ATI Mental Health Proctored Exam(10
Versions)(Latest, 2021-2022)(VERIFIED)
Section 1: Foundations & Therapeutic Communication (Q1–20)
1. A nurse is admitting a client with acute mania. Which action should the nurse take first?
A. Orient the client to the unit rules
B. Assess the client's safety and physical needs
C. Administer prescribed lithium
D. Encourage group therapy participation
Correct: B
Safety is always the priority. Maslow's hierarchy places physiological/safety needs before
psychosocial interventions. Manic clients are at risk for exhaustion, dehydration, and injury.
2. Which statement by the nurse demonstrates therapeutic communication?
A. "Why did you stop taking your medication?"
B. "I noticed you were crying earlier. Tell me what that was like."
C. "You shouldn't feel that way."
D. "Everything will be fine."
Correct: B
Using an open-ended, observational statement encourages exploration of feelings without
judgment. "Why" questions can feel accusatory; reassurance and minimizing are
nontherapeutic.
3. A client with borderline personality disorder says, "You're the only nurse who understands
me." What is the best response?
A. "I'm glad you feel that way."
B. "Let's talk about how you can develop trusting relationships with others."
C. "You shouldn't single me out."
D. "That's inappropriate."
, Correct: B
This response avoids reinforcing idealization/splitting and redirects toward building broader
interpersonal skills — a key intervention for BPD.
4. SATA — Which are components of a therapeutic milieu? (Select all that apply.)
A. Structured daily schedule
B. Physical safety
C. Staff consistency
D. Punitive consequences for rule-breaking
E. Client involvement in decision-making
Correct: A, B, C, E
A therapeutic milieu emphasizes structure, safety, consistency, and client empowerment —
not punishment.
5. A nurse is caring for a client in seclusion. Which assessment is priority?
A. Skin integrity
B. Respiratory status and circulation
C. Nutritional intake
D. Elimination pattern
Correct: B
Airway/breathing/circulation is always the priority; clients in seclusion must be monitored
at least every 15 minutes for physical safety.
6. Which is an example of countertransference?
A. The client transfers feelings about a parent onto the nurse
B. The nurse feels angry at a client who reminds her of her ex-spouse
C. The client refuses medication
D. The nurse documents objectively
Correct: B
Countertransference = the nurse's emotional reaction to the client based on the nurse's
own history. Transference is the client's reaction toward the nurse.
,7. A client is prescribed haloperidol. Which extrapyramidal symptom is irreversible?
A. Akathisia
B. Dystonia
C. Tardive dyskinesia
D. Pseudoparkinsonism
Correct: C
Tardive dyskinesia (involuntary facial/oral movements) may be irreversible. The others are
typically reversible with treatment.
8. SATA — Which findings suggest neuroleptic malignant syndrome (NMS)? (Select all that
apply.)
A. High fever
B. Muscle rigidity
C. Bradycardia
D. Altered mental status
E. Elevated CK
Correct: A, B, D, E
NMS = fever, rigidity, autonomic instability (tachycardia, not bradycardia), altered LOC,
elevated CK. It's a medical emergency.
9. A nurse is teaching a client about SSRIs. Which statement indicates understanding?
A. "I can stop it once I feel better."
B. "It may take 2–4 weeks to feel the full effect."
C. "I should take it with St. John's wort."
D. "I can drink alcohol freely."
Correct: B
SSRIs take 2–4 weeks for full effect; must be tapered, not stopped abruptly. St. John's wort
increases serotonin syndrome risk; alcohol worsens depression.
10. Which lab value must be monitored for a client on lithium?
A. CBC
B. Lithium level and TSH/renal function
, C. INR
D. HbA1c
Correct: B
Therapeutic lithium range is 0.6–1.2 mEq/L. Monitor thyroid and renal function due to
toxicity risks.
11. A client on lithium reports coarse hand tremor, vomiting, and ataxia. What is the priority
action?
A. Give the next dose
B. Hold the dose and notify the provider
C. Encourage fluids
D. Reassure the client
Correct: B
These are signs of lithium toxicity (level usually >1.5). Hold the drug and notify the provider
immediately.
12. SATA — Which are positive symptoms of schizophrenia? (Select all that apply.)
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
E. Avolition
Correct: A, B, D
Positive symptoms = added experiences (hallucinations, delusions, disorganized speech).
Negative symptoms = deficits (flat affect, avolition, anhedonia).
