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2025 ATI RN Mental Health
Proctored Exam – 70 Actual
Questions with Verified Clinical
Rationales | A+ Graded
Student Name: _________________________
Date: _______________
Time Limit: 70 minutes
Total Questions: 70
Instructions
• This exam contains 70 questions, including multiple-choice (MCQs), select-all-that-apply
(SATA), and case-based scenarios, aligned with the 2025 ATI RN Mental Health
Proctored Exam and NCLEX-RN standards.
• Read each question carefully and select the best answer(s). For SATA questions, choose
all options that apply.
• Complete the exam within the 70-minute time limit.
• This exam tests knowledge in therapeutic communication, psychiatric disorders, and
crisis intervention, reflecting current psychiatric nursing practices (DSM-5-TR and
evidence-based guidelines).
• A non-programmable calculator, pencil/pen, and scratch paper (provided by the proctor)
are permitted. No other materials are allowed.
Therapeutic Communication (Questions 1–25)
1. A client with major depressive disorder states, “I’m a failure at everything.” What
is the nurse’s best response?
A. “You’re not a failure; you have many strengths.”
B. “Can you tell me more about why you feel this way?”
C. “Everyone fails sometimes; it’s not a big deal.”
D. “Let’s focus on something positive instead.”
Answer: B. Can you tell me more about why you feel this way?
Rationale: Therapeutic communication encourages exploration of feelings using open-
, 2
ended questions. Option B validates the client’s emotions and promotes self-expression.
Options A, C, and D dismiss or redirect the client’s feelings, which is non-therapeutic.
2. A client with schizophrenia reports hearing voices. What is the nurse’s best
response?
A. “Those voices aren’t real.”
B. “What are the voices saying to you?”
C. “Just try to ignore them.”
D. “You’re safe; the voices can’t hurt you.”
Answer: B. What are the voices saying to you?
Rationale: Exploring hallucinations with open-ended questions assesses their content and
severity while validating the client’s experience. Denying (A), dismissing (C), or
reassuring without exploration (D) is non-therapeutic and may increase agitation.
3. Select All That Apply: Which responses are therapeutic for a client expressing
suicidal thoughts?
A. “What led you to feel this way?”
B. “You don’t really want to die.”
C. “Are you thinking about harming yourself?”
D. “Life is worth living; you’ll see.”
E. “Can we discuss your support system?”
Answer: A, C, E
Rationale: Therapeutic responses include exploring feelings (A), directly assessing
suicide risk (C), and identifying supports (E). Denying (B) or offering platitudes (D)
dismisses the client’s distress and is non-therapeutic.
4. A client with anxiety says, “I can’t breathe; I’m going to die.” What is the nurse’s
best response?
A. “You’re fine; just calm down.”
B. “Let’s take slow, deep breaths together.”
C. “You’re not going to die.”
D. “This will pass soon.”
Answer: B. Let’s take slow, deep breaths together.
Rationale: Guiding the client through breathing exercises addresses acute anxiety
symptoms and promotes self-regulation. Dismissing (A), contradicting (C), or vague
reassurance (D) is non-therapeutic and may escalate anxiety.
5. A client with bipolar disorder in a manic phase says, “I’m invincible!” What is the
nurse’s best response?
A. “That’s not true; you need to relax.”
B. “What makes you feel invincible?”
C. “You’re exaggerating.”
D. “Let’s talk about something else.”
Answer: B. What makes you feel invincible?
Rationale: Exploring the client’s grandiose thoughts assesses the severity of mania and
builds trust. Contradicting (A), dismissing (C), or redirecting (D) may escalate agitation
and is non-therapeutic.
6. A client with post-traumatic stress disorder (PTSD) says, “I can’t talk about the
trauma.” What is the nurse’s best response?
A. “You need to face it to heal.”
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B. “It’s okay; we can talk when you’re ready.”
C. “It’s not that bad; you’ll get over it.”
D. “Why are you avoiding this?”
Answer: B. It’s okay; we can talk when you’re ready.
