2023 ATI RN
MENTAL HEALTH
2 VERSION EXAMS PREP
(NGN-STYLE QUESTIONS & CASE “SCENARIOS”)
Get a Level 2 or Higher!
WHAT YOU WILL GET:
➢correct answers with detailed rationales
➢ EACH EXAM SET HAS 70 QUESTIONS
Not affiliated with ATI or NCLEX. For study purposes only.
, Preview Questions Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any
study resources, feel free to Message me."
,Table of Contents
SET 1 EXAM .................................................. 2
SET 2 EXAM ................................................ 46
SET 1 EXAM
1. A nurse is discussing a 12-step program with a client who has alcohol use disorder
and is in an acute care facility undergoing detoxification. Which of the following
information should the nurse include in the teaching?
A. The program will help the client accept responsibility for the disorder.
B. The client should obtain a sponsor before discharge for Fan increased chance of
success.
C. The client will need to identify individuals who have contributed to the disorder.
D. The program will need a prescription from the client's provider prior to attendance.
Correct Answer: B. The client should obtain a sponsor before discharge for an
increased chance of success.
Rationale: Obtaining a sponsor before discharge is a critical intervention for clients with
alcohol use disorder. A sponsor provides ongoing support, guidance, and accountability,
significantly increasing the chances of maintaining sobriety. 12-step programs like
Alcoholics Anonymous (AA) do not require prescriptions (Option D), focus on self-
acceptance rather than blame (Option C), and emphasize personal responsibility rather
than identifying others who contributed to the disorder (Option A). The nurse should
facilitate sponsor contact as part of discharge planning.
,2. A nurse is planning care for a client who has depression and has made frequent
suicide attempts. Which of the following statements indicates the client has a
decreased risk for suicide?
A. "I'm relieved now that my financial affairs are in order."
B. "It is easier to talk about my feelings now."
C. "Suddenly I have enough energy to do anything I want."
D. "Thank you for always taking such good care of me."
Correct Answer: B. "It is easier to talk about my feelings now."
Rationale: The statement "It is easier to talk about my feelings now" indicates the client
is expressing emotions openly and engaging in therapeutic communication, which
reflects a decreased suicide risk. The other options are warning signs: putting affairs in
order (Option A) suggests preparation for death; sudden energy increase (Option C) may
indicate resolved intent to attempt suicide (imminent risk); and excessive gratitude
(Option D) can be a form of farewell. Clients who begin openly discussing feelings
demonstrate therapeutic engagement and reduced isolation.
3. A nurse is preparing to administer diazepam 7.5 mg IV bolus to a client for alcohol
withdrawal. Available is diazepam injection 5 mg/mL. How many mL should the nurse
administer? (Round the answer to the nearest tenth. Use a leading zero if it applies.
Do not use a trailing zero.)
A. 1.5 mL
B. 0.7 mL
C. 2.5 mL
D. 1.2 mL
Correct Answer: A. 1.5 mL
Rationale: To calculate: Desired dose (7.5 mg) ÷ Available concentration (5 mg/mL) = 7.5
÷ 5 = 1.5 mL. The nurse should administer 1.5 mL of diazepam IV bolus. This follows the
standard dosage calculation formula: D/H × Q, where D = desired dose, H = available
dose, and Q = quantity of available concentration.
,4. A nurse on a mental health unit observes a client who has acute mania hit another
client. Which of the following actions should the nurse take first?
A. Call the provider to obtain an immediate prescription for restraint.
B. Prepare to administer benzodiazepine medication.
C. Call for a team of staff members to help with the situation.
D. Check the client who was hit for injuries.
Correct Answer: C. Call for a team of staff members to help with the situation.
Rationale: When a client with acute mania becomes physically aggressive, the FIRST
priority is ensuring safety for all clients and staff. The nurse should immediately call for a
team of staff members (show of force) to help de-escalate and manage the situation
safely. While checking the injured client (Option D) and obtaining orders for restraints
(Option A) or medication (Option B) are important, they follow after ensuring the
immediate safety of the environment. This follows the priority framework: Safety of the
environment → Individual client safety → Therapeutic interventions.
5. A nurse in a community health center is working with a group of clients who have
post-traumatic stress disorder. Which of the following interventions should the nurse
include to reduce anxiety among the group members?
A. Response prevention
B. Guided imagery
C. Aversion therapy
D. Light therapy
Correct Answer: B. Guided imagery
Rationale: Guided imagery is an effective non-pharmacological intervention for reducing
anxiety in clients with PTSD. It helps clients create calming mental images to promote
relaxation and reduce hyperarousal symptoms. Response prevention (Option A) is used
for OCD. Aversion therapy (Option C) is for substance use disorders. Light therapy
(Option D) is primarily for seasonal affective disorder.
