ATI Mental Health Proctored Exam 2026/2027 |
ACTUAL-Style Practice Questions & Answers, ATI
RN Mental Health Nursing Proctored Assessment
Prep, Psychiatric Nursing Test Bank, Depression,
Bipolar Disorder, Schizophrenia, Anxiety, PTSD,
Psychotropic Medications, Therapeutic
Communication, Patient Safety, and Detailed
Rationales
Question 1: A nurse is caring for a client with schizophrenia who is
experiencing command hallucinations telling him to harm his
roommate. Which of the following is the priority nursing action?
A. Distract the client by offering to play a card game.
B. Assess the client's ability to resist the command.
C. Document the hallucinations in the client's chart.
D. Encourage the client to attend group therapy.
CORRECT ANSWER: B. Assess the client's ability to resist the
command.
Rationale: Safety is the priority. Command hallucinations instructing harm
to self or others represent an imminent risk. The nurse must first assess the
client's ability to control his impulses before considering other
interventions.
Question 2: A nurse is assessing a client with bipolar disorder in the
acute manic phase. Which of the following findings should the nurse
expect?
A. Psychomotor retardation
B. Decreased need for sleep
C. Anhedonia
D. Weight gain
CORRECT ANSWER: B. Decreased need for sleep.
Rationale: Decreased need for sleep is a classic hallmark of mania. The
client may sleep very little without feeling tired, whereas psychomotor
retardation, anhedonia, and weight gain are associated with depressive
episodes.
,Question 3: A nurse is reviewing laboratory results for a client taking
clozapine. Which of the following values should the nurse monitor
most closely?
A. Hemoglobin
B. White blood cell count
C. Platelet count
D. Serum potassium
CORRECT ANSWER: B. White blood cell count.
Rationale: Clozapine carries a risk of agranulocytosis, a potentially life-
threatening drop in white blood cells. Clients must have regular WBC
monitoring, and the medication is withheld if levels are too low.
Question 4: A client states, "I'm worthless and everyone would be
better off without me." Which of the following is the nurse's priority
action?
A. Reassure the client that he is valued.
B. Ask directly whether the client has thoughts of suicide.
C. Change the subject to distract the client.
D. Notify the client's family immediately.
CORRECT ANSWER: B. Ask directly whether the client has thoughts of
suicide.
Rationale: Directly asking about suicidal thoughts is essential for
assessment and does not increase the risk of suicide. This allows the nurse
to determine the need for safety interventions.
Question 5: A nurse is teaching a client about disulfiram. Which of the
following client statements indicates understanding of the teaching?
A. "I can drink alcohol in moderation while taking this medication."
B. "I will avoid alcohol-containing products, including mouthwash."
C. "I can skip doses on days when I plan to drink."
D. "This medication will reduce my cravings for alcohol."
CORRECT ANSWER: B. "I will avoid alcohol-containing products,
including mouthwash."
,Rationale: Disulfiram causes a severe adverse reaction when combined
with any alcohol, including hidden sources such as mouthwash and cough
syrup. The client must avoid all alcohol-containing products.
Question 6: A nurse is caring for a client with borderline personality
disorder. Which of the following behaviors is the client most likely to
exhibit?
A. Splitting
B. Denial
C. Projection
D. Rationalization
CORRECT ANSWER: A. Splitting.
Rationale: Splitting is a primitive defense mechanism commonly seen in
borderline personality disorder, where the client views people as either all
good or all bad and may pit staff members against each other.
Question 7: A nurse is assessing a client with obsessive-compulsive
disorder. Which of the following is an expected finding?
A. Manic episodes
B. Compulsions performed to reduce anxiety
C. Flat affect
D. Catatonia
CORRECT ANSWER: B. Compulsions performed to reduce anxiety.
Rationale: Compulsions are repetitive behaviors performed in response to
obsessions. They serve to temporarily reduce the anxiety caused by the
obsessive thoughts.
Question 8: A nurse is monitoring a client who is starting fluoxetine for
depression. When should the nurse expect to see therapeutic
improvement?
A. Within 24 hours
B. Within 3 to 5 days
C. Within 2 to 4 weeks
D. Within 3 months
CORRECT ANSWER: C. Within 2 to 4 weeks.
, Rationale: SSRIs such as fluoxetine typically require 2 to 4 weeks to reach
full therapeutic effect. Clients should be educated about this delay to
prevent premature discontinuation.
Question 9: A nurse is assessing a client for serotonin syndrome. Which
of the following findings is a hallmark sign?
A. Bradycardia
B. Hypotension
C. Hyperreflexia
D. Hypothermia
CORRECT ANSWER: C. Hyperreflexia.
Rationale: Serotonin syndrome is characterized by neuromuscular
hyperactivity, including hyperreflexia and clonus, along with autonomic
instability and altered mental status.
Question 10: A nurse is caring for a client in acute alcohol withdrawal.
Which of the following medications should the nurse anticipate
administering?
A. Naloxone
B. Lorazepam
C. Methadone
D. Disulfiram
CORRECT ANSWER: B. Lorazepam.
Rationale: Benzodiazepines such as lorazepam are the first-line treatment
for alcohol withdrawal to prevent seizures and manage autonomic
hyperactivity.
Question 11: A nurse is assessing a client with narcissistic personality
disorder. Which of the following findings should the nurse expect?
A. Excessive need for admiration
B. Social isolation
C. Self-harm behaviors
D. Fear of abandonment
CORRECT ANSWER: A. Excessive need for admiration.
