward by sevens assesses cognition; observing facial expression assesses
affect; writing a sentence assesses language ability; identifying recent presidents assesses abstract
thinking or general knowledge. Repeating a list of objects assesses immediate or recent memory, not
remote memory. Remote memory involves recalling distant events . Key teaching point: Mental
status exam components: cognition (serial 7s), affect (facial expression), language (writing), abstract
thinking (proverbs/analogies); immediate memory (repeat objects), remote memory (distant
events).
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Q9: Which of the following is an example of active listening? (Select all that apply)
A. Giving frequent advice based on personal experience
B. Maintaining eye contact and nodding occasionally
C. Sitting with arms crossed while the client speaks
D. Using silence to allow the client to process thoughts
Correct Answers: B, D
Rationale: Active listening involves nonverbal cues (eye contact, nodding) and allowing silence.
Giving advice (A) is not active listening. Crossed arms (C) suggest defensiveness or lack of openness
. Key teaching point: Active listening includes eye contact, nodding, and allowing silence; avoid
giving advice or appearing defensive.
Q10: A nurse is caring for a client who smokes and has lung cancer. The client reports, "I'm coughing
because I have that cold that everyone has been getting." The nurse should identify that the client is
using which defense mechanism?
A. Reaction formation
B. Denial
C. Displacement
D. Sublimation
Correct Answer: B
Rationale: Denial involves refusing to acknowledge the reality of a situation. The client attributes
symptoms to a common cold rather than accepting the lung cancer diagnosis. Reaction formation (A)
involves acting the opposite of one's feelings. Displacement (C) involves redirecting feelings to a
safer target. Sublimation (D) involves channeling unacceptable impulses into socially acceptable
behaviors . Key teaching point: Denial = refusing to acknowledge reality; common defense
mechanism in clients with serious diagnoses.
Q11: A client with schizophrenia who is taking haloperidol is experiencing acute dystonia. Which
medication should the nurse anticipate administering?
A. Benztropine
B. Propranolol
C. Valbenazine
D. Diphenhydramine
Correct Answer: D
Rationale: Acute dystonia is treated with anticholinergic medications such as diphenhydramine
(Benadryl) or benztropine (Cogentin). Propranolol is used for akathisia. Valbenazine is used for
tardive dyskinesia. Diphenhydramine is often the first-line treatment for acute dystonia in the
emergency setting . Key teaching point: Acute dystonia is treated with anticholinergics
(diphenhydramine, benztropine); propranolol for akathisia; valbenazine for tardive dyskinesia.
ATI RN MENTAL HEALTH PROCTORED EXAM
2026/2027 | NEXT GENERATION NCLEX (NGN) |
EXPERT VERIFIED | 200 QUESTIONS & COMPLETE
RATIONALES | PASS GUARANTEED - A+ GRADED
SECTION 1: THERAPEUTIC COMMUNICATION & THE NURSE-CLIENT RELATIONSHIP (Questions 1-25)
Q1: A nurse is establishing a therapeutic relationship with a client diagnosed with major depressive
disorder. Which action by the nurse demonstrates the principle of genuineness?
A. Using a standardized greeting for all clients
B. Responding authentically and congruently while maintaining professional boundaries
C. Sharing personal experiences to build rapport
D. Avoiding eye contact to reduce pressure on the client
Correct Answer: B
Rationale: Genuineness involves being authentic, open, and honest with the client while maintaining
professional boundaries. It helps build trust and rapport in the therapeutic relationship. Option A is a
routine behavior, not genuineness. Option C violates professional boundaries. Option D is a barrier
to communication . Key teaching point: Genuineness is being authentic and honest with clients
within professional boundaries; it is a core component of the therapeutic relationship.
Q2: A nurse is in the working phase of a therapeutic relationship with a client who has
methamphetamine use disorder. Which client behavior indicates transference?
A. The client asks the nurse whether she will go out to dinner with him
B. The client accuses the nurses of telling him what to do just like his ex-girlfriend
C. The client reminds the nurse of a friend who died from a substance overdose
D. The client becomes angry and threatens to harm himself
Correct Answer: B
Rationale: Transference is the client's unconscious redirection of feelings from a significant person
(often a parent or former partner) onto the nurse. The client is transferring feelings about his ex-
girlfriend onto the nursing staff. Option A describes boundary crossing. Option C describes
countertransference (the nurse's feelings). Option D describes a safety concern . Key teaching
point: Transference = client unconsciously redirects feelings from past relationships onto the nurse;
countertransference = nurse's emotional response to the client.
Q3: A client on an inpatient unit tells the nurse, "I want to leave right now. You can't keep me here."
The client was voluntarily admitted 2 days ago. What is the nurse's best response?
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A. "You are correct; you can leave whenever you want."
B. "I understand you want to leave. Let's discuss your concerns with the treatment team."
C. "If you leave, we will have to call security."
D. "You signed a voluntary admission form, so you cannot leave."
Correct Answer: B
Rationale: A voluntary client has the right to request discharge. The nurse should acknowledge the
client's feelings and facilitate discussion with the treatment team rather than using threats or
coercion. Option A is legally incorrect; the provider must evaluate the client before discharge.
Options C and D are coercive and nontherapeutic . Key teaching point: Voluntary clients have the
right to request discharge; the nurse should facilitate discussion with the treatment team.
Q4: A client with major depressive disorder tells the nurse, "I don't have anything to live for
anymore." What is the nurse's best response?
