ATI PN MENTAL HEALTH PROCTORED
EXAM_2022/2023 | PN MENTAL HEALTH
PROCTORED EXAM_Graded A
SECTION I — FOUNDATIONS OF MENTAL HEALTH NURSING & THERAPEUTIC COMMUNICATION
(Q1–15)
1. A nurse is caring for a client who says, "I just can't take this anymore. Nobody would even
notice if I were gone." Which of the following is the nurse's priority action?
A. Reassure the client that everything will be fine.
B. Ask the client directly whether they are thinking about harming themselves.
C. Change the subject to a less distressing topic.
D. Document the statement and continue with the morning assessment.
B. Asking directly about suicidal ideation is the priority.
Direct, nonjudgmental questioning about self-harm does not "plant" the idea; it is the
essential first step in assessing risk and keeping the client safe. Reassurance (A) minimizes
feelings, changing the subject (C) blocks communication, and delayed documentation without
intervention (D) is unsafe.
2. Which of the following statements by the nurse demonstrates the therapeutic
communication technique of reflection?
A. "You feel angry because your mother canceled the visit."
B. "Everything will work out; try not to worry."
C. "Why did you do that?"
D. "Let's talk about something happier."
A. Reflection restates the client's feelings back to them.
Reflection mirrors the client's expressed emotion so they can explore it further. B is false
reassurance, C is a "why" question that implies judgment, and D is changing the subject — all
nontherapeutic.
,3. A client with severe anxiety is pacing, wringing their hands, and cannot sit still. Which
statement by the nurse is most appropriate?
A. "Sit down and tell me exactly what's bothering you."
B. "You're safe here. I'll stay with you while we walk to a quiet room."
C. "You need to calm down right now."
D. "Let's review your discharge plan."
B. A short, simple, present-focused statement with presence is appropriate for severe
anxiety.
Clients with severe anxiety cannot process complex information or problem-solve. The
nurse should stay with them, use short simple sentences, and reduce stimuli. A and D require
concentration the client does not yet have; C is a demand that increases anxiety.
4. Which of the following is an example of a nontherapeutic communication technique?
A. Offering self
B. Giving false reassurance
C. Restating
D. Clarifying
B. False reassurance is nontherapeutic.
False reassurance ("It'll be fine") discounts the client's feelings and can damage trust.
Offering self, restating, and clarifying are all therapeutic techniques.
5. A nurse is establishing a therapeutic relationship with a newly admitted client. Which
phase is characterized by the nurse and client identifying goals and formulating a plan of
action?
A. Preinteraction phase
B. Orientation phase
C. Working phase
D. Termination phase
C. The working phase is when goals are implemented.
During the working phase, the nurse and client explore problems, promote insight, and
implement the plan. The orientation phase establishes trust and the contract; the termination
phase summarizes progress and ends the relationship.
,6. A client tells the nurse, "I'm a failure. I can't do anything right." Which response uses the
therapeutic technique of presenting reality?
A. "You're not a failure; you've done many things well."
B. "I find it hard to believe you've never done anything right."
C. "Tell me more about why you feel that way."
D. "Let's focus on your successes instead."
B. Presenting reality gently challenges a distorted belief without arguing.
Presenting reality helps the client distinguish actual events from distorted perceptions while
preserving self-esteem. A dismisses the feeling, C explores but does not address the distortion,
and D deflects.
7. Which of the following best describes the nurse's role in a therapeutic relationship?
A. The nurse solves the client's problems for them.
B. The nurse and client are equal friends.
C. The nurse uses the relationship to promote the client's growth and coping.
D. The nurse shares personal problems to build rapport.
C. The therapeutic relationship is goal-directed and client-centered.
The nurse's purpose is to promote the client's insight, growth, and adaptive coping. Solving
problems for the client (A) fosters dependence, friendship (B) blurs boundaries, and self-
disclosure of personal problems (D) is inappropriate.
8. A nurse is caring for a client who speaks a different language than the nurse. Which action
is most appropriate when an interpreter is needed?
A. Ask the client's family member to interpret.
B. Use a trained medical interpreter.
C. Speak loudly and slowly in English.
D. Use gestures and pictures only.
B. A trained medical interpreter protects accuracy and confidentiality.
Family members may mistranslate, filter information, or breach confidentiality. Speaking
loudly (C) does not improve comprehension, and gestures alone (D) are inadequate for clinical
communication.
, 9. Which of the following is an example of a boundary violation in the nurse–client
relationship?
A. Maintaining professional appearance
B. Accepting a small gift of gratitude after discharge
C. Sharing the nurse's personal phone number with the client
D. Documenting the client's statements accurately
C. Sharing personal contact information crosses professional boundaries.
Boundary violations include role reversal, secrecy, excessive self-disclosure, and personal
contact outside the therapeutic setting. A, B (when agency policy allows and it is not
manipulative), and D are appropriate.
10. A client is admitted involuntarily. Which statement by the nurse is accurate regarding
client rights?
A. "You lose all your rights when you're admitted involuntarily."
B. "You retain the right to be treated with dignity and to receive information about your care."
C. "You cannot refuse any medication."
D. "You may not contact anyone outside the facility."
B. Involuntary admission does not remove basic rights.
Clients retain rights to dignity, information, privacy, and (in most jurisdictions) to refuse
treatment except in specific emergency situations. A, C, and D are false.
11. Which communication technique encourages the client to continue talking without
directing the conversation?
A. Giving advice
B. Using silence and open-ended questions
C. Asking "why" questions
D. Making value judgments
B. Silence and open-ended questions facilitate client-led expression.
Open-ended questions and silence encourage the client to explore thoughts and feelings.
Advice, "why" questions, and value judgments are nontherapeutic and can increase
defensiveness.
