ATI Mental Health Proctored Exam – ATI RN Mental Health
Nursing Study Guide, Original Practice Questions &
Answers, Comprehensive Assessment Preparation,
Psychiatric Nursing Review, Therapeutic Communication,
Mental Status Examination, Anxiety & Trauma-Related
Disorders, Mood Disorders, Bipolar Disorder, Depression,
Schizophrenia, Psychopharmacology, Substance Use
Disorders, Crisis Intervention, Suicide Prevention, Patient
Safety, Legal & Ethical Nursing & NGN-Style Clinical
Judgment
Question 1: A nurse is preparing to administer a benzodiazepine to a client
with generalized anxiety disorder. Which of the following concurrent
medications would place the client at the highest risk for severe respiratory
depression?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Amoxicillin
CORRECT ANSWER: C. Diphenhydramine
Rationale: Diphenhydramine is an antihistamine with significant central nervous system
depressant effects. When combined with a benzodiazepine, the sedative and respiratory
depressant effects are potentiated through additive mechanisms on GABA and
histaminergic pathways, leading to a high risk of severe respiratory depression.
Question 2: A client with schizophrenia is experiencing delusions of
persecution and auditory hallucinations. Which of the following is the priority
nursing intervention?
A. Tell the client the voices are not real.
B. Distract the client with a structured activity.
C. Ensure client safety and maintain a calm environment.
D. Encourage the client to express feelings about the hallucinations.
CORRECT ANSWER: C. Ensure client safety and maintain a calm environment.
Rationale: Safety is always the priority. A client experiencing command hallucinations or
persecutory delusions may act on internal stimuli, posing a risk to self or others. A calm,
structured environment reduces stimulation and potential for agitation.
Question 3: A client with major depressive disorder has been prescribed
phenelzine. Which of the following dietary instructions should the nurse
emphasize?
,A. Avoid foods high in tryptophan.
B. Avoid foods high in tyramine.
C. Increase intake of foods high in potassium.
D. Limit fluids to 1.5 liters per day.
CORRECT ANSWER: B. Avoid foods high in tyramine.
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). Consuming tyramine-
rich foods (e.g., aged cheeses, cured meats, fermented products) can precipitate a
hypertensive crisis due to the inability of MAOI to break down tyramine, leading to
massive norepinephrine release.
Question 4: A nurse is assessing a client with bipolar disorder who is
experiencing a manic episode. Which of the following findings is most
consistent with this diagnosis?
A. Psychomotor retardation and anhedonia.
B. Pressured speech and decreased need for sleep.
C. Panic attacks and agoraphobia.
D. Somatic complaints and compulsions.
CORRECT ANSWER: B. Pressured speech and decreased need for sleep.
Rationale: Pressured speech (rapid, loud, and difficult to interrupt) and a decreased
need for sleep (feeling rested after only a few hours) are hallmark symptoms of a manic
episode, reflecting elevated mood, increased energy, and hyperactivity.
Question 5: A client with post-traumatic stress disorder (PTSD) reports
recurrent nightmares and avoids driving near the site of a car accident. Which
type of symptom does avoiding the accident site represent?
A. Intrusion symptom
B. Hyperarousal symptom
C. Avoidance symptom
D. Negative alteration in cognition
CORRECT ANSWER: C. Avoidance symptom
Rationale: Avoidance symptoms in PTSD include efforts to avoid distressing memories,
thoughts, feelings, or external reminders (such as places, people, or activities) associated
with the traumatic event. This is a core diagnostic criterion for PTSD.
Question 6: A client is prescribed lithium carbonate for bipolar disorder. Which
laboratory value is most critical for the nurse to monitor for toxicity?
,A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
CORRECT ANSWER: A. Serum sodium
Rationale: Lithium is a monovalent cation similar to sodium. Low serum sodium levels
(e.g., from dehydration, diuretics, or low-salt diets) increase lithium reabsorption in the
kidneys, leading to elevated lithium levels and a high risk of toxicity.
Question 7: A nurse is caring for a client with antisocial personality disorder
who is being manipulative. Which of the following is the most appropriate
nursing intervention?
A. Ignore the manipulative behavior completely.
B. Set firm, consistent limits on behavior.
C. Confront the client aggressively about the manipulation.
D. Allow the behavior to avoid power struggles.
CORRECT ANSWER: B. Set firm, consistent limits on behavior.
Rationale: Clients with antisocial personality disorder often test limits and manipulate
staff. Consistent, non-punitive limit-setting provides structure, reduces the effectiveness
of manipulative behaviors, and maintains a therapeutic environment.
Question 8: A client with Alzheimer's disease is wandering into other clients'
rooms at night. Which of the following interventions should the nurse
implement first?
