ATI Mental Health Proctored Exam 2026/2027 |
ACTUAL-Style Practice Questions & Answers,
Psychiatric Nursing, Mental Health Disorders,
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. Decreased appetite with significant weight loss
B. Increased energy with psychomotor agitation
C. Grandiose delusions of persecution
D. Flight of ideas with pressured speech
CORRECT ANSWER: A. Decreased appetite with significant weight loss
Rationale: Major depressive disorder commonly presents with
neurovegetative symptoms including anorexia, weight loss, insomnia, and
psychomotor retardation. Increased energy and grandiosity are more
characteristic of mania, while flight of ideas and pressured speech suggest
a manic episode.
Question 2: A client is prescribed sertraline for major depressive
disorder. Which of the following statements by the client indicates a
need for further teaching?
A. "I should take this medication in the morning."
B. "I might feel better in one to two weeks."
C. "I can stop taking this medication once I feel better."
D. "I should avoid alcohol while taking this medication."
CORRECT ANSWER: C. "I can stop taking this medication once I feel
better."
Rationale: Antidepressant therapy must be continued for at least 6 to 12
months after symptom remission to prevent relapse. Abrupt
discontinuation can cause withdrawal symptoms and return of depression.
The other statements reflect correct understanding.
Question 3: A nurse is caring for a client experiencing acute mania.
Which of the following interventions should the nurse implement first?
,A. Encourage participation in group therapy sessions
B. Provide a stimulating environment to distract the client
C. Monitor for dehydration and exhaustion
D. Set strict limits on manipulative behavior
CORRECT ANSWER: C. Monitor for dehydration and exhaustion
Rationale: During acute mania, physiological safety needs take priority.
Clients experiencing mania are at high risk for dehydration, electrolyte
imbalance, and exhaustion due to hyperactivity and decreased intake.
Physiological needs must be addressed before psychosocial interventions.
Question 4: A client with schizophrenia is prescribed clozapine. Which
laboratory value requires weekly monitoring for the first six months of
therapy?
A. Serum potassium
B. Absolute neutrophil count
C. Liver function tests
D. Thyroid stimulating hormone
CORRECT ANSWER: B. Absolute neutrophil count
Rationale: Clozapine carries a risk of severe neutropenia and
agranulocytosis. Weekly ANC monitoring is required for the first six months,
then every two weeks. Other laboratory values do not require this intensive
monitoring schedule specifically for clozapine.
Question 5: A nurse is assessing a client who has been taking
haloperidol for schizophrenia. Which of the following findings should
the nurse identify as an extrapyramidal side effect?
A. Dry mouth and constipation
B. Weight gain and sedation
C. Tremors and muscle rigidity
D. Orthostatic hypotension
CORRECT ANSWER: C. Tremors and muscle rigidity
Rationale: Extrapyramidal symptoms include acute dystonia,
pseudoparkinsonism (tremors, rigidity, bradykinesia), and akathisia. Dry
mouth, constipation, weight gain, and orthostatic hypotension are
anticholinergic and metabolic side effects, not EPS.
,Question 6: A client with bipolar disorder is prescribed lithium
carbonate. Which of the following instructions should the nurse
include in teaching?
A. "Increase your sodium intake during hot weather."
B. "Take the medication on an empty stomach."
C. "Limit your fluid intake to prevent water retention."
D. "Stop the medication if you develop a fine hand tremor."
CORRECT ANSWER: A. "Increase your sodium intake during hot
weather."
Rationale: Sodium and lithium compete for renal reabsorption. Decreased
sodium levels (through sweating or low dietary intake) increase lithium
retention and toxicity risk. Adequate sodium and fluid intake must be
maintained. Fine hand tremor is a common early side effect that often
resolves.
Question 7: A nurse is caring for a client who is experiencing alcohol
withdrawal. Which medication should the nurse anticipate
administering first-line?
A. Lorazepam
B. Haloperidol
C. Naltrexone
D. Disulfiram
CORRECT ANSWER: A. Lorazepam
Rationale: Benzodiazepines such as lorazepam are first-line for managing
alcohol withdrawal symptoms and preventing seizures and delirium
tremens. Haloperidol may be used for agitation but is not first-line.