ACTUAL-Style Practice Questions & Answers, ATI
RN Mental Health Nursing Proctored Assessment
Prep, Psychiatric Nursing Test Bank, Depression,
Bipolar Disorder, Schizophrenia, Anxiety, PTSD,
Psychotropic Medications, Therapeutic
Communication, Patient Safety, and Detailed
Rationales
Question 1: A nurse is caring for a client with schizophrenia who is
experiencing command hallucinations telling him to harm his
roommate. Which of the following is the priority nursing action?
A. Distract the client by offering to play a card game.
B. Assess the client's ability to resist the command.
C. Document the hallucinations in the client's chart.
D. Encourage the client to attend group therapy.
CORRECT ANSWER: B. Assess the client's ability to resist the
command.
Rationale: Safety is the priority. Command hallucinations instructing harm
to self or others represent an imminent risk. The nurse must first assess the
client's ability to control his impulses before considering other
interventions.
Question 2: A nurse is assessing a client with bipolar disorder in the
acute manic phase. Which of the following findings should the nurse
expect?
A. Psychomotor retardation
B. Decreased need for sleep
C. Anhedonia
D. Weight gain
CORRECT ANSWER: B. Decreased need for sleep.
Rationale: Decreased need for sleep is a classic hallmark of mania. The
client may sleep very little without feeling tired, whereas psychomotor
retardation, anhedonia, and weight gain are associated with depressive
episodes.
,Question 3: A nurse is reviewing laboratory results for a client taking
clozapine. Which of the following values should the nurse monitor
most closely?
A. Hemoglobin
B. White blood cell count
C. Platelet count
D. Serum potassium
CORRECT ANSWER: B. White blood cell count.
Rationale: Clozapine carries a risk of agranulocytosis, a potentially life-
threatening drop in white blood cells. Clients must have regular WBC
monitoring, and the medication is withheld if levels are too low.
Question 4: A client states, "I'm worthless and everyone would be
better off without me." Which of the following is the nurse's priority
action?
A. Reassure the client that he is valued.
B. Ask directly whether the client has thoughts of suicide.
C. Change the subject to distract the client.
D. Notify the client's family immediately.
CORRECT ANSWER: B. Ask directly whether the client has thoughts of
suicide.
Rationale: Directly asking about suicidal thoughts is essential for
assessment and does not increase the risk of suicide. This allows the nurse
to determine the need for safety interventions.
Question 5: A nurse is teaching a client about disulfiram. Which of the
following client statements indicates understanding of the teaching?
A. "I can drink alcohol in moderation while taking this medication."
B. "I will avoid alcohol-containing products, including mouthwash."
C. "I can skip doses on days when I plan to drink."
D. "This medication will reduce my cravings for alcohol."
CORRECT ANSWER: B. "I will avoid alcohol-containing products,
including mouthwash."
,Rationale: Disulfiram causes a severe adverse reaction when combined
with any alcohol, including hidden sources such as mouthwash and cough
syrup. The client must avoid all alcohol-containing products.
Question 6: A nurse is caring for a client with borderline personality
disorder. Which of the following behaviors is the client most likely to
exhibit?
A. Splitting
B. Denial
C. Projection
D. Rationalization
CORRECT ANSWER: A. Splitting.
Rationale: Splitting is a primitive defense mechanism commonly seen in
borderline personality disorder, where the client views people as either all
good or all bad and may pit staff members against each other.
Question 7: A nurse is assessing a client with obsessive-compulsive
disorder. Which of the following is an expected finding?
A. Manic episodes
B. Compulsions performed to reduce anxiety
C. Flat affect
D. Catatonia
CORRECT ANSWER: B. Compulsions performed to reduce anxiety.
Rationale: Compulsions are repetitive behaviors performed in response to
obsessions. They serve to temporarily reduce the anxiety caused by the
obsessive thoughts.
Question 8: A nurse is monitoring a client who is starting fluoxetine for
depression. When should the nurse expect to see therapeutic
improvement?
A. Within 24 hours
B. Within 3 to 5 days
C. Within 2 to 4 weeks
D. Within 3 months
CORRECT ANSWER: C. Within 2 to 4 weeks.
, Rationale: SSRIs such as fluoxetine typically require 2 to 4 weeks to reach
full therapeutic effect. Clients should be educated about this delay to
prevent premature discontinuation.
Question 9: A nurse is assessing a client for serotonin syndrome. Which
of the following findings is a hallmark sign?
A. Bradycardia
B. Hypotension
C. Hyperreflexia
D. Hypothermia
CORRECT ANSWER: C. Hyperreflexia.
Rationale: Serotonin syndrome is characterized by neuromuscular
hyperactivity, including hyperreflexia and clonus, along with autonomic
instability and altered mental status.
Question 10: A nurse is caring for a client in acute alcohol withdrawal.
Which of the following medications should the nurse anticipate
administering?
A. Naloxone
B. Lorazepam
C. Methadone
D. Disulfiram
CORRECT ANSWER: B. Lorazepam.
Rationale: Benzodiazepines such as lorazepam are the first-line treatment
for alcohol withdrawal to prevent seizures and manage autonomic
hyperactivity.
Question 11: A nurse is assessing a client with narcissistic personality
disorder. Which of the following findings should the nurse expect?
A. Excessive need for admiration
B. Social isolation
C. Self-harm behaviors
D. Fear of abandonment
CORRECT ANSWER: A. Excessive need for admiration.