A. Apply a bed alarm to the client's bed.
B. Place the client in a room near the nursing station.
C. Administer a sedative-hypnotic medication.
D. Restrict the client to the room using a soft vest restraint.
CORRECT ANSWER: B. Place the client in a room near the nursing station.
Rationale: The least restrictive intervention should be used first. Placing the client near
the nursing station allows for increased visual supervision and reduces the risk of
elopement or injury while maintaining dignity and mobility.
Question 9: A client with panic disorder is experiencing an acute panic attack.
Which of the following nursing actions is the priority during the attack?
A. Encourage deep breathing and guided imagery.
B. Stay with the client and provide reassurance.
, C. Leave the client alone to de-escalate independently.
D. Ask the client to describe the trigger in detail.
CORRECT ANSWER: B. Stay with the client and provide reassurance.
Rationale: During a panic attack, the client fears loss of control or impending doom. The
nurse should remain with the client to provide a calming presence, safety, and
reassurance. The client should not be left alone.
Question 10: A nurse is reviewing the medical record of a client who has been
prescribed fluoxetine. Which of the following concurrent diagnoses is a
contraindication for this medication?
A. Obsessive-compulsive disorder
B. Bulimia nervosa
C. Hepatic impairment
D. Seizure disorder
CORRECT ANSWER: D. Seizure disorder
Rationale: Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), can lower the
seizure threshold, making it contraindicated or requiring cautious use in clients with a
history of seizure disorders. The risk of seizure increases at higher doses.
Question 11: A client with anorexia nervosa is admitted with a BMI of 16.2 and
electrolyte imbalances. Which of the following is the priority nursing
intervention?
A. Initiate a weight-gain contract.
B. Monitor vital signs and cardiac rhythm.
C. Encourage the client to talk about body image.
D. Offer the client a high-calorie supplement.
CORRECT ANSWER: B. Monitor vital signs and cardiac rhythm.
Rationale: Clients with severe anorexia are at risk for cardiac complications, including
bradycardia, hypotension, and arrhythmias due to electrolyte imbalances (especially
hypokalemia). Monitoring vital signs and cardiac function is the priority intervention to
prevent life-threatening events.
Question 12: A client with alcohol use disorder is prescribed naltrexone. What
is the primary purpose of this medication?
A. To reduce withdrawal symptoms.
B. To decrease cravings for alcohol.
Nursing Study Guide, Original Practice Questions &
Answers, Comprehensive Assessment Preparation,
Psychiatric Nursing Review, Therapeutic Communication,
Mental Status Examination, Anxiety & Trauma-Related
Disorders, Mood Disorders, Bipolar Disorder, Depression,
Schizophrenia, Psychopharmacology, Substance Use
Disorders, Crisis Intervention, Suicide Prevention, Patient
Safety, Legal & Ethical Nursing & NGN-Style Clinical
Judgment
Question 1: A nurse is preparing to administer a benzodiazepine to a client
with generalized anxiety disorder. Which of the following concurrent
medications would place the client at the highest risk for severe respiratory
depression?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Amoxicillin
CORRECT ANSWER: C. Diphenhydramine
Rationale: Diphenhydramine is an antihistamine with significant central nervous system
depressant effects. When combined with a benzodiazepine, the sedative and respiratory
depressant effects are potentiated through additive mechanisms on GABA and
histaminergic pathways, leading to a high risk of severe respiratory depression.
Question 2: A client with schizophrenia is experiencing delusions of
persecution and auditory hallucinations. Which of the following is the priority
nursing intervention?
A. Tell the client the voices are not real.
B. Distract the client with a structured activity.
C. Ensure client safety and maintain a calm environment.
D. Encourage the client to express feelings about the hallucinations.
CORRECT ANSWER: C. Ensure client safety and maintain a calm environment.
Rationale: Safety is always the priority. A client experiencing command hallucinations or
persecutory delusions may act on internal stimuli, posing a risk to self or others. A calm,
structured environment reduces stimulation and potential for agitation.
Question 3: A client with major depressive disorder has been prescribed
phenelzine. Which of the following dietary instructions should the nurse
emphasize?
,A. Avoid foods high in tryptophan.
B. Avoid foods high in tyramine.
C. Increase intake of foods high in potassium.
D. Limit fluids to 1.5 liters per day.
CORRECT ANSWER: B. Avoid foods high in tyramine.
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). Consuming tyramine-
rich foods (e.g., aged cheeses, cured meats, fermented products) can precipitate a
hypertensive crisis due to the inability of MAOI to break down tyramine, leading to
massive norepinephrine release.
Question 4: A nurse is assessing a client with bipolar disorder who is
experiencing a manic episode. Which of the following findings is most
consistent with this diagnosis?