,6. A nurse is admitting a client who has anorexia nervosa and is at 60% of their ideal
body weight. Which of the following interventions should the nurse include in the plan
of care?
A. Encourage the client to drink 125 mL of fluid each hour while awake.
B. Allow the client to eat independently in their room.
C. Weigh the client twice weekly.
D. Measure the client's vital signs once each day.
Correct Answer: A. Encourage the client to drink 125 mL of fluid each hour while
awake.
Rationale: For a client with anorexia nervosa at 60% ideal body weight, fluid intake is
critical to prevent dehydration and electrolyte imbalances. Encouraging 125 mL of fluid
hourly (approximately 1,500-2,000 mL/day while awake) supports hydration. Clients with
anorexia should NOT eat independently (Option B)—supervised meals prevent
hiding/purging. They should be weighed daily (Option C), not twice weekly, at the same
time with consistent clothing. Vital signs should be monitored more frequently than
once daily (Option D) due to risk for cardiac complications from malnutrition
(bradycardia, hypotension, arrhythmias).
7. A nurse is caring for a newly admitted client who has schizophrenia. For each
potential assessment finding, click to specify if the finding is consistent with positive or
negative symptoms of schizophrenia.
Table
Assessment Classification Rationale
Finding
Delusions of Positive Delusions are positive symptoms—excesses or
grandeur distortions of normal function.
, Assessment Classification Rationale
Finding
Clang associations Positive Clang associations (word associations based on
sound rather than meaning) are positive
symptoms of disorganized thinking.
Catatonia Positive Catatonia (abnormal motor behaviors) is
classified as a positive symptom in
schizophrenia spectrum disorders.
Alogia Negative Alogia (poverty of speech) is a negative
symptom—diminution or loss of normal
functions.
Withdrawal from Negative Social withdrawal is a negative symptom
social activities reflecting diminished emotional expression and
avolition.
Rationale: Positive symptoms of schizophrenia include hallucinations, delusions,
disorganized thinking (clang associations), and abnormal motor behavior (catatonia).
Negative symptoms include affective flattening, alogia (decreased speech), avolition
(lack of motivation), and anhedonia (lack of pleasure). Understanding this distinction is
essential for targeted nursing interventions. Positive symptoms respond better to
antipsychotic medications, while negative symptoms often require psychosocial
interventions.
8. A nurse on a mental health unit is caring for a client who has schizophrenia and has
taken chlorpromazine and loxapine with minimal improvement. After reviewing the
client's medical record, the nurse should notify the provider of which of the following
findings? Select the 5 unexpected findings that require notification of the provider.
,A. Temperature 38°C (100.4°F)
B. Blood pressure 116/80 mm Hg
C. Bowel sounds absent
D. WBC count 7,500/mm³
E. ANC level 1,200/mm³
F. Myalgia reported by client
G. Heart rate 88/min
Correct Answers: A, C, E, F, G (Temperature 38°C, Bowel sounds absent, ANC level
1,200/mm³, Myalgia, Heart rate 88/min)
Rationale: The client is being considered for clozapine (indicated after failure of two
other antipsychotics). Critical findings requiring provider notification include:
• FEVER (38°C/100.4°F) and MYALGIA—potential signs of agranulocytosis or
infection
• ABSENT BOWEL SOUNDS—risk for paralytic ileus/constipation (clozapine is highly
anticholinergic)
• LOW ANC (1,200/mm³)—approaching threshold for clozapine-induced
agranulocytosis (requires monitoring; normal ANC ≥1,500/mm³ for initiation)
• ELEVATED HEART RATE (88/min)—possible tachycardia from anticholinergic
effects
Normal BP (Option B) and WBC within range (Option D) do not require immediate
notification.
9. A nurse is caring for a client who has panic disorder and is taking fluoxetine 40 mg
PO daily. Click to highlight the findings in the medical record that indicate maladaptive
uses of defense mechanisms.
Medical Record Findings:
☐ Eager to participate in group therapy and is looking forward to group exercise class
later this afternoon.
☑ Returned from exercise class in agitated state.
,☑ Client tells the nurse, "That exercise instructor was one of my favorite people here.
We had so much in common. But now I know their true nature. She's evil!"
Rationale: The client's statement demonstrates SPLITTING—a primitive defense
mechanism common in personality disorders where people are viewed as all good or all
bad. The sudden devaluation of the instructor (from "favorite" to "evil") reflects this
maladaptive defense. The agitated state upon return suggests emotional dysregulation.
