ATI PN Mental Health CMS: Question
Section 1: Foundations of Psychiatric Nursing & Therapeutic
Communication (Q1–Q15)
Q1. A nurse is caring for a patient who states, "I just don't want to live
anymore. Nothing matters." The nurse sits down, makes eye contact,
and remains silent for a moment before responding. Which
therapeutic communication technique is the nurse demonstrating by
using silence?
A. Offering self to encourage the patient to continue when ready
B. Broad opening to initiate conversation
C. Active listening through nonverbal presence and allowing the patient
time to process and respond
D. Focusing to direct the conversation
Answer: C
Rationale: Silence is a therapeutic communication technique that
demonstrates active listening and allows the patient time to collect thoughts
and process emotions. ATI PN Mental Health emphasizes that silence is
particularly valuable when a patient is experiencing strong emotions or
disclosing difficult information. Offering self involves the nurse's presence
and availability but is verbalized ("I'll sit with you"). Broad openings invite
the patient to set the direction. Focusing redirects a wandering
conversation.
Q2. A patient tells the nurse, "I'm a terrible mother. My children would
be better off without me." Which response by the nurse demonstrates
the therapeutic technique of exploring?
A. "Don't say that. You're a good mother."
B. "Tell me more about what makes you feel that way."
C. "Why do you think your children would be better off?"
D. "I'm sure your children love you very much."
Answer: B
Rationale: Exploring ("Tell me more...") encourages the patient to
,elaborate on feelings and thoughts, facilitating deeper assessment of
suicide risk. ATI PN guidelines emphasize open-ended, exploratory
statements when patients express suicidal ideation. Option A is false
reassurance/disapproval; Option C uses "why," which can feel judgmental;
Option D is false reassurance.
Q3. A patient says to the nurse, "My doctor doesn't care about me. He
never has time to listen." The nurse responds, "You feel your doctor
doesn't listen to you." Which therapeutic communication technique is
the nurse using?
A. Restating
B. Reflecting
C. Clarifying
D. Summarizing
Answer: B
Rationale: Reflecting involves restating the patient's feelings and thoughts
to show understanding and encourage further discussion. Restating
involves repeating the main idea using the patient's own words. Clarifying
seeks to understand the message more fully. Summarizing reviews the
main points of the conversation.
Q4. A nurse is caring for a patient who was voluntarily admitted for
major depressive disorder. The patient approaches the nurse and
states, "I want to leave the hospital immediately. I don't need to be
here anymore." Which of the following actions should the nurse take
first?
A. Place the patient on one-to-one observation
B. Notify the healthcare provider of the patient's request
C. Inform the patient of their right to request discharge and explain the
process
D. Administer PRN anxiolytic medication to reduce agitation
,Answer: C
Rationale: Voluntarily admitted patients have the legal right to request
discharge against medical advice (AMA). The nurse's first action is to
inform the patient of this right and explain the process, which typically
involves the provider evaluating the patient for continued danger to self or
others. One-to-one observation is implemented if the patient is at
immediate risk; PRN medication is not the priority.
Q5. A nurse is assessing a patient who has been diagnosed with
schizophrenia. The patient states, "The CIA is watching me through
the television." Which symptom is the patient experiencing?
A. Hallucination
B. Delusion of persecution
C. Negative symptom
D. Catatonia
Answer: B
Rationale: Delusions of persecution involve false beliefs that one is being
targeted or harmed. Hallucinations involve sensory perceptions that are not
real. Negative symptoms include flat affect, apathy, and social withdrawal.
Catatonia involves immobility, mutism, and rigidity.
Q6. A nurse is caring for a patient with schizophrenia who is
experiencing auditory hallucinations. Which response by the nurse is
appropriate?
A. "I don't hear voices, but I believe you do."
B. "You're imagining things."
C. "Stop talking about the voices."
D. "The voices aren't real."
Answer: A
Rationale: Acknowledging the patient's experience without reinforcing the
hallucination is therapeutic. Arguing or dismissing the hallucination is
nontherapeutic and can damage the therapeutic relationship.
, Q7. A nurse is using therapeutic communication. Which technique is
appropriate?
A. Giving advice
B. Offering self
C. Changing the subject
D. False reassurance
Answer: B
Rationale: "Offering self" (e.g., "I'll stay with you") is therapeutic. Giving
advice and false reassurance are nontherapeutic.
Q8. Which is an example of a nontherapeutic communication
technique?
A. Silence
B. Reflecting
C. Asking "why" questions
D. Clarifying
Answer: C
Rationale: "Why" questions can feel accusatory and increase
defensiveness. Therapeutic techniques include silence, reflection, and
clarification.
Q9. A client is crying. Which response by the nurse is therapeutic?
A. "Don't cry."
B. "You seem upset. Would you like to talk about it?"
C. "It's not that bad."
D. "Let's talk about something else."
Answer: B
Rationale: Acknowledging the client's emotion and offering to talk is
therapeutic. Dismissing or redirecting is nontherapeutic.
