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 Disorders, Mood Disorders, Bipolar
Disorder, Depression, Schizophrenia,
Psychopharmacology, Substance Use Disorders,
Crisis Intervention, Suicide Prevention, Patient
Safety & NGN-Style Clinical Judgment
Question 1: A client with bipolar disorder is experiencing a manic episode and
has been prescribed lithium. Which of the following serum levels indicates that
the client is at risk for severe toxicity?
A. 0.6 mEq/L
B. 0.8 mEq/L
C. 1.2 mEq/L
D. 1.8 mEq/L
CORRECT ANSWER: D. 1.8 mEq/L
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L is
above the therapeutic range and places the client at risk for severe toxicity, with
symptoms such as severe ataxia, confusion, and seizures. Levels above 2.0 mEq/L are
considered potentially fatal.
Question 2: A client with schizophrenia who takes haloperidol reports
restlessness and an inability to sit still. Which extrapyramidal symptom is the
client most likely experiencing?
A. Dystonia
B. Tardive dyskinesia
C. Akathisia
D. Parkinsonism
CORRECT ANSWER: C. Akathisia
Rationale: Akathisia is characterized by subjective feelings of restlessness and an
objective inability to remain still, often manifested as pacing or constant fidgeting. This
is a common extrapyramidal side effect of first-generation antipsychotics like
haloperidol. Dystonia involves muscle spasms, tardive dyskinesia involves involuntary
movements, and parkinsonism includes rigidity and bradykinesia.
,Question 3: A client diagnosed with major depressive disorder is prescribed
phenelzine. Which dietary instruction is most important for the nurse to
provide?
A. Avoid foods high in tyramine.
B. Increase intake of foods high in tryptophan.
C. Avoid foods high in vitamin K.
D. Increase intake of dairy products.
CORRECT ANSWER: A. Avoid foods high in tyramine.
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). Consuming foods high
in tyramine while taking an MAOI can lead to a hypertensive crisis. Foods high in
tyramine include aged cheeses, cured meats, fermented foods, and red wine.
Question 4: The nurse is planning care for a client with borderline personality
disorder. Which nursing intervention is most appropriate to address the
client's manipulative behaviors?
A. Allow the client to set their own limits.
B. Establish consistent, firm, and non-punitive boundaries.
C. Ignore the manipulative behaviors to avoid reinforcing them.
D. Negotiate the unit rules with the client to promote autonomy.
CORRECT ANSWER: B. Establish consistent, firm, and non-punitive
boundaries.
Rationale: Clients with borderline personality disorder often test limits and engage in
manipulative behaviors. Consistent and firm boundaries provide a sense of security and
help the client learn appropriate behaviors. Inconsistent or punitive responses can
exacerbate the client's symptoms.
Question 5: A client with dementia is unable to recall recent events but can
vividly describe events from 40 years ago. Which term best describes this
phenomenon?
A. Anterograde amnesia
B. Retrograde amnesia
C. Confabulation
D. Perseveration
CORRECT ANSWER: B. Retrograde amnesia
Rationale: Retrograde amnesia refers to the inability to recall past memories, but in
dementia, there is often a preservation of long-term memories, especially from the
distant past, while recent memory (anterograde memory) is impaired. Anterograde
,amnesia is the inability to form new memories, confabulation is filling memory gaps with
false information, and perseveration is the repetition of words or actions.
Question 6: A client is admitted involuntarily to a psychiatric unit. Which right
does the client retain?
A. The right to refuse all psychiatric medications.
B. The right to leave the hospital at any time.
C. The right to refuse treatment, except in emergencies.
D. The right to sign out against medical advice.
CORRECT ANSWER: C. The right to refuse treatment, except in emergencies.
Rationale: Involuntary clients retain their civil rights, including the right to refuse
treatment, except in emergency situations where the client poses an imminent danger to
themselves or others. They are not free to leave the hospital and the right to sign out
AMA is not applicable as they are court-committed.
Question 7: Which statement by a client with post-traumatic stress disorder
(PTSD) indicates the client is using dissociation as a defense mechanism?
A. "I feel like I'm watching myself from outside my body."
B. "I can't remember what happened, but I know I was there."
C. "I'm having nightmares about the event every night."
D. "I don't like to talk about it because it makes me angry."
CORRECT ANSWER: A. "I feel like I'm watching myself from outside my body."
Rationale: Dissociation involves a disruption in consciousness, memory, or identity. The
feeling of watching oneself from outside the body is a classic symptom of
depersonalization, a type of dissociation often seen in PTSD. While B (amnesia) is also a
dissociative symptom, A is a more direct description of depersonalization.
Question 8: A client is taking clozapine. The nurse should monitor for which
potentially fatal adverse effect?