Naltrexone and disulfiram are used for maintenance and relapse
prevention, not acute withdrawal.
Question 8: A client with anorexia nervosa is being refed. Which of the
following findings should the nurse monitor for as a sign of refeeding
syndrome?
A. Hypernatremia
B. Hypophosphatemia
C. Hypercalcemia
D. Hyperkalemia
, CORRECT ANSWER: B. Hypophosphatemia
Rationale: Refeeding syndrome causes dangerous electrolyte shifts, most
notably hypophosphatemia, which can lead to cardiac failure and
neurological complications. Hypokalemia and hypomagnesemia are also
common. Close monitoring of electrolytes is essential during refeeding.
Question 9: During a therapeutic communication session, a client
states, "I feel like I am a burden to everyone." Which response by the
nurse demonstrates the technique of reflection?
A. "You should not feel that way; your family loves you."
B. "Why do you think you are a burden?"
C. "You feel like a burden to others."
D. "Let us talk about something more positive."
CORRECT ANSWER: C. "You feel like a burden to others."
Rationale: Reflection involves restating the client's message to encourage
further expression and demonstrate understanding. Option A minimizes
feelings, Option B is probing with "why," and Option D changes the subject,
all of which are non-therapeutic.
Question 10: A nurse is caring for a client who has borderline
personality disorder and engages in self-mutilation. Which group
should the nurse encourage the client to participate in?
A. Dual diagnosis treatment group
B. Dialectical behavior therapy group
C. Desensitization therapy group
D. Reminiscence therapy group
CORRECT ANSWER: B. Dialectical behavior therapy group
Rationale: Dialectical behavior therapy is specifically designed for clients
with borderline personality disorder and self-injurious behaviors. It focuses
on gradual behavior changes, acceptance, and validation. Other group
types do not address the core features of this disorder.
Question 11: A nurse is assessing a client for suicidal risk. Which of the
following findings indicates the highest risk for completed suicide?
A. A client who has a specific plan with access to lethal means
B. A client who states, "I wish I were dead"
ACTUAL-Style Practice Questions & Answers,
Psychiatric Nursing, Mental Health Disorders,
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. Decreased appetite with significant weight loss
B. Increased energy with psychomotor agitation
C. Grandiose delusions of persecution
D. Flight of ideas with pressured speech
CORRECT ANSWER: A. Decreased appetite with significant weight loss
Rationale: Major depressive disorder commonly presents with
neurovegetative symptoms including anorexia, weight loss, insomnia, and
psychomotor retardation. Increased energy and grandiosity are more
characteristic of mania, while flight of ideas and pressured speech suggest
a manic episode.
Question 2: A client is prescribed sertraline for major depressive
disorder. Which of the following statements by the client indicates a
need for further teaching?
A. "I should take this medication in the morning."
B. "I might feel better in one to two weeks."
C. "I can stop taking this medication once I feel better."
D. "I should avoid alcohol while taking this medication."
CORRECT ANSWER: C. "I can stop taking this medication once I feel
better."
Rationale: Antidepressant therapy must be continued for at least 6 to 12
months after symptom remission to prevent relapse. Abrupt
discontinuation can cause withdrawal symptoms and return of depression.
The other statements reflect correct understanding.
Question 3: A nurse is caring for a client experiencing acute mania.
Which of the following interventions should the nurse implement first?
,A. Encourage participation in group therapy sessions
B. Provide a stimulating environment to distract the client
C. Monitor for dehydration and exhaustion
D. Set strict limits on manipulative behavior
CORRECT ANSWER: C. Monitor for dehydration and exhaustion
Rationale: During acute mania, physiological safety needs take priority.
Clients experiencing mania are at high risk for dehydration, electrolyte
imbalance, and exhaustion due to hyperactivity and decreased intake.
Physiological needs must be addressed before psychosocial interventions.
Question 4: A client with schizophrenia is prescribed clozapine. Which
laboratory value requires weekly monitoring for the first six months of
therapy?
