ATI MENTAL HEALTH A 2019 PROCTORED
EXAM
SECTION I — FOUNDATIONS OF PSYCHIATRIC-MENTAL HEALTH NURSING
1. A nurse is assessing a client who reports feeling "overwhelmed and unable to cope" for the
past 3 weeks. Which of the following findings should the nurse identify as the priority?
A. The client reports sleeping 5 hours per night
B. The client states, "Everyone would be better off without me"
C. The client reports a 3-lb weight loss
D. The client reports difficulty concentrating at work
Correct Answer: B
Rationale: Priority assessment in mental health is always safety. A statement of being
"better off without me" is a passive suicidal ideation indicator and takes precedence over sleep,
weight, or concentration changes, which are important but not immediately life-threatening.
The nurse must complete a suicide risk assessment immediately.
2. Which of the following is the best definition of "milieu therapy"?
A. A form of insight-oriented psychotherapy conducted one-on-one
B. The use of the total environment as a therapeutic tool to promote client growth
C. A behavioral contract used to reduce self-harm
D. A structured group that focuses on medication education
Correct Answer: B
Rationale: Milieu therapy (therapeutic community) uses the physical and social
environment—structure, norms, safety, and interpersonal interactions—as the treatment
modality. It is not a single therapy technique or a medication group.
3. A nurse is admitting a client to an inpatient psychiatric unit. Which of the following actions
should the nurse take first?
A. Orient the client to unit rules and routines
B. Search the client's belongings for contraband
C. Obtain a suicide risk assessment and ensure safety
D. Introduce the client to other clients in the dayroom
, Correct Answer: C
Rationale: Safety is the first priority on admission. A suicide/risk assessment and removal of
dangerous items must occur before orientation, socialization, or routine education.
4. Which of the following statements by a nurse demonstrates an understanding of the "least
restrictive" principle?
A. "I will place the client in seclusion immediately if they refuse medication."
B. "I will use verbal de-escalation before considering physical restraints."
C. "I will restrict all visitors until the client behaves appropriately."
D. "I will keep the client in a locked room until they calm down."
Correct Answer: B
Rationale: Least restrictive intervention means using the mildest effective measure first.
Verbal de-escalation, environmental modification, and voluntary medication precede seclusion
or restraint, which require a provider order and strict monitoring.
5. A nurse is teaching a client about the purpose of a "no-suicide contract." Which of the
following client statements indicates correct understanding?
A. "It legally prevents me from harming myself."
B. "It is a promise I make to contact staff before acting on suicidal thoughts."
C. "It replaces the need for close observation."
D. "It means I cannot be discharged until I sign it."
Correct Answer: B
Rationale: No-suicide contracts are safety-planning tools, not legally binding documents.
They do not replace observation or prevent suicide, and they are not a discharge requirement.
The client agrees to seek help before acting on urges.
6. Which of the following is a characteristic of a therapeutic nurse-client relationship?
A. The nurse shares personal problems to build trust
B. The relationship is goal-directed and time-limited
C. The nurse accepts gifts from the client to show caring
D. The relationship continues after discharge as a friendship
Correct Answer: B
Rationale: The therapeutic relationship is purposefully goal-directed, time-limited, and
,client-centered. Self-disclosure should be minimal and purposeful; accepting gifts and forming
friendships blur boundaries.
7. A nurse is caring for a client who is experiencing a panic attack. Which of the following
actions should the nurse take first?
A. Teach the client diaphragmatic breathing
B. Stay with the client and speak in a calm, short, simple manner
C. Administer the PRN anxiolytic immediately
D. Move the client to a quiet, Stimulating environment
Correct Answer: B
Rationale: During acute panic, the nurse stays with the client, uses short simple sentences,
and provides a calm presence. Teaching breathing techniques is effective after the peak anxiety
decreases. Medication may be given but presence and reassurance come first.
8. Which of the following findings indicates a client is in the "working phase" of the nurse-
client relationship?