Eagerness to participate in group therapy is an adaptive, healthy behavior, not a defense
mechanism.
10. A nurse is caring for a client who has impaired cognition. The client was treated for
UTI 8 months ago. The client fell getting out of bed to go to the bathroom last night
and sustained a bruise to the left knee. A nurse is updating the client's plan of care. For
each of the following potential nursing interventions, click to specify if the potential
intervention is anticipated, nonessential, or contraindicated for the client.
Table
Potential Nursing Classification Rationale
Intervention
Implement fall Anticipated Client has history of falls and impaired
precautions cognition—fall precautions are essential
for safety.
Administer Contraindicated Anticholinergics worsen confusion and
anticholinergic urinary retention in older adults with
medication cognitive impairment.
Restrict fluid intake Contraindicated Fluid restriction increases risk of
to 1,000 mL/day dehydration and UTI recurrence;
adequate hydration is needed.
, Potential Nursing Classification Rationale
Intervention
Encourage use of call Anticipated Teaching client to use call light reduces
light for toileting risk of unassisted ambulation and falls.
Perform hourly Anticipated Hourly rounding addresses toileting
rounding needs proactively and prevents falls in
cognitively impaired clients.
Rationale: For a client with impaired cognition and history of falls/UTI, anticipated
interventions focus on safety (fall precautions, call light use, hourly rounding).
Contraindicated interventions include anticholinergics (worsen delirium) and fluid
restriction (increases infection risk). This follows the safety priority framework for clients
with cognitive impairment.
11. A nurse is monitoring a client who began taking sertraline 3 days ago. Which of the
following findings should the nurse report to the provider as potential adverse effects
of this new medication? Select all that apply.
A. Temperature 38.7°C (101.7°F)
B. Heart rate 98/min
C. Sodium level 128 mEq/L
D. Diaphoresis
E. Insomnia
F. Headache
G. Blood pressure 140/86 mm Hg
Correct Answers: A, C, D, E, F, G (Temperature 38.7°C, Sodium level 128 mEq/L,
Diaphoresis, Insomnia, Headache, Blood pressure 140/86 mm Hg)
Rationale: Sertraline (SSRI) adverse effects to report include:
• FEVER (38.7°C)—possible sign of serotonin syndrome
MENTAL HEALTH
2 VERSION EXAMS PREP
(NGN-STYLE QUESTIONS & CASE “SCENARIOS”)
Get a Level 2 or Higher!
WHAT YOU WILL GET:
➢correct answers with detailed rationales
➢ EACH EXAM SET HAS 70 QUESTIONS
Not affiliated with ATI or NCLEX. For study purposes only.
, Preview Questions Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any
study resources, feel free to Message me."
,Table of Contents
SET 1 EXAM .................................................. 2
SET 2 EXAM ................................................ 46
SET 1 EXAM
1. A nurse is discussing a 12-step program with a client who has alcohol use disorder
and is in an acute care facility undergoing detoxification. Which of the following
information should the nurse include in the teaching?
A. The program will help the client accept responsibility for the disorder.
B. The client should obtain a sponsor before discharge for Fan increased chance of
success.
C. The client will need to identify individuals who have contributed to the disorder.
D. The program will need a prescription from the client's provider prior to attendance.
Correct Answer: B. The client should obtain a sponsor before discharge for an
increased chance of success.
Rationale: Obtaining a sponsor before discharge is a critical intervention for clients with
alcohol use disorder. A sponsor provides ongoing support, guidance, and accountability,
significantly increasing the chances of maintaining sobriety. 12-step programs like
Alcoholics Anonymous (AA) do not require prescriptions (Option D), focus on self-
acceptance rather than blame (Option C), and emphasize personal responsibility rather
than identifying others who contributed to the disorder (Option A). The nurse should
facilitate sponsor contact as part of discharge planning.
,2. A nurse is planning care for a client who has depression and has made frequent
suicide attempts. Which of the following statements indicates the client has a
decreased risk for suicide?
A. "I'm relieved now that my financial affairs are in order."
B. "It is easier to talk about my feelings now."
C. "Suddenly I have enough energy to do anything I want."
D. "Thank you for always taking such good care of me."
Correct Answer: B. "It is easier to talk about my feelings now."
Rationale: The statement "It is easier to talk about my feelings now" indicates the client
is expressing emotions openly and engaging in therapeutic communication, which
reflects a decreased suicide risk. The other options are warning signs: putting affairs in
order (Option A) suggests preparation for death; sudden energy increase (Option C) may
indicate resolved intent to attempt suicide (imminent risk); and excessive gratitude
(Option D) can be a form of farewell. Clients who begin openly discussing feelings
demonstrate therapeutic engagement and reduced isolation.
