ATI Mental Health Nursing Exam 2026/2027 |
ACTUAL-Style Practice Questions & Answers,
Psychiatric Nursing, Mental Health Disorders,
Therapeutic Communication, Psychotropic
Medications, and Detailed Rationales
Question 1: A nurse is assessing a client who has been diagnosed
with major depressive disorder. Which of the following findings
should the nurse expect?
A. Increased energy and activity level
B. Anhedonia and flat affect
C. Grandiose delusions
D. Flight of ideas
CORRECT ANSWER: B. Anhedonia and flat affect
Rationale: Major depressive disorder is characterized by persistent low
mood, anhedonia (loss of pleasure in previously enjoyable activities), flat
affect, fatigue, and impaired concentration. Increased energy, grandiosity,
and flight of ideas are more consistent with mania or bipolar disorder.
Question 2: A client is experiencing a panic attack. Which of the
following nursing interventions is the priority?
A. Encourage the client to discuss childhood conflicts
B. Stay with the client and speak in a calm, reassuring voice
C. Administer a PRN antipsychotic medication immediately
D. Instruct the client to hyperventilate into a paper bag
CORRECT ANSWER: B. Stay with the client and speak in a calm,
reassuring voice
Rationale: During a panic attack, the priority is to ensure safety and reduce
anxiety by staying with the client and using a calm, reassuring approach.
Confronting unconscious conflicts is not appropriate during acute panic.
Antipsychotics are not first-line for panic, and hyperventilation into a paper
bag is not recommended due to risk of hypoxia.
Question 3: A nurse is caring for a client with schizophrenia who is
experiencing auditory hallucinations. Which statement by the
nurse is most therapeutic?
A. "Those voices aren't real, so just ignore them."
B. "What are the voices telling you right now?"
,C. "You shouldn't talk about the voices; they'll go away."
D. "I'll turn up the TV so you can't hear them."
CORRECT ANSWER: B. "What are the voices telling you right now?"
Rationale: Asking the client directly about the content of the hallucinations
helps the nurse assess for command hallucinations and safety risk. Telling
the client to ignore the voices or distracting with television minimizes the
client's experience and is non-therapeutic.
Question 4: A client with bipolar I disorder is admitted in a manic
state. Which of the following is the priority nursing action?
A. Provide a stimulating environment to channel energy
B. Encourage group therapy participation
C. Provide a safe, low-stimulation environment
D. Allow the client to skip meals to reduce hyperactivity
CORRECT ANSWER: C. Provide a safe, low-stimulation
environment
Rationale: A manic client has heightened sensitivity to stimuli and impaired
impulse control. A low-stimulation, safe environment reduces the risk of
injury and agitation. Group therapy is not appropriate during acute mania,
and nutritional needs must be maintained.
Question 5: A nurse is assessing a client for signs of serotonin
syndrome. Which of the following findings should the nurse
expect?
A. Bradycardia and hypotension
B. Hyperreflexia, clonus, and agitation
C. Dry mucous membranes and constipation
D. Decreased deep tendon reflexes
CORRECT ANSWER: B. Hyperreflexia, clonus, and agitation
Rationale: Serotonin syndrome presents with mental status changes,
autonomic instability, and neuromuscular abnormalities such as
hyperreflexia, clonus, tremors, and agitation. Bradycardia and dry mucous
membranes are not characteristic.
Question 6: A client on lithium therapy reports nausea, vomiting,
and coarse hand tremors. Which action should the nurse take first?
,A. Administer the next scheduled lithium dose
B. Withhold the lithium dose and notify the provider
C. Encourage increased sodium intake
D. Reassure the client that these are expected side effects
CORRECT ANSWER: B. Withhold the lithium dose and notify the
provider
Rationale: Nausea, vomiting, and coarse hand tremors are signs of lithium
toxicity. The nurse should withhold the medication and notify the provider
immediately. Administering more lithium would worsen toxicity.
Question 7: A nurse is teaching a client about clozapine. Which of
the following instructions is essential?
A. "You should report any sore throat or fever immediately."
B. "You can stop the medication once you feel better."
C. "This medication has no serious side effects."
D. "You should avoid all dairy products while taking this."
CORRECT ANSWER: A. "You should report any sore throat or fever
immediately."