A. The client tests the nurse's boundaries
B. The client identifies problems and explores solutions
C. The client and nurse establish trust and rapport
D. The client expresses feelings about termination
Correct Answer: B
Rationale: The working phase is characterized by problem identification, exploration of
feelings, and development of coping strategies. Testing occurs in the orientation phase;
termination feelings occur in the termination phase.
9. A nurse is reviewing the medical record of a client prescribed clozapine. Which of the
following laboratory values should the nurse monitor?
A. Serum potassium
B. Absolute neutrophil count (ANC)
C. Serum calcium
D. Thyroid-stimulating hormone
Correct Answer: B
Rationale: Clozapine carries a risk of severe neutropenia/agranulocytosis. ANC must be
, monitored weekly for the first 6 months, then biweekly, then monthly. Potassium, calcium, and
TSH are not the priority for clozapine.
10. Which of the following is an example of a cognitive distortion known as "catastrophizing"?
A. "I failed one test, so I will never be a good nurse."
B. "My friend didn't call me because she is busy."
C. "I feel sad today, but it will pass."
D. "I made a mistake, and I can learn from it."
Correct Answer: A
Rationale: Catastrophizing is expecting the worst possible outcome from a minor event.
Option A magnifies a single failure into a global, permanent conclusion.
11. A nurse is assessing a client's judgment. Which of the following questions is most
appropriate?
A. "What day of the week is it?"
B. "What would you do if you found a wallet on the sidewalk?"
C. "Can you repeat these three words?"
D. "Who is the current president?"
Correct Answer: B
Rationale: Judgment is assessed by asking about hypothetical or real-life problem-solving.
Orientation questions test orientation; repetition tests memory; naming the president tests
general knowledge.
12. A nurse is providing care to a client who speaks a different language. Which of the
following actions should the nurse take?
A. Ask the client's family member to interpret
B. Use a certified medical interpreter
C. Speak loudly and use hand gestures
D. Provide written materials in English only
Correct Answer: B
Rationale: A certified medical interpreter ensures accuracy and confidentiality. Family
members may edit, misinterpret, or breach confidentiality, and are not acceptable substitutes
except in emergencies.
EXAM
SECTION I — FOUNDATIONS OF PSYCHIATRIC-MENTAL HEALTH NURSING
1. A nurse is assessing a client who reports feeling "overwhelmed and unable to cope" for the
past 3 weeks. Which of the following findings should the nurse identify as the priority?
A. The client reports sleeping 5 hours per night
B. The client states, "Everyone would be better off without me"
C. The client reports a 3-lb weight loss
D. The client reports difficulty concentrating at work
Correct Answer: B
Rationale: Priority assessment in mental health is always safety. A statement of being
"better off without me" is a passive suicidal ideation indicator and takes precedence over sleep,
weight, or concentration changes, which are important but not immediately life-threatening.
The nurse must complete a suicide risk assessment immediately.
2. Which of the following is the best definition of "milieu therapy"?
A. A form of insight-oriented psychotherapy conducted one-on-one
B. The use of the total environment as a therapeutic tool to promote client growth
C. A behavioral contract used to reduce self-harm
D. A structured group that focuses on medication education
Correct Answer: B
Rationale: Milieu therapy (therapeutic community) uses the physical and social
environment—structure, norms, safety, and interpersonal interactions—as the treatment
modality. It is not a single therapy technique or a medication group.
3. A nurse is admitting a client to an inpatient psychiatric unit. Which of the following actions
should the nurse take first?
A. Orient the client to unit rules and routines
B. Search the client's belongings for contraband
C. Obtain a suicide risk assessment and ensure safety
D. Introduce the client to other clients in the dayroom
, Correct Answer: C
Rationale: Safety is the first priority on admission. A suicide/risk assessment and removal of
dangerous items must occur before orientation, socialization, or routine education.
4. Which of the following statements by a nurse demonstrates an understanding of the "least
restrictive" principle?
A. "I will place the client in seclusion immediately if they refuse medication."
B. "I will use verbal de-escalation before considering physical restraints."
C. "I will restrict all visitors until the client behaves appropriately."
D. "I will keep the client in a locked room until they calm down."
Correct Answer: B
Rationale: Least restrictive intervention means using the mildest effective measure first.
