ATI MENTAL HEALTH EXAM 1 2019
PROCTORED - ATI REVISION QUESTIONS
and ANSWERS
SECTION I: THERAPEUTIC COMMUNICATION & NURSE-CLIENT RELATIONSHIP
Question 1
A nurse in an acute mental health facility is communicating with a client. The client states, "I
can't sleep. I stay up all night." The nurse responds, "You are having difficulty sleeping?" Which
therapeutic communication technique is the nurse demonstrating?
A. Offering general leads
B. Summarizing
C. Focusing
D. Restating
Correct Answer: D
Rationale: Restating allows the nurse to repeat the main idea expressed by the client,
demonstrating active listening and encouraging the client to elaborate . This technique shows
the nurse is paying attention and validates the client's experience. Offering general leads would
be a broad statement like "Go on." Summarizing would involve recapping multiple points.
Focusing would direct the conversation to a specific topic.
Question 2
A nurse is communicating with a client who was just admitted for treatment of a substance use
disorder. Which communication technique should the nurse identify as a barrier to therapeutic
communication?
A. Offering advice
B. Reflecting
C. Listening attentively
D. Giving information
Correct Answer: A
, Rationale: Offering advice interferes with the client's ability to make personal decisions and
choices . The therapeutic relationship should empower clients to find their own solutions.
Reflecting, listening attentively, and giving information are therapeutic techniques that facilitate
client growth and self-discovery.
Question 3
A client tells a student nurse, "Don't tell anyone, but I hid a sharp knife under my mattress in
order to protect myself from my roommate, who is always yelling at me and threatening me."
Which of the following actions should the nurse take?
A. Keep the client's communication confidential, but talk to the client daily using therapeutic
communication to convince him to admit to holding the knife.
B. Keep the client's communication confidential, but watch the client and his roommate closely.
C. Tell the client that this must be reported to health care staff because it concerns the health
and safety of the client and others.
D. Report the incident, but do not inform the client of the intention to do so.
Correct Answer: C
Rationale: The information cannot be kept confidential and the client must be informed
that this will be reported to the health care staff . The nurse has a duty to warn and protect
when a client poses a threat to self or others. Client confidentiality is limited when there is a
safety concern. The nurse must be honest with the client about the obligation to report.
Question 4
A nurse is establishing a therapeutic relationship with a patient who has major depressive
disorder. Which action demonstrates the principle of genuineness?
A. Using a standardized greeting for all patients
B. Responding authentically and congruently while maintaining professional boundaries
C. Agreeing with the patient's negative self-statements to build rapport
D. Avoiding self-disclosure of any kind to maintain objectivity
Correct Answer: B
Rationale: Genuineness involves being real, honest, and authentic . The nurse's responses
should match their feelings. Superficial or formulaic responses are not genuine. Agreeing with
,negative statements reinforces distortions and is nontherapeutic. Avoiding all self-disclosure is
not required for genuineness and may make the nurse appear distant.
Question 5
A patient with borderline personality disorder tells the nurse, "You're the only one who
understands me; the other nurses don't care." Which is the nurse's most therapeutic response?
A. "Thank you. I'm glad we have a connection."
B. "It must feel lonely when you think others don't care. The treatment team works together to
support you."
C. "You're right, the night nurse is often busy."
D. "I'll make sure you only work with me."
Correct Answer: B
Rationale: This response avoids reinforcing splitting (idealizing one staff, devaluing others) .
It validates the patient's feeling while redirecting to the team approach. Taking sides or
promising exclusive attention would worsen splitting. Thanking the client for the compliment
reinforces the idealization without addressing the underlying distortion.
Question 6
During a client's initial interview in a mental health inpatient setting, a nurse identifies that the
client is maintaining eye contact and leaning forward. Which assumption should the nurse make
based on the client's nonverbal behaviors?
A. The client is interested in what the nurse is saying.
B. The client is attempting to manipulate the nurse.
C. The client is physically attracted to the nurse.
D. The client needs to feel accepted by the nurse.
Correct Answer: A
Rationale: The client's posture and eye contact demonstrate interest in the interview and
what the nurse is saying . Nonverbal behaviors provide important cues about client engagement
and should be interpreted objectively. Assuming manipulation or attraction is making an
unwarranted leap based solely on posture.
, Question 7
A charge nurse is discussing the characteristics of a nurse-client relationship with a newly
licensed nurse. Which of the following characteristics should the nurse include in the
discussion? (Select all that apply.)
A. The needs of both participants are met.
B. An emotional commitment exists between the participants.
C. It is goal-directed.
D. Behavioral change is encouraged.
E. A termination date is established.
Correct Answers: C, D, E
Rationale: A therapeutic nurse-client relationship is goal-directed, encourages behavioral
change, and has a termination date . The relationship is client-centered—the needs of the client
are the focus, not the nurse's needs. An emotional commitment exists in social or intimate
relationships, not in a professional therapeutic relationship.
Question 8
A nurse is in the working phase of a therapeutic relationship with a client who has
methamphetamine use disorder. Which of the following actions indicates transference
behavior?
A. The client asks the nurse whether she will go out to dinner with him.
B. The client accuses the nurse of telling him what to do just like his ex-girlfriend.
C. The client reminds the nurse of a friend who died from a substance overdose.
D. The client becomes angry and threatens to harm himself.
Correct Answer: B
Rationale: Transference occurs when the client unconsciously displaces feelings about a
person from the past onto the nurse . The client accusing the nurse of behaving like his ex-
girlfriend is an example of transference. Option C describes countertransference (the nurse's
feelings toward the client). Option A is testing boundaries, not transference.