Rationale: Clozapine can cause agranulocytosis, which may present with
fever or sore throat. Clients require regular WBC monitoring and must
report signs of infection immediately. Abrupt discontinuation can cause
rebound psychosis.
Question 8: A client with anorexia nervosa is admitted to the unit.
Which of the following is the priority nursing concern?
A. Distorted body image
B. Electrolyte imbalance
C. Fear of gaining weight
D. Excessive exercise
CORRECT ANSWER: B. Electrolyte imbalance
Rationale: Physiological stabilization takes priority. Clients with anorexia
nervosa are at risk for life-threatening electrolyte imbalances, cardiac
dysrhythmias, and refeeding syndrome. Psychological concerns are
addressed after physical stabilization.
, Question 9: A nurse is assessing a client who has been prescribed
haloperidol. Which finding indicates a serious adverse effect
requiring immediate intervention?
A. Dry mouth
B. Drowsiness
C. Acute dystonia
D. Weight gain
CORRECT ANSWER: C. Acute dystonia
Rationale: Acute dystonia is a serious extrapyramidal side effect that can
compromise the airway and requires immediate treatment with an
anticholinergic agent such as benztropine. Dry mouth and drowsiness are
common, less urgent side effects.
Question 10: A nurse is caring for a client who is experiencing
alcohol withdrawal. Which medication is typically used to manage
withdrawal symptoms?
A. Fluoxetine
B. Lorazepam
C. Haloperidol
D. Lithium
CORRECT ANSWER: B. Lorazepam
Rationale: Benzodiazepines such as lorazepam are the standard treatment
for alcohol withdrawal because they stabilize GABA activity and prevent
seizures and delirium tremens. SSRIs and antipsychotics are not first-line
for withdrawal.
Question 11: A client with post-traumatic stress disorder reports
frequent nightmares. Which nursing intervention is most
appropriate?
A. Encourage the client to avoid discussing the trauma
B. Teach relaxation techniques and grounding exercises
C. Tell the client the nightmares will disappear on their own
D. Restrict sleep to prevent nightmares
CORRECT ANSWER: B. Teach relaxation techniques and grounding
exercises
ACTUAL-Style Practice Questions & Answers,
Psychiatric Nursing, Mental Health Disorders,
Therapeutic Communication, Psychotropic
Medications, and Detailed Rationales
Question 1: A nurse is assessing a client who has been diagnosed
with major depressive disorder. Which of the following findings
should the nurse expect?
A. Increased energy and activity level
B. Anhedonia and flat affect
C. Grandiose delusions
D. Flight of ideas
CORRECT ANSWER: B. Anhedonia and flat affect
Rationale: Major depressive disorder is characterized by persistent low
mood, anhedonia (loss of pleasure in previously enjoyable activities), flat
affect, fatigue, and impaired concentration. Increased energy, grandiosity,
and flight of ideas are more consistent with mania or bipolar disorder.
Question 2: A client is experiencing a panic attack. Which of the
following nursing interventions is the priority?
A. Encourage the client to discuss childhood conflicts
B. Stay with the client and speak in a calm, reassuring voice
C. Administer a PRN antipsychotic medication immediately
D. Instruct the client to hyperventilate into a paper bag
CORRECT ANSWER: B. Stay with the client and speak in a calm,
reassuring voice
Rationale: During a panic attack, the priority is to ensure safety and reduce
anxiety by staying with the client and using a calm, reassuring approach.
Confronting unconscious conflicts is not appropriate during acute panic.
Antipsychotics are not first-line for panic, and hyperventilation into a paper
bag is not recommended due to risk of hypoxia.
Question 3: A nurse is caring for a client with schizophrenia who is
experiencing auditory hallucinations. Which statement by the
nurse is most therapeutic?
A. "Those voices aren't real, so just ignore them."
B. "What are the voices telling you right now?"
,C. "You shouldn't talk about the voices; they'll go away."
D. "I'll turn up the TV so you can't hear them."
CORRECT ANSWER: B. "What are the voices telling you right now?"
Rationale: Asking the client directly about the content of the hallucinations
helps the nurse assess for command hallucinations and safety risk. Telling
the client to ignore the voices or distracting with television minimizes the
client's experience and is non-therapeutic.