Rationale: Respecting the client’s readiness to discuss trauma builds trust and supports
autonomy. Forcing (A), minimizing (C), or questioning avoidance (D) may retraumatize
the client and is non-therapeutic.
7. A client with obsessive-compulsive disorder (OCD) says, “I can’t stop checking the
door.” What is the nurse’s best response?
A. “The door is fine; stop checking.”
B. “How does checking the door make you feel?”
C. “You don’t need to check so much.”
D. “Let’s lock the door together.”
Answer: B. How does checking the door make you feel?
Rationale: Exploring the client’s compulsions assesses anxiety and encourages self-
reflection. Directives (A, C) or enabling the compulsion (D) are non-therapeutic and may
reinforce OCD behaviors.
8. A client with generalized anxiety disorder says, “I’m always worried about
everything.” What is the nurse’s best response?
A. “You need to stop worrying so much.”
B. “What triggers your worry the most?”
C. “Everyone worries sometimes.”
D. “Try to think positive thoughts.”
Answer: B. What triggers your worry the most?
Rationale: Exploring triggers promotes understanding and identifies coping strategies.
Directives (A), minimizing (C), or redirecting (D) dismiss the client’s anxiety and are
non-therapeutic.
9. A client with schizophrenia is agitated and says, “They’re watching me.” What is
the nurse’s best response?
A. “No one is watching you.”
B. “That must feel frightening; can you tell me more?”
C. “You’re imagining things.”
D. “Just ignore those thoughts.”
Answer: B. That must feel frightening; can you tell me more?
Rationale: Acknowledging the client’s fear and exploring delusions validates their
experience and assesses risk. Denying (A), dismissing (C), or ignoring (D) may escalate
agitation and is non-therapeutic.
10. A client with depression says, “No one cares about me.” What is the nurse’s best
response?
A. “That’s not true; lots of people care.”
B. “Can you share what makes you feel uncared for?”
C. “You’re just feeling down right now.”
D. “Let’s focus on your achievements.”
Answer: B. Can you share what makes you feel uncared for?
Rationale: Exploring the client’s feelings encourages self-expression and identifies
2025 ATI RN Mental Health
Proctored Exam – 70 Actual
Questions with Verified Clinical
Rationales | A+ Graded
Student Name: _________________________
Date: _______________
Time Limit: 70 minutes
Total Questions: 70
Instructions
• This exam contains 70 questions, including multiple-choice (MCQs), select-all-that-apply
(SATA), and case-based scenarios, aligned with the 2025 ATI RN Mental Health
Proctored Exam and NCLEX-RN standards.
• Read each question carefully and select the best answer(s). For SATA questions, choose
all options that apply.
• Complete the exam within the 70-minute time limit.
• This exam tests knowledge in therapeutic communication, psychiatric disorders, and
crisis intervention, reflecting current psychiatric nursing practices (DSM-5-TR and
evidence-based guidelines).
• A non-programmable calculator, pencil/pen, and scratch paper (provided by the proctor)
are permitted. No other materials are allowed.
Therapeutic Communication (Questions 1–25)
1. A client with major depressive disorder states, “I’m a failure at everything.” What
is the nurse’s best response?
A. “You’re not a failure; you have many strengths.”
B. “Can you tell me more about why you feel this way?”
C. “Everyone fails sometimes; it’s not a big deal.”
D. “Let’s focus on something positive instead.”
Answer: B. Can you tell me more about why you feel this way?
Rationale: Therapeutic communication encourages exploration of feelings using open-
, 2
ended questions. Option B validates the client’s emotions and promotes self-expression.
Options A, C, and D dismiss or redirect the client’s feelings, which is non-therapeutic.
2. A client with schizophrenia reports hearing voices. What is the nurse’s best
response?
A. “Those voices aren’t real.”
B. “What are the voices saying to you?”
C. “Just try to ignore them.”
D. “You’re safe; the voices can’t hurt you.”
Answer: B. What are the voices saying to you?
Rationale: Exploring hallucinations with open-ended questions assesses their content and
severity while validating the client’s experience. Denying (A), dismissing (C), or
reassuring without exploration (D) is non-therapeutic and may increase agitation.