13. A client with schizophrenia says, "The TV is talking about me." This is:
A. Hallucination
B. Delusion of reference
C. Thought broadcasting
D. Loose association
Versions)(Latest, 2021-2022)(VERIFIED)
Section 1: Foundations & Therapeutic Communication (Q1–20)
1. A nurse is admitting a client with acute mania. Which action should the nurse take first?
A. Orient the client to the unit rules
B. Assess the client's safety and physical needs
C. Administer prescribed lithium
D. Encourage group therapy participation
Correct: B
Safety is always the priority. Maslow's hierarchy places physiological/safety needs before
psychosocial interventions. Manic clients are at risk for exhaustion, dehydration, and injury.
2. Which statement by the nurse demonstrates therapeutic communication?
A. "Why did you stop taking your medication?"
B. "I noticed you were crying earlier. Tell me what that was like."
C. "You shouldn't feel that way."
D. "Everything will be fine."
Correct: B
Using an open-ended, observational statement encourages exploration of feelings without
judgment. "Why" questions can feel accusatory; reassurance and minimizing are
nontherapeutic.
3. A client with borderline personality disorder says, "You're the only nurse who understands
me." What is the best response?
A. "I'm glad you feel that way."
B. "Let's talk about how you can develop trusting relationships with others."
C. "You shouldn't single me out."
D. "That's inappropriate."
, Correct: B
This response avoids reinforcing idealization/splitting and redirects toward building broader
interpersonal skills — a key intervention for BPD.
4. SATA — Which are components of a therapeutic milieu? (Select all that apply.)
A. Structured daily schedule
B. Physical safety
C. Staff consistency
D. Punitive consequences for rule-breaking
E. Client involvement in decision-making
Correct: A, B, C, E
A therapeutic milieu emphasizes structure, safety, consistency, and client empowerment —
not punishment.
5. A nurse is caring for a client in seclusion. Which assessment is priority?
A. Skin integrity
B. Respiratory status and circulation
C. Nutritional intake
D. Elimination pattern
Correct: B
Airway/breathing/circulation is always the priority; clients in seclusion must be monitored
at least every 15 minutes for physical safety.
6. Which is an example of countertransference?
A. The client transfers feelings about a parent onto the nurse
B. The nurse feels angry at a client who reminds her of her ex-spouse
C. The client refuses medication
D. The nurse documents objectively
Correct: B
Countertransference = the nurse's emotional reaction to the client based on the nurse's
own history. Transference is the client's reaction toward the nurse.
,7. A client is prescribed haloperidol. Which extrapyramidal symptom is irreversible?
A. Akathisia
B. Dystonia
C. Tardive dyskinesia
D. Pseudoparkinsonism
Correct: C
Tardive dyskinesia (involuntary facial/oral movements) may be irreversible. The others are
typically reversible with treatment.
8. SATA — Which findings suggest neuroleptic malignant syndrome (NMS)? (Select all that
apply.)
A. High fever
B. Muscle rigidity
C. Bradycardia
D. Altered mental status
E. Elevated CK
Correct: A, B, D, E
NMS = fever, rigidity, autonomic instability (tachycardia, not bradycardia), altered LOC,
elevated CK. It's a medical emergency.
9. A nurse is teaching a client about SSRIs. Which statement indicates understanding?
A. "I can stop it once I feel better."
B. "It may take 2–4 weeks to feel the full effect."
C. "I should take it with St. John's wort."
D. "I can drink alcohol freely."
Correct: B
SSRIs take 2–4 weeks for full effect; must be tapered, not stopped abruptly. St. John's wort
increases serotonin syndrome risk; alcohol worsens depression.
10. Which lab value must be monitored for a client on lithium?
A. CBC
B. Lithium level and TSH/renal function
, C. INR
D. HbA1c
Correct: B
Therapeutic lithium range is 0.6–1.2 mEq/L. Monitor thyroid and renal function due to
toxicity risks.
11. A client on lithium reports coarse hand tremor, vomiting, and ataxia. What is the priority
action?
A. Give the next dose
B. Hold the dose and notify the provider
C. Encourage fluids
D. Reassure the client
Correct: B
These are signs of lithium toxicity (level usually >1.5). Hold the drug and notify the provider
immediately.
12. SATA — Which are positive symptoms of schizophrenia? (Select all that apply.)
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
E. Avolition
Correct: A, B, D
Positive symptoms = added experiences (hallucinations, delusions, disorganized speech).
Negative symptoms = deficits (flat affect, avolition, anhedonia).
13. A client with schizophrenia says, "The TV is talking about me." This is:
A. Hallucination
B. Delusion of reference
C. Thought broadcasting
D. Loose association