A. Hypertensive crisis
B. Neuroleptic malignant syndrome
C. Agranulocytosis
D. Serotonin syndrome
CORRECT ANSWER: C. Agranulocytosis
Rationale: Clozapine has a significant risk of agranulocytosis, a severe drop in white
blood cells, which can be fatal. Because of this risk, strict monitoring of absolute
neutrophil counts (ANC) is required through the REMS (Risk Evaluation and Mitigation
, Strategy) program. While NMS is a risk with all antipsychotics, agranulocytosis is most
specifically associated with clozapine.
Question 9: A client on a mental health unit is exhibiting signs of alcohol
withdrawal. Which assessment finding is the earliest indicator of alcohol
withdrawal?
A. Seizures
B. Delirium tremens
C. Tremors
D. Hallucinations
CORRECT ANSWER: C. Tremors
Rationale: Tremors (often "the shakes") are typically the earliest and most common sign
of alcohol withdrawal, appearing within 6-8 hours after the last drink. Seizures and
hallucinations usually occur later, and delirium tremens is a severe, late-stage withdrawal
complication.
Question 10: A client with generalized anxiety disorder is prescribed
buspirone. Which instruction regarding this medication is correct?
A. "This medication may cause physical dependence."
B. "You should take this medication as needed for anxiety attacks."
C. "It may take 2-4 weeks to experience the therapeutic effects."
D. "You must avoid alcohol completely while taking this medication."
CORRECT ANSWER: C. "It may take 2-4 weeks to experience the therapeutic
effects."
Rationale: Buspirone is a non-benzodiazepine anxiolytic. Unlike benzodiazepines, it is
not effective on an as-needed basis for acute anxiety and does not have a high potential
for physical dependence or abuse. Its therapeutic effect is delayed and typically takes 2-
4 weeks of consistent dosing to become fully effective.
Question 11: A nurse is assessing a client with somatic symptom disorder.
Which of the following is a key characteristic of this disorder?
A. Deliberate fabrication of physical symptoms.
B. Excessive thoughts, feelings, or behaviors related to physical symptoms.
C. Conversion of psychological distress into motor or sensory deficits.
D. A lack of concern about the severity of physical symptoms.
CORRECT ANSWER: B. Excessive thoughts, feelings, or behaviors related to
physical symptoms.
Health Nursing Study Guide, Original Practice
Questions & Answers, Comprehensive Assessment
Preparation, Psychiatric Nursing Review, Therapeutic
Communication, Mental Status Examination, Anxiety
& Trauma Disorders, Mood Disorders, Bipolar
Disorder, Depression, Schizophrenia,
Psychopharmacology, Substance Use Disorders,
Crisis Intervention, Suicide Prevention, Patient
Safety & NGN-Style Clinical Judgment
Question 1: A client with bipolar disorder is experiencing a manic episode and
has been prescribed lithium. Which of the following serum levels indicates that
the client is at risk for severe toxicity?
A. 0.6 mEq/L
B. 0.8 mEq/L
C. 1.2 mEq/L
D. 1.8 mEq/L
CORRECT ANSWER: D. 1.8 mEq/L
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L is
above the therapeutic range and places the client at risk for severe toxicity, with
symptoms such as severe ataxia, confusion, and seizures. Levels above 2.0 mEq/L are
considered potentially fatal.
Question 2: A client with schizophrenia who takes haloperidol reports
restlessness and an inability to sit still. Which extrapyramidal symptom is the
client most likely experiencing?
A. Dystonia
B. Tardive dyskinesia
C. Akathisia
D. Parkinsonism
CORRECT ANSWER: C. Akathisia
Rationale: Akathisia is characterized by subjective feelings of restlessness and an
objective inability to remain still, often manifested as pacing or constant fidgeting. This
is a common extrapyramidal side effect of first-generation antipsychotics like
haloperidol. Dystonia involves muscle spasms, tardive dyskinesia involves involuntary
movements, and parkinsonism includes rigidity and bradykinesia.
,Question 3: A client diagnosed with major depressive disorder is prescribed
phenelzine. Which dietary instruction is most important for the nurse to
provide?
A. Avoid foods high in tyramine.
B. Increase intake of foods high in tryptophan.
C. Avoid foods high in vitamin K.
D. Increase intake of dairy products.
CORRECT ANSWER: A. Avoid foods high in tyramine.
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). Consuming foods high
in tyramine while taking an MAOI can lead to a hypertensive crisis. Foods high in
tyramine include aged cheeses, cured meats, fermented foods, and red wine.
Question 4: The nurse is planning care for a client with borderline personality
disorder. Which nursing intervention is most appropriate to address the
client's manipulative behaviors?
