ATI MENTAL HEALTH B 2019 PROCTORED
EXAM 70 QUESTIONS WITH ANSWERS
HIGHLITED
Section 1: Foundations of Mental Health Nursing
1. A nurse is using the DSM-5 to diagnose a client. Which statement best describes the
purpose of the DSM-5?
A. It provides a framework for psychiatric nursing interventions
B. It identifies expected outcomes for mental health treatment
C. It provides criteria for diagnosing and classifying mental disorders
D. It determines reimbursement for psychiatric care
The DSM-5 is the standard classification system used by providers to diagnose mental
disorders based on specific criteria. It is not a nursing intervention guide, outcome tool, or
reimbursement system.
2. Which theorist is associated with the hierarchy of needs?
A. Sigmund Freud
B. Erik Erikson
C. Abraham Maslow
D. Jean Piaget
Maslow developed the hierarchy of needs, prioritizing physiologic needs before higher-level
psychological needs. Freud = psychoanalysis; Erikson = psychosocial development; Piaget =
cognitive development.
3. A nurse is assessing a client using Erikson's stages. A 45-year-old client expresses regret
over not having children or mentoring others. Which stage is the client struggling with?
A. Intimacy vs. isolation
B. Generativity vs. stagnation
C. Integrity vs. despair
D. Identity vs. role confusion
, Generativity vs. stagnation (middle adulthood) involves contributing to society and guiding
the next generation. Regret over not mentoring or parenting reflects stagnation.
4. Which neurotransmitter is most associated with schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
The dopamine hypothesis suggests excess dopamine activity (particularly in mesolimbic
pathways) contributes to positive symptoms of schizophrenia.
5. A nurse is performing a mental status exam. Which finding should be documented under
"affect"?
A. "Client states, 'I feel sad today.'"
B. "Client is oriented to person, place, and time."
C. "Client's facial expression is flat and does not change."
D. "Client reports auditory hallucinations."
Affect refers to the observable expression of emotion. Flat affect is an objective finding.
Mood is the client's subjective report.
6. Which is an example of a positive symptom of schizophrenia?
A. Avolition
B. Anhedonia
C. Hallucinations
D. Alogia
Positive symptoms are added experiences (hallucinations, delusions, disorganized speech).
Negative symptoms are deficits (avolition, anhedonia, alogia, flat affect).
7. A nurse is assessing a client's judgment. Which question best evaluates judgment?
A. "Can you tell me today's date?"
B. "What does 'a rolling stone gathers no moss' mean?"
,C. "What would you do if you found a wallet on the street?"
D. "Can you count backward from 100 by 7s?"
Judgment is assessed by asking about problem-solving in real-life situations. Date =
orientation; proverb = abstraction; serial 7s = concentration.
8. Which defense mechanism is a client using who blames a spouse for their own drinking
problem?
A. Sublimation
B. Projection
C. Reaction formation
D. Displacement
Projection involves attributing one's own unacceptable feelings or behaviors to others. The
client denies responsibility by blaming the spouse.
9. A nurse is caring for a client on an inpatient unit. Which action demonstrates the nurse's
role as an advocate?
A. Administering PRN medications as ordered
B. Ensuring the client's right to refuse treatment is respected
C. Documenting client behavior every 15 minutes
D. Leading a group therapy session
Advocacy involves protecting client rights, including the right to refuse treatment (when
competent). Other options are provider or educator roles.
10. Which factor places a client at highest risk for developing a mental illness?
A. Occasional stress at work
B. A first-degree relative with schizophrenia
C. Living in a suburban area
D. Having a supportive family
Genetic predisposition (family history) is a major risk factor. Social support and mild stress
are protective or neutral.
, 11. A nurse is teaching about neurotransmitters. Which neurotransmitter is associated with
mood regulation and is targeted by SSRIs?
A. Dopamine
B. Serotonin
C. Norepinephrine
D. Glutamate
SSRIs block serotonin reuptake, increasing serotonin availability. Serotonin regulates mood,
sleep, appetite, and anxiety.
12. A client says, "I can't go to group today; I'm too anxious." What is the nurse's best
response?
A. "You have to attend; it's unit policy."
B. "Why are you anxious?"
C. "I'll walk with you to group and stay nearby for a few minutes."
D. "You can skip it today; maybe tomorrow."
Offering support and gradual exposure reduces anxiety without reinforcing avoidance.
"Why" questions and forcing attendance increase anxiety; allowing avoidance reinforces it.
13. Which statement about the nurse-client relationship is accurate?
A. It is a social relationship.
B. It is goal-directed and time-limited.
C. It focuses primarily on the nurse's needs.
D. It continues indefinitely after discharge.
The therapeutic relationship is goal-directed, client-centered, and time-limited with
professional boundaries.
14. A nurse is documenting a client's speech as "pressured." Which description matches this
finding?