Verbal de-escalation, environmental modification, and voluntary medication precede seclusion
or restraint, which require a provider order and strict monitoring.
5. A nurse is teaching a client about the purpose of a "no-suicide contract." Which of the
following client statements indicates correct understanding?
A. "It legally prevents me from harming myself."
B. "It is a promise I make to contact staff before acting on suicidal thoughts."
C. "It replaces the need for close observation."
D. "It means I cannot be discharged until I sign it."
Correct Answer: B
Rationale: No-suicide contracts are safety-planning tools, not legally binding documents.
They do not replace observation or prevent suicide, and they are not a discharge requirement.
The client agrees to seek help before acting on urges.
6. Which of the following is a characteristic of a therapeutic nurse-client relationship?
A. The nurse shares personal problems to build trust
B. The relationship is goal-directed and time-limited
C. The nurse accepts gifts from the client to show caring
D. The relationship continues after discharge as a friendship
Correct Answer: B
Rationale: The therapeutic relationship is purposefully goal-directed, time-limited, and
,client-centered. Self-disclosure should be minimal and purposeful; accepting gifts and forming
friendships blur boundaries.
7. A nurse is caring for a client who is experiencing a panic attack. Which of the following
actions should the nurse take first?
A. Teach the client diaphragmatic breathing
B. Stay with the client and speak in a calm, short, simple manner
C. Administer the PRN anxiolytic immediately
D. Move the client to a quiet, Stimulating environment
Correct Answer: B
Rationale: During acute panic, the nurse stays with the client, uses short simple sentences,
and provides a calm presence. Teaching breathing techniques is effective after the peak anxiety
decreases. Medication may be given but presence and reassurance come first.
8. Which of the following findings indicates a client is in the "working phase" of the nurse-
client relationship?
A. The client tests the nurse's boundaries
B. The client identifies problems and explores solutions
C. The client and nurse establish trust and rapport
D. The client expresses feelings about termination
Correct Answer: B
Rationale: The working phase is characterized by problem identification, exploration of
feelings, and development of coping strategies. Testing occurs in the orientation phase;
termination feelings occur in the termination phase.
9. A nurse is reviewing the medical record of a client prescribed clozapine. Which of the
following laboratory values should the nurse monitor?
A. Serum potassium
B. Absolute neutrophil count (ANC)
C. Serum calcium
D. Thyroid-stimulating hormone
Correct Answer: B
Rationale: Clozapine carries a risk of severe neutropenia/agranulocytosis. ANC must be
, monitored weekly for the first 6 months, then biweekly, then monthly. Potassium, calcium, and
TSH are not the priority for clozapine.
10. Which of the following is an example of a cognitive distortion known as "catastrophizing"?
A. "I failed one test, so I will never be a good nurse."
B. "My friend didn't call me because she is busy."
C. "I feel sad today, but it will pass."
D. "I made a mistake, and I can learn from it."
Correct Answer: A
Rationale: Catastrophizing is expecting the worst possible outcome from a minor event.
Option A magnifies a single failure into a global, permanent conclusion.
11. A nurse is assessing a client's judgment. Which of the following questions is most
appropriate?
A. "What day of the week is it?"
B. "What would you do if you found a wallet on the sidewalk?"
C. "Can you repeat these three words?"
D. "Who is the current president?"
Correct Answer: B
Rationale: Judgment is assessed by asking about hypothetical or real-life problem-solving.
Orientation questions test orientation; repetition tests memory; naming the president tests
general knowledge.
12. A nurse is providing care to a client who speaks a different language. Which of the
following actions should the nurse take?
A. Ask the client's family member to interpret
B. Use a certified medical interpreter
C. Speak loudly and use hand gestures
D. Provide written materials in English only
Correct Answer: B
Rationale: A certified medical interpreter ensures accuracy and confidentiality. Family
members may edit, misinterpret, or breach confidentiality, and are not acceptable substitutes
except in emergencies.