A. Allow the client to set their own limits.
B. Establish consistent, firm, and non-punitive boundaries.
C. Ignore the manipulative behaviors to avoid reinforcing them.
D. Negotiate the unit rules with the client to promote autonomy.
CORRECT ANSWER: B. Establish consistent, firm, and non-punitive
boundaries.
Rationale: Clients with borderline personality disorder often test limits and engage in
manipulative behaviors. Consistent and firm boundaries provide a sense of security and
help the client learn appropriate behaviors. Inconsistent or punitive responses can
exacerbate the client's symptoms.
Question 5: A client with dementia is unable to recall recent events but can
vividly describe events from 40 years ago. Which term best describes this
phenomenon?
A. Anterograde amnesia
B. Retrograde amnesia
C. Confabulation
D. Perseveration
CORRECT ANSWER: B. Retrograde amnesia
Rationale: Retrograde amnesia refers to the inability to recall past memories, but in
dementia, there is often a preservation of long-term memories, especially from the
distant past, while recent memory (anterograde memory) is impaired. Anterograde
,amnesia is the inability to form new memories, confabulation is filling memory gaps with
false information, and perseveration is the repetition of words or actions.
Question 6: A client is admitted involuntarily to a psychiatric unit. Which right
does the client retain?
A. The right to refuse all psychiatric medications.
B. The right to leave the hospital at any time.
C. The right to refuse treatment, except in emergencies.
D. The right to sign out against medical advice.
CORRECT ANSWER: C. The right to refuse treatment, except in emergencies.
Rationale: Involuntary clients retain their civil rights, including the right to refuse
treatment, except in emergency situations where the client poses an imminent danger to
themselves or others. They are not free to leave the hospital and the right to sign out
AMA is not applicable as they are court-committed.
Question 7: Which statement by a client with post-traumatic stress disorder
(PTSD) indicates the client is using dissociation as a defense mechanism?
A. "I feel like I'm watching myself from outside my body."
B. "I can't remember what happened, but I know I was there."
C. "I'm having nightmares about the event every night."
D. "I don't like to talk about it because it makes me angry."
CORRECT ANSWER: A. "I feel like I'm watching myself from outside my body."
Rationale: Dissociation involves a disruption in consciousness, memory, or identity. The
feeling of watching oneself from outside the body is a classic symptom of
depersonalization, a type of dissociation often seen in PTSD. While B (amnesia) is also a
dissociative symptom, A is a more direct description of depersonalization.
Question 8: A client is taking clozapine. The nurse should monitor for which
potentially fatal adverse effect?
A. Hypertensive crisis
B. Neuroleptic malignant syndrome
C. Agranulocytosis
D. Serotonin syndrome
CORRECT ANSWER: C. Agranulocytosis
Rationale: Clozapine has a significant risk of agranulocytosis, a severe drop in white
blood cells, which can be fatal. Because of this risk, strict monitoring of absolute
neutrophil counts (ANC) is required through the REMS (Risk Evaluation and Mitigation
, Strategy) program. While NMS is a risk with all antipsychotics, agranulocytosis is most
specifically associated with clozapine.
Question 9: A client on a mental health unit is exhibiting signs of alcohol
withdrawal. Which assessment finding is the earliest indicator of alcohol
withdrawal?
A. Seizures
B. Delirium tremens
C. Tremors
D. Hallucinations
CORRECT ANSWER: C. Tremors
Rationale: Tremors (often "the shakes") are typically the earliest and most common sign
of alcohol withdrawal, appearing within 6-8 hours after the last drink. Seizures and
hallucinations usually occur later, and delirium tremens is a severe, late-stage withdrawal
complication.
Question 10: A client with generalized anxiety disorder is prescribed
buspirone. Which instruction regarding this medication is correct?
A. "This medication may cause physical dependence."
B. "You should take this medication as needed for anxiety attacks."
C. "It may take 2-4 weeks to experience the therapeutic effects."
D. "You must avoid alcohol completely while taking this medication."
CORRECT ANSWER: C. "It may take 2-4 weeks to experience the therapeutic
effects."
Rationale: Buspirone is a non-benzodiazepine anxiolytic. Unlike benzodiazepines, it is
not effective on an as-needed basis for acute anxiety and does not have a high potential
for physical dependence or abuse. Its therapeutic effect is delayed and typically takes 2-
4 weeks of consistent dosing to become fully effective.
Question 11: A nurse is assessing a client with somatic symptom disorder.
Which of the following is a key characteristic of this disorder?
A. Deliberate fabrication of physical symptoms.
B. Excessive thoughts, feelings, or behaviors related to physical symptoms.
C. Conversion of psychological distress into motor or sensory deficits.
D. A lack of concern about the severity of physical symptoms.
CORRECT ANSWER: B. Excessive thoughts, feelings, or behaviors related to
physical symptoms.