EXAM_2022/2023 | PN MENTAL HEALTH
PROCTORED EXAM_Graded A
SECTION I — FOUNDATIONS OF MENTAL HEALTH NURSING & THERAPEUTIC COMMUNICATION
(Q1–15)
1. A nurse is caring for a client who says, "I just can't take this anymore. Nobody would even
notice if I were gone." Which of the following is the nurse's priority action?
A. Reassure the client that everything will be fine.
B. Ask the client directly whether they are thinking about harming themselves.
C. Change the subject to a less distressing topic.
D. Document the statement and continue with the morning assessment.
B. Asking directly about suicidal ideation is the priority.
Direct, nonjudgmental questioning about self-harm does not "plant" the idea; it is the
essential first step in assessing risk and keeping the client safe. Reassurance (A) minimizes
feelings, changing the subject (C) blocks communication, and delayed documentation without
intervention (D) is unsafe.
2. Which of the following statements by the nurse demonstrates the therapeutic
communication technique of reflection?
A. "You feel angry because your mother canceled the visit."
B. "Everything will work out; try not to worry."
C. "Why did you do that?"
D. "Let's talk about something happier."
A. Reflection restates the client's feelings back to them.
Reflection mirrors the client's expressed emotion so they can explore it further. B is false
reassurance, C is a "why" question that implies judgment, and D is changing the subject — all
nontherapeutic.
,3. A client with severe anxiety is pacing, wringing their hands, and cannot sit still. Which
statement by the nurse is most appropriate?
A. "Sit down and tell me exactly what's bothering you."
B. "You're safe here. I'll stay with you while we walk to a quiet room."
C. "You need to calm down right now."
D. "Let's review your discharge plan."
B. A short, simple, present-focused statement with presence is appropriate for severe
anxiety.
Clients with severe anxiety cannot process complex information or problem-solve. The
nurse should stay with them, use short simple sentences, and reduce stimuli. A and D require
concentration the client does not yet have; C is a demand that increases anxiety.
4. Which of the following is an example of a nontherapeutic communication technique?
A. Offering self
B. Giving false reassurance
C. Restating
D. Clarifying
B. False reassurance is nontherapeutic.
False reassurance ("It'll be fine") discounts the client's feelings and can damage trust.
Offering self, restating, and clarifying are all therapeutic techniques.
5. A nurse is establishing a therapeutic relationship with a newly admitted client. Which
phase is characterized by the nurse and client identifying goals and formulating a plan of
action?
A. Preinteraction phase
B. Orientation phase
C. Working phase
D. Termination phase
C. The working phase is when goals are implemented.
During the working phase, the nurse and client explore problems, promote insight, and
implement the plan. The orientation phase establishes trust and the contract; the termination
phase summarizes progress and ends the relationship.
,6. A client tells the nurse, "I'm a failure. I can't do anything right." Which response uses the
therapeutic technique of presenting reality?
A. "You're not a failure; you've done many things well."
B. "I find it hard to believe you've never done anything right."
C. "Tell me more about why you feel that way."
D. "Let's focus on your successes instead."
B. Presenting reality gently challenges a distorted belief without arguing.
Presenting reality helps the client distinguish actual events from distorted perceptions while
preserving self-esteem. A dismisses the feeling, C explores but does not address the distortion,
and D deflects.
7. Which of the following best describes the nurse's role in a therapeutic relationship?
A. The nurse solves the client's problems for them.
B. The nurse and client are equal friends.
C. The nurse uses the relationship to promote the client's growth and coping.
D. The nurse shares personal problems to build rapport.
C. The therapeutic relationship is goal-directed and client-centered.
The nurse's purpose is to promote the client's insight, growth, and adaptive coping. Solving
problems for the client (A) fosters dependence, friendship (B) blurs boundaries, and self-
disclosure of personal problems (D) is inappropriate.
8. A nurse is caring for a client who speaks a different language than the nurse. Which action
is most appropriate when an interpreter is needed?
A. Ask the client's family member to interpret.
B. Use a trained medical interpreter.
C. Speak loudly and slowly in English.
D. Use gestures and pictures only.
B. A trained medical interpreter protects accuracy and confidentiality.
Family members may mistranslate, filter information, or breach confidentiality. Speaking
loudly (C) does not improve comprehension, and gestures alone (D) are inadequate for clinical
communication.
, 9. Which of the following is an example of a boundary violation in the nurse–client
relationship?
A. Maintaining professional appearance
B. Accepting a small gift of gratitude after discharge
C. Sharing the nurse's personal phone number with the client
D. Documenting the client's statements accurately
C. Sharing personal contact information crosses professional boundaries.
Boundary violations include role reversal, secrecy, excessive self-disclosure, and personal
contact outside the therapeutic setting. A, B (when agency policy allows and it is not
manipulative), and D are appropriate.
10. A client is admitted involuntarily. Which statement by the nurse is accurate regarding
client rights?
A. "You lose all your rights when you're admitted involuntarily."
B. "You retain the right to be treated with dignity and to receive information about your care."
C. "You cannot refuse any medication."
D. "You may not contact anyone outside the facility."
B. Involuntary admission does not remove basic rights.
Clients retain rights to dignity, information, privacy, and (in most jurisdictions) to refuse
treatment except in specific emergency situations. A, C, and D are false.
11. Which communication technique encourages the client to continue talking without
directing the conversation?
A. Giving advice
B. Using silence and open-ended questions
C. Asking "why" questions
D. Making value judgments
B. Silence and open-ended questions facilitate client-led expression.
Open-ended questions and silence encourage the client to explore thoughts and feelings.
Advice, "why" questions, and value judgments are nontherapeutic and can increase
defensiveness.