A. "Everything will be fine."
B. "You have so much to live for."
C. "Are you thinking of hurting yourself?"
D. "Don't say that."
Correct Answer: C
Rationale: Direct questioning about suicidal ideation is essential and does not increase suicide risk.
The nurse must assess for intent, plan, and means. False reassurance or minimizing the statement is
not therapeutic. The most important action is to perform a suicide risk assessment by asking directly
about suicidal thoughts and plans . Key teaching point: Always directly assess for suicidal ideation;
direct questioning does not increase suicide risk.
Q5: A nurse is caring for a client who gave birth to a stillborn baby. Which statement should the
nurse make?
A. "Everything happens for a reason."
B. "You can have another baby."
C. "I'll stay with you just in case you want to talk."
D. "I know how you feel."
Correct Answer: C
Rationale: Offering presence without pressure to talk is therapeutic. Statements A, B, and D are
nontherapeutic—they minimize the client's pain, offer false reassurance, or presume to understand.
Silence and presence are often most therapeutic in grief situations . Key teaching point: Offering
presence without pressure to talk is therapeutic in grief situations; avoid platitudes and false
reassurance.
Q6: A nurse overhears a newly licensed nurse discussing a client's hallucinations in the hallway with
another nurse. Which action should the nurse take first?
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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
Correct Answer: B
Rationale: The nurse should first directly address the breach of confidentiality by telling the nurse to
stop discussing client information in a public area. This immediate intervention protects client
privacy. Follow-up actions (notifying manager, providing education, completing an incident report)
should occur after the immediate safety concern is addressed . Key teaching point: Directly address
confidentiality breaches immediately; follow-up actions should occur after the immediate concern is
resolved.
Q7: A client says, "Nobody cares about me; I'm all alone." Which response by the nurse is most
therapeutic?
A. "That's not true; your family visits every day."
B. "Why do you feel alone when people care?"
C. "It sounds like you are feeling very lonely right now."
D. "You need to focus on the positive relationships you have."
Correct Answer: C
Rationale: Reflecting feelings validates the client's emotional experience without arguing or
dismissing. It opens communication. Responses A, B, and D are nontherapeutic—they argue,
question in a judgmental way, or dismiss the client's feelings . Key teaching point: Reflecting feelings
validates the client's experience and opens communication; avoid arguing, questioning in a
judgmental way, or dismissing feelings.
Q8: A charge nurse is discussing mental status exams with a newly licensed nurse. Which statements
indicate an understanding of the teaching? (Select all that apply)
A. "To assess cognitive ability, I should ask the client to count backward by sevens."
B. "To assess affect, I should observe the client's facial expression."
C. "To assess language ability, I should instruct the client to write a sentence."
D. "To assess remote memory, I should have the client repeat a list of objects."
E. "To assess abstract thinking, I should ask the client to identify our most recent presidents."
Correct Answers: A, B, C, E
Rationale: Counting backward by sevens assesses cognition; observing facial expression assesses
affect; writing a sentence assesses language ability; identifying recent presidents assesses abstract
thinking or general knowledge. Repeating a list of objects assesses immediate or recent memory, not
remote memory. Remote memory involves recalling distant events . Key teaching point: Mental
status exam components: cognition (serial 7s), affect (facial expression), language (writing), abstract
thinking (proverbs/analogies); immediate memory (repeat objects), remote memory (distant
events).
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Q9: Which of the following is an example of active listening? (Select all that apply)
A. Giving frequent advice based on personal experience
B. Maintaining eye contact and nodding occasionally
C. Sitting with arms crossed while the client speaks
D. Using silence to allow the client to process thoughts
Correct Answers: B, D
Rationale: Active listening involves nonverbal cues (eye contact, nodding) and allowing silence.
Giving advice (A) is not active listening. Crossed arms (C) suggest defensiveness or lack of openness
. Key teaching point: Active listening includes eye contact, nodding, and allowing silence; avoid
giving advice or appearing defensive.
Q10: A nurse is caring for a client who smokes and has lung cancer. The client reports, "I'm coughing
because I have that cold that everyone has been getting." The nurse should identify that the client is
using which defense mechanism?
A. Reaction formation
B. Denial
C. Displacement
D. Sublimation
Correct Answer: B
Rationale: Denial involves refusing to acknowledge the reality of a situation. The client attributes
symptoms to a common cold rather than accepting the lung cancer diagnosis. Reaction formation (A)
involves acting the opposite of one's feelings. Displacement (C) involves redirecting feelings to a
safer target. Sublimation (D) involves channeling unacceptable impulses into socially acceptable
behaviors . Key teaching point: Denial = refusing to acknowledge reality; common defense
mechanism in clients with serious diagnoses.
Q11: A client with schizophrenia who is taking haloperidol is experiencing acute dystonia. Which
medication should the nurse anticipate administering?
A. Benztropine
B. Propranolol
C. Valbenazine
D. Diphenhydramine
Correct Answer: D
Rationale: Acute dystonia is treated with anticholinergic medications such as diphenhydramine
(Benadryl) or benztropine (Cogentin). Propranolol is used for akathisia. Valbenazine is used for
tardive dyskinesia. Diphenhydramine is often the first-line treatment for acute dystonia in the
emergency setting . Key teaching point: Acute dystonia is treated with anticholinergics
(diphenhydramine, benztropine); propranolol for akathisia; valbenazine for tardive dyskinesia.