3. A nurse is preparing to administer diazepam 7.5 mg IV bolus to a client for alcohol
withdrawal. Available is diazepam injection 5 mg/mL. How many mL should the nurse
administer? (Round the answer to the nearest tenth. Use a leading zero if it applies.
Do not use a trailing zero.)
A. 1.5 mL
B. 0.7 mL
C. 2.5 mL
D. 1.2 mL
Correct Answer: A. 1.5 mL
Rationale: To calculate: Desired dose (7.5 mg) ÷ Available concentration (5 mg/mL) = 7.5
÷ 5 = 1.5 mL. The nurse should administer 1.5 mL of diazepam IV bolus. This follows the
standard dosage calculation formula: D/H × Q, where D = desired dose, H = available
dose, and Q = quantity of available concentration.
,4. A nurse on a mental health unit observes a client who has acute mania hit another
client. Which of the following actions should the nurse take first?
A. Call the provider to obtain an immediate prescription for restraint.
B. Prepare to administer benzodiazepine medication.
C. Call for a team of staff members to help with the situation.
D. Check the client who was hit for injuries.
Correct Answer: C. Call for a team of staff members to help with the situation.
Rationale: When a client with acute mania becomes physically aggressive, the FIRST
priority is ensuring safety for all clients and staff. The nurse should immediately call for a
team of staff members (show of force) to help de-escalate and manage the situation
safely. While checking the injured client (Option D) and obtaining orders for restraints
(Option A) or medication (Option B) are important, they follow after ensuring the
immediate safety of the environment. This follows the priority framework: Safety of the
environment → Individual client safety → Therapeutic interventions.
5. A nurse in a community health center is working with a group of clients who have
post-traumatic stress disorder. Which of the following interventions should the nurse
include to reduce anxiety among the group members?
A. Response prevention
B. Guided imagery
C. Aversion therapy
D. Light therapy
Correct Answer: B. Guided imagery
Rationale: Guided imagery is an effective non-pharmacological intervention for reducing
anxiety in clients with PTSD. It helps clients create calming mental images to promote
relaxation and reduce hyperarousal symptoms. Response prevention (Option A) is used
for OCD. Aversion therapy (Option C) is for substance use disorders. Light therapy
(Option D) is primarily for seasonal affective disorder.
,6. A nurse is admitting a client who has anorexia nervosa and is at 60% of their ideal
body weight. Which of the following interventions should the nurse include in the plan
of care?
A. Encourage the client to drink 125 mL of fluid each hour while awake.
B. Allow the client to eat independently in their room.
C. Weigh the client twice weekly.
D. Measure the client's vital signs once each day.
Correct Answer: A. Encourage the client to drink 125 mL of fluid each hour while
awake.
Rationale: For a client with anorexia nervosa at 60% ideal body weight, fluid intake is
critical to prevent dehydration and electrolyte imbalances. Encouraging 125 mL of fluid
hourly (approximately 1,500-2,000 mL/day while awake) supports hydration. Clients with
anorexia should NOT eat independently (Option B)—supervised meals prevent
hiding/purging. They should be weighed daily (Option C), not twice weekly, at the same
time with consistent clothing. Vital signs should be monitored more frequently than
once daily (Option D) due to risk for cardiac complications from malnutrition
(bradycardia, hypotension, arrhythmias).
7. A nurse is caring for a newly admitted client who has schizophrenia. For each
potential assessment finding, click to specify if the finding is consistent with positive or
negative symptoms of schizophrenia.
Table
Assessment Classification Rationale
Finding
Delusions of Positive Delusions are positive symptoms—excesses or
grandeur distortions of normal function.
, Assessment Classification Rationale
Finding
Clang associations Positive Clang associations (word associations based on
sound rather than meaning) are positive
symptoms of disorganized thinking.
Catatonia Positive Catatonia (abnormal motor behaviors) is
classified as a positive symptom in
schizophrenia spectrum disorders.
Alogia Negative Alogia (poverty of speech) is a negative
symptom—diminution or loss of normal
functions.
Withdrawal from Negative Social withdrawal is a negative symptom
social activities reflecting diminished emotional expression and
avolition.
Rationale: Positive symptoms of schizophrenia include hallucinations, delusions,
disorganized thinking (clang associations), and abnormal motor behavior (catatonia).