Question 4: A client with bipolar I disorder is admitted in a manic
state. Which of the following is the priority nursing action?
A. Provide a stimulating environment to channel energy
B. Encourage group therapy participation
C. Provide a safe, low-stimulation environment
D. Allow the client to skip meals to reduce hyperactivity
CORRECT ANSWER: C. Provide a safe, low-stimulation
environment
Rationale: A manic client has heightened sensitivity to stimuli and impaired
impulse control. A low-stimulation, safe environment reduces the risk of
injury and agitation. Group therapy is not appropriate during acute mania,
and nutritional needs must be maintained.
Question 5: A nurse is assessing a client for signs of serotonin
syndrome. Which of the following findings should the nurse
expect?
A. Bradycardia and hypotension
B. Hyperreflexia, clonus, and agitation
C. Dry mucous membranes and constipation
D. Decreased deep tendon reflexes
CORRECT ANSWER: B. Hyperreflexia, clonus, and agitation
Rationale: Serotonin syndrome presents with mental status changes,
autonomic instability, and neuromuscular abnormalities such as
hyperreflexia, clonus, tremors, and agitation. Bradycardia and dry mucous
membranes are not characteristic.
Question 6: A client on lithium therapy reports nausea, vomiting,
and coarse hand tremors. Which action should the nurse take first?
,A. Administer the next scheduled lithium dose
B. Withhold the lithium dose and notify the provider
C. Encourage increased sodium intake
D. Reassure the client that these are expected side effects
CORRECT ANSWER: B. Withhold the lithium dose and notify the
provider
Rationale: Nausea, vomiting, and coarse hand tremors are signs of lithium
toxicity. The nurse should withhold the medication and notify the provider
immediately. Administering more lithium would worsen toxicity.
Question 7: A nurse is teaching a client about clozapine. Which of
the following instructions is essential?
A. "You should report any sore throat or fever immediately."
B. "You can stop the medication once you feel better."
C. "This medication has no serious side effects."
D. "You should avoid all dairy products while taking this."
CORRECT ANSWER: A. "You should report any sore throat or fever
immediately."
Rationale: Clozapine can cause agranulocytosis, which may present with
fever or sore throat. Clients require regular WBC monitoring and must
report signs of infection immediately. Abrupt discontinuation can cause
rebound psychosis.
Question 8: A client with anorexia nervosa is admitted to the unit.
Which of the following is the priority nursing concern?
A. Distorted body image
B. Electrolyte imbalance
C. Fear of gaining weight
D. Excessive exercise
CORRECT ANSWER: B. Electrolyte imbalance
Rationale: Physiological stabilization takes priority. Clients with anorexia
nervosa are at risk for life-threatening electrolyte imbalances, cardiac
dysrhythmias, and refeeding syndrome. Psychological concerns are
addressed after physical stabilization.
, Question 9: A nurse is assessing a client who has been prescribed
haloperidol. Which finding indicates a serious adverse effect
requiring immediate intervention?
A. Dry mouth
B. Drowsiness
C. Acute dystonia
D. Weight gain
CORRECT ANSWER: C. Acute dystonia
Rationale: Acute dystonia is a serious extrapyramidal side effect that can
compromise the airway and requires immediate treatment with an
anticholinergic agent such as benztropine. Dry mouth and drowsiness are
common, less urgent side effects.
Question 10: A nurse is caring for a client who is experiencing
alcohol withdrawal. Which medication is typically used to manage
withdrawal symptoms?
A. Fluoxetine
B. Lorazepam
C. Haloperidol
D. Lithium
CORRECT ANSWER: B. Lorazepam
Rationale: Benzodiazepines such as lorazepam are the standard treatment
for alcohol withdrawal because they stabilize GABA activity and prevent
seizures and delirium tremens. SSRIs and antipsychotics are not first-line
for withdrawal.
Question 11: A client with post-traumatic stress disorder reports
frequent nightmares. Which nursing intervention is most
appropriate?
A. Encourage the client to avoid discussing the trauma
B. Teach relaxation techniques and grounding exercises
C. Tell the client the nightmares will disappear on their own
D. Restrict sleep to prevent nightmares
CORRECT ANSWER: B. Teach relaxation techniques and grounding
exercises