A. Psychomotor retardation and anhedonia.
B. Pressured speech and decreased need for sleep.
C. Panic attacks and agoraphobia.
D. Somatic complaints and compulsions.
CORRECT ANSWER: B. Pressured speech and decreased need for sleep.
Rationale: Pressured speech (rapid, loud, and difficult to interrupt) and a decreased
need for sleep (feeling rested after only a few hours) are hallmark symptoms of a manic
episode, reflecting elevated mood, increased energy, and hyperactivity.
Question 5: A client with post-traumatic stress disorder (PTSD) reports
recurrent nightmares and avoids driving near the site of a car accident. Which
type of symptom does avoiding the accident site represent?
A. Intrusion symptom
B. Hyperarousal symptom
C. Avoidance symptom
D. Negative alteration in cognition
CORRECT ANSWER: C. Avoidance symptom
Rationale: Avoidance symptoms in PTSD include efforts to avoid distressing memories,
thoughts, feelings, or external reminders (such as places, people, or activities) associated
with the traumatic event. This is a core diagnostic criterion for PTSD.
Question 6: A client is prescribed lithium carbonate for bipolar disorder. Which
laboratory value is most critical for the nurse to monitor for toxicity?
,A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
CORRECT ANSWER: A. Serum sodium
Rationale: Lithium is a monovalent cation similar to sodium. Low serum sodium levels
(e.g., from dehydration, diuretics, or low-salt diets) increase lithium reabsorption in the
kidneys, leading to elevated lithium levels and a high risk of toxicity.
Question 7: A nurse is caring for a client with antisocial personality disorder
who is being manipulative. Which of the following is the most appropriate
nursing intervention?
A. Ignore the manipulative behavior completely.
B. Set firm, consistent limits on behavior.
C. Confront the client aggressively about the manipulation.
D. Allow the behavior to avoid power struggles.
CORRECT ANSWER: B. Set firm, consistent limits on behavior.
Rationale: Clients with antisocial personality disorder often test limits and manipulate
staff. Consistent, non-punitive limit-setting provides structure, reduces the effectiveness
of manipulative behaviors, and maintains a therapeutic environment.
Question 8: A client with Alzheimer's disease is wandering into other clients'
rooms at night. Which of the following interventions should the nurse
implement first?
A. Apply a bed alarm to the client's bed.
B. Place the client in a room near the nursing station.
C. Administer a sedative-hypnotic medication.
D. Restrict the client to the room using a soft vest restraint.
CORRECT ANSWER: B. Place the client in a room near the nursing station.
Rationale: The least restrictive intervention should be used first. Placing the client near
the nursing station allows for increased visual supervision and reduces the risk of
elopement or injury while maintaining dignity and mobility.
Question 9: A client with panic disorder is experiencing an acute panic attack.
Which of the following nursing actions is the priority during the attack?
A. Encourage deep breathing and guided imagery.
B. Stay with the client and provide reassurance.
, C. Leave the client alone to de-escalate independently.
D. Ask the client to describe the trigger in detail.
CORRECT ANSWER: B. Stay with the client and provide reassurance.
Rationale: During a panic attack, the client fears loss of control or impending doom. The
nurse should remain with the client to provide a calming presence, safety, and
reassurance. The client should not be left alone.
Question 10: A nurse is reviewing the medical record of a client who has been
prescribed fluoxetine. Which of the following concurrent diagnoses is a
contraindication for this medication?
A. Obsessive-compulsive disorder
B. Bulimia nervosa
C. Hepatic impairment
D. Seizure disorder
CORRECT ANSWER: D. Seizure disorder
Rationale: Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), can lower the
seizure threshold, making it contraindicated or requiring cautious use in clients with a
history of seizure disorders. The risk of seizure increases at higher doses.
Question 11: A client with anorexia nervosa is admitted with a BMI of 16.2 and
electrolyte imbalances. Which of the following is the priority nursing
intervention?
A. Initiate a weight-gain contract.
B. Monitor vital signs and cardiac rhythm.
C. Encourage the client to talk about body image.
D. Offer the client a high-calorie supplement.
CORRECT ANSWER: B. Monitor vital signs and cardiac rhythm.
Rationale: Clients with severe anorexia are at risk for cardiac complications, including
bradycardia, hypotension, and arrhythmias due to electrolyte imbalances (especially
hypokalemia). Monitoring vital signs and cardiac function is the priority intervention to
prevent life-threatening events.
Question 12: A client with alcohol use disorder is prescribed naltrexone. What
is the primary purpose of this medication?
A. To reduce withdrawal symptoms.
B. To decrease cravings for alcohol.