Section 1: Foundations of Psychiatric Nursing & Therapeutic
Communication (Q1–Q15)
Q1. A nurse is caring for a patient who states, "I just don't want to live
anymore. Nothing matters." The nurse sits down, makes eye contact,
and remains silent for a moment before responding. Which
therapeutic communication technique is the nurse demonstrating by
using silence?
A. Offering self to encourage the patient to continue when ready
B. Broad opening to initiate conversation
C. Active listening through nonverbal presence and allowing the patient
time to process and respond
D. Focusing to direct the conversation
Answer: C
Rationale: Silence is a therapeutic communication technique that
demonstrates active listening and allows the patient time to collect thoughts
and process emotions. ATI PN Mental Health emphasizes that silence is
particularly valuable when a patient is experiencing strong emotions or
disclosing difficult information. Offering self involves the nurse's presence
and availability but is verbalized ("I'll sit with you"). Broad openings invite
the patient to set the direction. Focusing redirects a wandering
conversation.
Q2. A patient tells the nurse, "I'm a terrible mother. My children would
be better off without me." Which response by the nurse demonstrates
the therapeutic technique of exploring?
A. "Don't say that. You're a good mother."
B. "Tell me more about what makes you feel that way."
C. "Why do you think your children would be better off?"
D. "I'm sure your children love you very much."
Answer: B
Rationale: Exploring ("Tell me more...") encourages the patient to
,elaborate on feelings and thoughts, facilitating deeper assessment of
suicide risk. ATI PN guidelines emphasize open-ended, exploratory
statements when patients express suicidal ideation. Option A is false
reassurance/disapproval; Option C uses "why," which can feel judgmental;
Option D is false reassurance.
Q3. A patient says to the nurse, "My doctor doesn't care about me. He
never has time to listen." The nurse responds, "You feel your doctor
doesn't listen to you." Which therapeutic communication technique is
the nurse using?
A. Restating
B. Reflecting
C. Clarifying
D. Summarizing
Answer: B
Rationale: Reflecting involves restating the patient's feelings and thoughts
to show understanding and encourage further discussion. Restating
involves repeating the main idea using the patient's own words. Clarifying
seeks to understand the message more fully. Summarizing reviews the
main points of the conversation.
Q4. A nurse is caring for a patient who was voluntarily admitted for
major depressive disorder. The patient approaches the nurse and
states, "I want to leave the hospital immediately. I don't need to be
here anymore." Which of the following actions should the nurse take
first?
A. Place the patient on one-to-one observation
B. Notify the healthcare provider of the patient's request
C. Inform the patient of their right to request discharge and explain the
process
D. Administer PRN anxiolytic medication to reduce agitation
,Answer: C
Rationale: Voluntarily admitted patients have the legal right to request
discharge against medical advice (AMA). The nurse's first action is to
inform the patient of this right and explain the process, which typically
involves the provider evaluating the patient for continued danger to self or
others. One-to-one observation is implemented if the patient is at
immediate risk; PRN medication is not the priority.
Q5. A nurse is assessing a patient who has been diagnosed with
schizophrenia. The patient states, "The CIA is watching me through
the television." Which symptom is the patient experiencing?
A. Hallucination
B. Delusion of persecution
C. Negative symptom
D. Catatonia
Answer: B
Rationale: Delusions of persecution involve false beliefs that one is being
targeted or harmed. Hallucinations involve sensory perceptions that are not
real. Negative symptoms include flat affect, apathy, and social withdrawal.
Catatonia involves immobility, mutism, and rigidity.
Q6. A nurse is caring for a patient with schizophrenia who is
experiencing auditory hallucinations. Which response by the nurse is
appropriate?
A. "I don't hear voices, but I believe you do."
B. "You're imagining things."
C. "Stop talking about the voices."
D. "The voices aren't real."
Answer: A
Rationale: Acknowledging the patient's experience without reinforcing the
hallucination is therapeutic. Arguing or dismissing the hallucination is
nontherapeutic and can damage the therapeutic relationship.
, Q7. A nurse is using therapeutic communication. Which technique is
appropriate?
A. Giving advice
B. Offering self
C. Changing the subject
D. False reassurance
Answer: B
Rationale: "Offering self" (e.g., "I'll stay with you") is therapeutic. Giving
advice and false reassurance are nontherapeutic.
Q8. Which is an example of a nontherapeutic communication
technique?
A. Silence
B. Reflecting
C. Asking "why" questions
D. Clarifying
Answer: C
Rationale: "Why" questions can feel accusatory and increase
defensiveness. Therapeutic techniques include silence, reflection, and
clarification.
Q9. A client is crying. Which response by the nurse is therapeutic?
A. "Don't cry."
B. "You seem upset. Would you like to talk about it?"
C. "It's not that bad."
D. "Let's talk about something else."
Answer: B
Rationale: Acknowledging the client's emotion and offering to talk is
therapeutic. Dismissing or redirecting is nontherapeutic.