A. Serum potassium
B. Absolute neutrophil count
C. Liver function tests
D. Thyroid stimulating hormone
CORRECT ANSWER: B. Absolute neutrophil count
Rationale: Clozapine carries a risk of severe neutropenia and
agranulocytosis. Weekly ANC monitoring is required for the first six months,
then every two weeks. Other laboratory values do not require this intensive
monitoring schedule specifically for clozapine.
Question 5: A nurse is assessing a client who has been taking
haloperidol for schizophrenia. Which of the following findings should
the nurse identify as an extrapyramidal side effect?
A. Dry mouth and constipation
B. Weight gain and sedation
C. Tremors and muscle rigidity
D. Orthostatic hypotension
CORRECT ANSWER: C. Tremors and muscle rigidity
Rationale: Extrapyramidal symptoms include acute dystonia,
pseudoparkinsonism (tremors, rigidity, bradykinesia), and akathisia. Dry
mouth, constipation, weight gain, and orthostatic hypotension are
anticholinergic and metabolic side effects, not EPS.
,Question 6: A client with bipolar disorder is prescribed lithium
carbonate. Which of the following instructions should the nurse
include in teaching?
A. "Increase your sodium intake during hot weather."
B. "Take the medication on an empty stomach."
C. "Limit your fluid intake to prevent water retention."
D. "Stop the medication if you develop a fine hand tremor."
CORRECT ANSWER: A. "Increase your sodium intake during hot
weather."
Rationale: Sodium and lithium compete for renal reabsorption. Decreased
sodium levels (through sweating or low dietary intake) increase lithium
retention and toxicity risk. Adequate sodium and fluid intake must be
maintained. Fine hand tremor is a common early side effect that often
resolves.
Question 7: A nurse is caring for a client who is experiencing alcohol
withdrawal. Which medication should the nurse anticipate
administering first-line?
A. Lorazepam
B. Haloperidol
C. Naltrexone
D. Disulfiram
CORRECT ANSWER: A. Lorazepam
Rationale: Benzodiazepines such as lorazepam are first-line for managing
alcohol withdrawal symptoms and preventing seizures and delirium
tremens. Haloperidol may be used for agitation but is not first-line.
Naltrexone and disulfiram are used for maintenance and relapse
prevention, not acute withdrawal.
Question 8: A client with anorexia nervosa is being refed. Which of the
following findings should the nurse monitor for as a sign of refeeding
syndrome?
A. Hypernatremia
B. Hypophosphatemia
C. Hypercalcemia
D. Hyperkalemia
, CORRECT ANSWER: B. Hypophosphatemia
Rationale: Refeeding syndrome causes dangerous electrolyte shifts, most
notably hypophosphatemia, which can lead to cardiac failure and
neurological complications. Hypokalemia and hypomagnesemia are also
common. Close monitoring of electrolytes is essential during refeeding.
Question 9: During a therapeutic communication session, a client
states, "I feel like I am a burden to everyone." Which response by the
nurse demonstrates the technique of reflection?
A. "You should not feel that way; your family loves you."
B. "Why do you think you are a burden?"
C. "You feel like a burden to others."
D. "Let us talk about something more positive."
CORRECT ANSWER: C. "You feel like a burden to others."
Rationale: Reflection involves restating the client's message to encourage
further expression and demonstrate understanding. Option A minimizes
feelings, Option B is probing with "why," and Option D changes the subject,
all of which are non-therapeutic.
Question 10: A nurse is caring for a client who has borderline
personality disorder and engages in self-mutilation. Which group
should the nurse encourage the client to participate in?
A. Dual diagnosis treatment group
B. Dialectical behavior therapy group
C. Desensitization therapy group
D. Reminiscence therapy group
CORRECT ANSWER: B. Dialectical behavior therapy group
Rationale: Dialectical behavior therapy is specifically designed for clients
with borderline personality disorder and self-injurious behaviors. It focuses
on gradual behavior changes, acceptance, and validation. Other group
types do not address the core features of this disorder.
Question 11: A nurse is assessing a client for suicidal risk. Which of the
following findings indicates the highest risk for completed suicide?
A. A client who has a specific plan with access to lethal means
B. A client who states, "I wish I were dead"