A. Slow, deliberate speech
B. Rapid, urgent speech that is difficult to interrupt
C. Speech with made-up words
D. Speech that jumps between unrelated topics
EXAM 70 QUESTIONS WITH ANSWERS
HIGHLITED
Section 1: Foundations of Mental Health Nursing
1. A nurse is using the DSM-5 to diagnose a client. Which statement best describes the
purpose of the DSM-5?
A. It provides a framework for psychiatric nursing interventions
B. It identifies expected outcomes for mental health treatment
C. It provides criteria for diagnosing and classifying mental disorders
D. It determines reimbursement for psychiatric care
The DSM-5 is the standard classification system used by providers to diagnose mental
disorders based on specific criteria. It is not a nursing intervention guide, outcome tool, or
reimbursement system.
2. Which theorist is associated with the hierarchy of needs?
A. Sigmund Freud
B. Erik Erikson
C. Abraham Maslow
D. Jean Piaget
Maslow developed the hierarchy of needs, prioritizing physiologic needs before higher-level
psychological needs. Freud = psychoanalysis; Erikson = psychosocial development; Piaget =
cognitive development.
3. A nurse is assessing a client using Erikson's stages. A 45-year-old client expresses regret
over not having children or mentoring others. Which stage is the client struggling with?
A. Intimacy vs. isolation
B. Generativity vs. stagnation
C. Integrity vs. despair
D. Identity vs. role confusion
, Generativity vs. stagnation (middle adulthood) involves contributing to society and guiding
the next generation. Regret over not mentoring or parenting reflects stagnation.
4. Which neurotransmitter is most associated with schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
The dopamine hypothesis suggests excess dopamine activity (particularly in mesolimbic
pathways) contributes to positive symptoms of schizophrenia.
5. A nurse is performing a mental status exam. Which finding should be documented under
"affect"?
A. "Client states, 'I feel sad today.'"
B. "Client is oriented to person, place, and time."
C. "Client's facial expression is flat and does not change."
D. "Client reports auditory hallucinations."
Affect refers to the observable expression of emotion. Flat affect is an objective finding.
Mood is the client's subjective report.
6. Which is an example of a positive symptom of schizophrenia?
A. Avolition
B. Anhedonia
C. Hallucinations
D. Alogia
Positive symptoms are added experiences (hallucinations, delusions, disorganized speech).
Negative symptoms are deficits (avolition, anhedonia, alogia, flat affect).
7. A nurse is assessing a client's judgment. Which question best evaluates judgment?
A. "Can you tell me today's date?"
B. "What does 'a rolling stone gathers no moss' mean?"
,C. "What would you do if you found a wallet on the street?"
D. "Can you count backward from 100 by 7s?"
Judgment is assessed by asking about problem-solving in real-life situations. Date =
orientation; proverb = abstraction; serial 7s = concentration.
8. Which defense mechanism is a client using who blames a spouse for their own drinking
problem?
A. Sublimation
B. Projection
C. Reaction formation
D. Displacement
Projection involves attributing one's own unacceptable feelings or behaviors to others. The
client denies responsibility by blaming the spouse.
9. A nurse is caring for a client on an inpatient unit. Which action demonstrates the nurse's
role as an advocate?
A. Administering PRN medications as ordered
B. Ensuring the client's right to refuse treatment is respected
C. Documenting client behavior every 15 minutes
D. Leading a group therapy session
Advocacy involves protecting client rights, including the right to refuse treatment (when
competent). Other options are provider or educator roles.
10. Which factor places a client at highest risk for developing a mental illness?
A. Occasional stress at work
B. A first-degree relative with schizophrenia
C. Living in a suburban area
D. Having a supportive family
Genetic predisposition (family history) is a major risk factor. Social support and mild stress
are protective or neutral.
, 11. A nurse is teaching about neurotransmitters. Which neurotransmitter is associated with
mood regulation and is targeted by SSRIs?
A. Dopamine
B. Serotonin
C. Norepinephrine
D. Glutamate
SSRIs block serotonin reuptake, increasing serotonin availability. Serotonin regulates mood,
sleep, appetite, and anxiety.
12. A client says, "I can't go to group today; I'm too anxious." What is the nurse's best
response?
A. "You have to attend; it's unit policy."
B. "Why are you anxious?"
C. "I'll walk with you to group and stay nearby for a few minutes."
D. "You can skip it today; maybe tomorrow."
Offering support and gradual exposure reduces anxiety without reinforcing avoidance.
"Why" questions and forcing attendance increase anxiety; allowing avoidance reinforces it.
13. Which statement about the nurse-client relationship is accurate?
A. It is a social relationship.
B. It is goal-directed and time-limited.
C. It focuses primarily on the nurse's needs.
D. It continues indefinitely after discharge.
The therapeutic relationship is goal-directed, client-centered, and time-limited with
professional boundaries.
14. A nurse is documenting a client's speech as "pressured." Which description matches this
finding?
A. Slow, deliberate speech
B. Rapid, urgent speech that is difficult to interrupt
C. Speech with made-up words
D. Speech that jumps between unrelated topics
