ATI CMS Mental Health Exam verified with correct answers plus
rationales 2026/2027 version
1. A nurse is assessing a client who reports hearing voices that others do not
hear. Which term should the nurse use to document this finding?
A. Delusion
B. Hallucination
C. Illusion
D. Obsession
Answer: B. Hallucination
Rationale: A hallucination is a sensory perception without an external stimulus. Hearing voices
is an auditory hallucination.
2. A client tells the nurse, “The FBI implanted a tracking device in my tooth.”
Which finding does this statement represent?
A. Hallucination
B. Delusion
C. Compulsion
D. Flight of ideas
Answer: B. Delusion
Rationale: A delusion is a fixed, false belief that persists despite evidence to the contrary. The
statement represents a persecutory-type delusion.
3. Which finding is characteristic of mania?
A. Decreased energy and slowed speech
B. Increased need for sleep
C. Grandiosity and decreased need for sleep
D. Social withdrawal and hopelessness
Answer: C. Grandiosity and decreased need for sleep
Rationale: Mania commonly includes elevated or irritable mood, increased energy, decreased
need for sleep, pressured speech, grandiosity, distractibility, and impulsive behavior.
,4. A client with mania is speaking rapidly and changing topics frequently. Which
finding is this?
A. Echolalia
B. Flight of ideas
C. Thought blocking
D. Neologism
Answer: B. Flight of ideas
Rationale: Flight of ideas is rapid shifting from one topic to another with understandable
connections that become increasingly difficult to follow.
5. Which nursing intervention is appropriate for a client experiencing acute
mania?
A. Encourage multiple stimulating group activities
B. Provide a quiet, low-stimulation environment
C. Allow unlimited decision-making
D. Challenge grandiose beliefs directly
Answer: B. Provide a quiet, low-stimulation environment
Rationale: Reducing environmental stimulation can decrease agitation and help the client
maintain behavioral control.
6. A client with major depressive disorder says, “Everyone would be better off
without me.” What should the nurse do first?
A. Change the subject
B. Ask directly whether the client is thinking about suicide
C. Tell the client to focus on positive thoughts
D. Leave the client alone to rest
Answer: B. Ask directly whether the client is thinking about suicide
Rationale: Statements suggesting hopelessness or worthlessness require direct suicide
assessment. Asking about suicide does not cause suicidal behavior.
,7. Which finding is the highest priority for a client with major depressive
disorder?
A. Fatigue
B. Poor appetite
C. Suicidal thoughts with a specific plan
D. Social withdrawal
Answer: C. Suicidal thoughts with a specific plan
Rationale: A specific suicidal plan indicates an immediate safety risk and requires urgent
intervention.
8. Which intervention is appropriate for a client with suicidal ideation?
A. Place the client in a safe environment and remove potential means of self-harm
B. Allow the client unlimited privacy
C. Leave the client alone during meals
D. Promise to keep suicidal thoughts confidential
Answer: A. Place the client in a safe environment and remove potential means of self-harm
Rationale: Suicide precautions focus on maintaining safety, reducing access to lethal means, and
providing appropriate observation.
9. A client with schizophrenia says, “The voices are telling me to hurt myself.”
What should the nurse do first?
A. Ask the client whether the voices are commanding self-harm
B. Tell the client the voices are not real
C. Ignore the statement
D. Encourage the client to argue with the voices
Answer: A. Ask the client whether the voices are commanding self-harm
Rationale: Command hallucinations require immediate assessment of content, intent, ability to
resist the commands, and safety risk.
, 10. Which response is therapeutic for a client experiencing hallucinations?
A. “I don't hear the voices, but I understand that you do.”
B. “Those voices are real.”
C. “You are imagining everything.”
D. “Stop talking about the voices.”
Answer: A. “I don't hear the voices, but I understand that you do.”
Rationale: The nurse acknowledges the client's experience without validating the hallucination
as reality.
11. A client with schizophrenia says, “The other patients are plotting against
me.” Which response is best?
A. “That is definitely happening.”
B. “I don't see evidence of that, but I understand that you feel afraid.”
C. “You're being irrational.”
D. “Why would anyone plot against you?”
Answer: B. “I don't see evidence of that, but I understand that you feel afraid.”
Rationale: The nurse should present reality without arguing or reinforcing the delusion.
12. Which medication is an atypical antipsychotic?
A. Risperidone
B. Lithium
C. Diazepam
D. Lorazepam
Answer: A. Risperidone
Rationale: Risperidone is a second-generation antipsychotic used to treat disorders such as
schizophrenia and bipolar disorder.