3. Select All That Apply: Which responses are therapeutic for a client expressing
suicidal thoughts?
A. “What led you to feel this way?”
B. “You don’t really want to die.”
C. “Are you thinking about harming yourself?”
D. “Life is worth living; you’ll see.”
E. “Can we discuss your support system?”
Answer: A, C, E
Rationale: Therapeutic responses include exploring feelings (A), directly assessing
suicide risk (C), and identifying supports (E). Denying (B) or offering platitudes (D)
dismisses the client’s distress and is non-therapeutic.
4. A client with anxiety says, “I can’t breathe; I’m going to die.” What is the nurse’s
best response?
A. “You’re fine; just calm down.”
B. “Let’s take slow, deep breaths together.”
C. “You’re not going to die.”
D. “This will pass soon.”
Answer: B. Let’s take slow, deep breaths together.
Rationale: Guiding the client through breathing exercises addresses acute anxiety
symptoms and promotes self-regulation. Dismissing (A), contradicting (C), or vague
reassurance (D) is non-therapeutic and may escalate anxiety.
5. A client with bipolar disorder in a manic phase says, “I’m invincible!” What is the
nurse’s best response?
A. “That’s not true; you need to relax.”
B. “What makes you feel invincible?”
C. “You’re exaggerating.”
D. “Let’s talk about something else.”
Answer: B. What makes you feel invincible?
Rationale: Exploring the client’s grandiose thoughts assesses the severity of mania and
builds trust. Contradicting (A), dismissing (C), or redirecting (D) may escalate agitation
and is non-therapeutic.
6. A client with post-traumatic stress disorder (PTSD) says, “I can’t talk about the
trauma.” What is the nurse’s best response?
A. “You need to face it to heal.”
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B. “It’s okay; we can talk when you’re ready.”
C. “It’s not that bad; you’ll get over it.”
D. “Why are you avoiding this?”
Answer: B. It’s okay; we can talk when you’re ready.
Rationale: Respecting the client’s readiness to discuss trauma builds trust and supports
autonomy. Forcing (A), minimizing (C), or questioning avoidance (D) may retraumatize
the client and is non-therapeutic.
7. A client with obsessive-compulsive disorder (OCD) says, “I can’t stop checking the
door.” What is the nurse’s best response?
A. “The door is fine; stop checking.”
B. “How does checking the door make you feel?”
C. “You don’t need to check so much.”
D. “Let’s lock the door together.”
Answer: B. How does checking the door make you feel?
Rationale: Exploring the client’s compulsions assesses anxiety and encourages self-
reflection. Directives (A, C) or enabling the compulsion (D) are non-therapeutic and may
reinforce OCD behaviors.
8. A client with generalized anxiety disorder says, “I’m always worried about
everything.” What is the nurse’s best response?
A. “You need to stop worrying so much.”
B. “What triggers your worry the most?”
C. “Everyone worries sometimes.”
D. “Try to think positive thoughts.”
Answer: B. What triggers your worry the most?
Rationale: Exploring triggers promotes understanding and identifies coping strategies.
Directives (A), minimizing (C), or redirecting (D) dismiss the client’s anxiety and are
non-therapeutic.
9. A client with schizophrenia is agitated and says, “They’re watching me.” What is
the nurse’s best response?
A. “No one is watching you.”
B. “That must feel frightening; can you tell me more?”
C. “You’re imagining things.”
D. “Just ignore those thoughts.”
Answer: B. That must feel frightening; can you tell me more?
Rationale: Acknowledging the client’s fear and exploring delusions validates their
experience and assesses risk. Denying (A), dismissing (C), or ignoring (D) may escalate
agitation and is non-therapeutic.
10. A client with depression says, “No one cares about me.” What is the nurse’s best
response?
A. “That’s not true; lots of people care.”
B. “Can you share what makes you feel uncared for?”
C. “You’re just feeling down right now.”
D. “Let’s focus on your achievements.”
Answer: B. Can you share what makes you feel uncared for?
Rationale: Exploring the client’s feelings encourages self-expression and identifies