Negative symptoms include affective flattening, alogia (decreased speech), avolition
(lack of motivation), and anhedonia (lack of pleasure). Understanding this distinction is
essential for targeted nursing interventions. Positive symptoms respond better to
antipsychotic medications, while negative symptoms often require psychosocial
interventions.
8. A nurse on a mental health unit is caring for a client who has schizophrenia and has
taken chlorpromazine and loxapine with minimal improvement. After reviewing the
client's medical record, the nurse should notify the provider of which of the following
findings? Select the 5 unexpected findings that require notification of the provider.
,A. Temperature 38°C (100.4°F)
B. Blood pressure 116/80 mm Hg
C. Bowel sounds absent
D. WBC count 7,500/mm³
E. ANC level 1,200/mm³
F. Myalgia reported by client
G. Heart rate 88/min
Correct Answers: A, C, E, F, G (Temperature 38°C, Bowel sounds absent, ANC level
1,200/mm³, Myalgia, Heart rate 88/min)
Rationale: The client is being considered for clozapine (indicated after failure of two
other antipsychotics). Critical findings requiring provider notification include:
• FEVER (38°C/100.4°F) and MYALGIA—potential signs of agranulocytosis or
infection
• ABSENT BOWEL SOUNDS—risk for paralytic ileus/constipation (clozapine is highly
anticholinergic)
• LOW ANC (1,200/mm³)—approaching threshold for clozapine-induced
agranulocytosis (requires monitoring; normal ANC ≥1,500/mm³ for initiation)
• ELEVATED HEART RATE (88/min)—possible tachycardia from anticholinergic
effects
Normal BP (Option B) and WBC within range (Option D) do not require immediate
notification.
9. A nurse is caring for a client who has panic disorder and is taking fluoxetine 40 mg
PO daily. Click to highlight the findings in the medical record that indicate maladaptive
uses of defense mechanisms.
Medical Record Findings:
☐ Eager to participate in group therapy and is looking forward to group exercise class
later this afternoon.
☑ Returned from exercise class in agitated state.
,☑ Client tells the nurse, "That exercise instructor was one of my favorite people here.
We had so much in common. But now I know their true nature. She's evil!"
Rationale: The client's statement demonstrates SPLITTING—a primitive defense
mechanism common in personality disorders where people are viewed as all good or all
bad. The sudden devaluation of the instructor (from "favorite" to "evil") reflects this
maladaptive defense. The agitated state upon return suggests emotional dysregulation.
Eagerness to participate in group therapy is an adaptive, healthy behavior, not a defense
mechanism.
10. A nurse is caring for a client who has impaired cognition. The client was treated for
UTI 8 months ago. The client fell getting out of bed to go to the bathroom last night
and sustained a bruise to the left knee. A nurse is updating the client's plan of care. For
each of the following potential nursing interventions, click to specify if the potential
intervention is anticipated, nonessential, or contraindicated for the client.
Table
Potential Nursing Classification Rationale
Intervention
Implement fall Anticipated Client has history of falls and impaired
precautions cognition—fall precautions are essential
for safety.
Administer Contraindicated Anticholinergics worsen confusion and
anticholinergic urinary retention in older adults with
medication cognitive impairment.
Restrict fluid intake Contraindicated Fluid restriction increases risk of
to 1,000 mL/day dehydration and UTI recurrence;
adequate hydration is needed.
, Potential Nursing Classification Rationale
Intervention
Encourage use of call Anticipated Teaching client to use call light reduces
light for toileting risk of unassisted ambulation and falls.
Perform hourly Anticipated Hourly rounding addresses toileting
rounding needs proactively and prevents falls in
cognitively impaired clients.
Rationale: For a client with impaired cognition and history of falls/UTI, anticipated
interventions focus on safety (fall precautions, call light use, hourly rounding).
Contraindicated interventions include anticholinergics (worsen delirium) and fluid
restriction (increases infection risk). This follows the safety priority framework for clients
with cognitive impairment.
11. A nurse is monitoring a client who began taking sertraline 3 days ago. Which of the
following findings should the nurse report to the provider as potential adverse effects
of this new medication? Select all that apply.
A. Temperature 38.7°C (101.7°F)
B. Heart rate 98/min
C. Sodium level 128 mEq/L
D. Diaphoresis
E. Insomnia
F. Headache
G. Blood pressure 140/86 mm Hg
Correct Answers: A, C, D, E, F, G (Temperature 38.7°C, Sodium level 128 mEq/L,
Diaphoresis, Insomnia, Headache, Blood pressure 140/86 mm Hg)
Rationale: Sertraline (SSRI) adverse effects to report include:
• FEVER (38.7°C)—possible sign of serotonin syndrome