Question 9
PROCTORED - ATI REVISION QUESTIONS
and ANSWERS
SECTION I: THERAPEUTIC COMMUNICATION & NURSE-CLIENT RELATIONSHIP
Question 1
A nurse in an acute mental health facility is communicating with a client. The client states, "I
can't sleep. I stay up all night." The nurse responds, "You are having difficulty sleeping?" Which
therapeutic communication technique is the nurse demonstrating?
A. Offering general leads
B. Summarizing
C. Focusing
D. Restating
Correct Answer: D
Rationale: Restating allows the nurse to repeat the main idea expressed by the client,
demonstrating active listening and encouraging the client to elaborate . This technique shows
the nurse is paying attention and validates the client's experience. Offering general leads would
be a broad statement like "Go on." Summarizing would involve recapping multiple points.
Focusing would direct the conversation to a specific topic.
Question 2
A nurse is communicating with a client who was just admitted for treatment of a substance use
disorder. Which communication technique should the nurse identify as a barrier to therapeutic
communication?
A. Offering advice
B. Reflecting
C. Listening attentively
D. Giving information
Correct Answer: A
, Rationale: Offering advice interferes with the client's ability to make personal decisions and
choices . The therapeutic relationship should empower clients to find their own solutions.
Reflecting, listening attentively, and giving information are therapeutic techniques that facilitate
client growth and self-discovery.
Question 3
A client tells a student nurse, "Don't tell anyone, but I hid a sharp knife under my mattress in
order to protect myself from my roommate, who is always yelling at me and threatening me."
Which of the following actions should the nurse take?
A. Keep the client's communication confidential, but talk to the client daily using therapeutic
communication to convince him to admit to holding the knife.
B. Keep the client's communication confidential, but watch the client and his roommate closely.
C. Tell the client that this must be reported to health care staff because it concerns the health
and safety of the client and others.
D. Report the incident, but do not inform the client of the intention to do so.
Correct Answer: C
Rationale: The information cannot be kept confidential and the client must be informed
that this will be reported to the health care staff . The nurse has a duty to warn and protect
when a client poses a threat to self or others. Client confidentiality is limited when there is a
safety concern. The nurse must be honest with the client about the obligation to report.
Question 4
A nurse is establishing a therapeutic relationship with a patient who has major depressive
disorder. Which action demonstrates the principle of genuineness?
A. Using a standardized greeting for all patients
B. Responding authentically and congruently while maintaining professional boundaries
C. Agreeing with the patient's negative self-statements to build rapport
D. Avoiding self-disclosure of any kind to maintain objectivity
Correct Answer: B
Rationale: Genuineness involves being real, honest, and authentic . The nurse's responses
should match their feelings. Superficial or formulaic responses are not genuine. Agreeing with
,negative statements reinforces distortions and is nontherapeutic. Avoiding all self-disclosure is
not required for genuineness and may make the nurse appear distant.
Question 5
A patient with borderline personality disorder tells the nurse, "You're the only one who
understands me; the other nurses don't care." Which is the nurse's most therapeutic response?
A. "Thank you. I'm glad we have a connection."
B. "It must feel lonely when you think others don't care. The treatment team works together to
support you."
C. "You're right, the night nurse is often busy."
D. "I'll make sure you only work with me."
Correct Answer: B
Rationale: This response avoids reinforcing splitting (idealizing one staff, devaluing others) .
It validates the patient's feeling while redirecting to the team approach. Taking sides or
promising exclusive attention would worsen splitting. Thanking the client for the compliment
reinforces the idealization without addressing the underlying distortion.
Question 6
During a client's initial interview in a mental health inpatient setting, a nurse identifies that the
client is maintaining eye contact and leaning forward. Which assumption should the nurse make
based on the client's nonverbal behaviors?
A. The client is interested in what the nurse is saying.
B. The client is attempting to manipulate the nurse.
C. The client is physically attracted to the nurse.
D. The client needs to feel accepted by the nurse.
Correct Answer: A
Rationale: The client's posture and eye contact demonstrate interest in the interview and
what the nurse is saying . Nonverbal behaviors provide important cues about client engagement
and should be interpreted objectively. Assuming manipulation or attraction is making an
unwarranted leap based solely on posture.
, Question 7
A charge nurse is discussing the characteristics of a nurse-client relationship with a newly
licensed nurse. Which of the following characteristics should the nurse include in the
discussion? (Select all that apply.)
A. The needs of both participants are met.
B. An emotional commitment exists between the participants.
C. It is goal-directed.
D. Behavioral change is encouraged.
E. A termination date is established.
Correct Answers: C, D, E
Rationale: A therapeutic nurse-client relationship is goal-directed, encourages behavioral
change, and has a termination date . The relationship is client-centered—the needs of the client
are the focus, not the nurse's needs. An emotional commitment exists in social or intimate
relationships, not in a professional therapeutic relationship.
Question 8
A nurse is in the working phase of a therapeutic relationship with a client who has
methamphetamine use disorder. Which of the following actions indicates transference
behavior?
A. The client asks the nurse whether she will go out to dinner with him.
B. The client accuses the nurse of telling him what to do just like his ex-girlfriend.
C. The client reminds the nurse of a friend who died from a substance overdose.
D. The client becomes angry and threatens to harm himself.
Correct Answer: B
Rationale: Transference occurs when the client unconsciously displaces feelings about a
person from the past onto the nurse . The client accusing the nurse of behaving like his ex-
girlfriend is an example of transference. Option C describes countertransference (the nurse's
feelings toward the client). Option A is testing boundaries, not transference.
Question 9