13. Which adverse effect of antipsychotic medications requires immediate
attention?
rationales 2026/2027 version
1. A nurse is assessing a client who reports hearing voices that others do not
hear. Which term should the nurse use to document this finding?
A. Delusion
B. Hallucination
C. Illusion
D. Obsession
Answer: B. Hallucination
Rationale: A hallucination is a sensory perception without an external stimulus. Hearing voices
is an auditory hallucination.
2. A client tells the nurse, “The FBI implanted a tracking device in my tooth.”
Which finding does this statement represent?
A. Hallucination
B. Delusion
C. Compulsion
D. Flight of ideas
Answer: B. Delusion
Rationale: A delusion is a fixed, false belief that persists despite evidence to the contrary. The
statement represents a persecutory-type delusion.
3. Which finding is characteristic of mania?
A. Decreased energy and slowed speech
B. Increased need for sleep
C. Grandiosity and decreased need for sleep
D. Social withdrawal and hopelessness
Answer: C. Grandiosity and decreased need for sleep
Rationale: Mania commonly includes elevated or irritable mood, increased energy, decreased
need for sleep, pressured speech, grandiosity, distractibility, and impulsive behavior.
,4. A client with mania is speaking rapidly and changing topics frequently. Which
finding is this?
A. Echolalia
B. Flight of ideas
C. Thought blocking
D. Neologism
Answer: B. Flight of ideas
Rationale: Flight of ideas is rapid shifting from one topic to another with understandable
connections that become increasingly difficult to follow.
5. Which nursing intervention is appropriate for a client experiencing acute
mania?
A. Encourage multiple stimulating group activities
B. Provide a quiet, low-stimulation environment
C. Allow unlimited decision-making
D. Challenge grandiose beliefs directly
Answer: B. Provide a quiet, low-stimulation environment
Rationale: Reducing environmental stimulation can decrease agitation and help the client
maintain behavioral control.
6. A client with major depressive disorder says, “Everyone would be better off
without me.” What should the nurse do first?
A. Change the subject
B. Ask directly whether the client is thinking about suicide
C. Tell the client to focus on positive thoughts
D. Leave the client alone to rest
Answer: B. Ask directly whether the client is thinking about suicide
Rationale: Statements suggesting hopelessness or worthlessness require direct suicide
assessment. Asking about suicide does not cause suicidal behavior.
,7. Which finding is the highest priority for a client with major depressive
disorder?
A. Fatigue
B. Poor appetite
C. Suicidal thoughts with a specific plan
D. Social withdrawal
Answer: C. Suicidal thoughts with a specific plan
Rationale: A specific suicidal plan indicates an immediate safety risk and requires urgent
intervention.
8. Which intervention is appropriate for a client with suicidal ideation?
A. Place the client in a safe environment and remove potential means of self-harm
B. Allow the client unlimited privacy
C. Leave the client alone during meals
D. Promise to keep suicidal thoughts confidential
Answer: A. Place the client in a safe environment and remove potential means of self-harm
Rationale: Suicide precautions focus on maintaining safety, reducing access to lethal means, and
providing appropriate observation.
9. A client with schizophrenia says, “The voices are telling me to hurt myself.”
What should the nurse do first?
A. Ask the client whether the voices are commanding self-harm
B. Tell the client the voices are not real
C. Ignore the statement
D. Encourage the client to argue with the voices
Answer: A. Ask the client whether the voices are commanding self-harm
Rationale: Command hallucinations require immediate assessment of content, intent, ability to
resist the commands, and safety risk.
, 10. Which response is therapeutic for a client experiencing hallucinations?
A. “I don't hear the voices, but I understand that you do.”
B. “Those voices are real.”
C. “You are imagining everything.”
D. “Stop talking about the voices.”
Answer: A. “I don't hear the voices, but I understand that you do.”
Rationale: The nurse acknowledges the client's experience without validating the hallucination
as reality.
11. A client with schizophrenia says, “The other patients are plotting against
me.” Which response is best?
A. “That is definitely happening.”
B. “I don't see evidence of that, but I understand that you feel afraid.”
C. “You're being irrational.”
D. “Why would anyone plot against you?”
Answer: B. “I don't see evidence of that, but I understand that you feel afraid.”
Rationale: The nurse should present reality without arguing or reinforcing the delusion.
12. Which medication is an atypical antipsychotic?
A. Risperidone
B. Lithium
C. Diazepam
D. Lorazepam
Answer: A. Risperidone
Rationale: Risperidone is a second-generation antipsychotic used to treat disorders such as
schizophrenia and bipolar disorder.
13. Which adverse effect of antipsychotic medications requires immediate
attention?
