MENTAL HEALTH
RN ATI
PROCTORED EXAM
2025/2026
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-
CLIENT RELATIONSHIP (Questions 1-10)
1. A nurse is caring for a client who has schizophrenia and tells the nurse, "The
government is reading my mail." Which response should the nurse make?
A. "You know that's not true because it's against the law."
B. "All of your letters come sealed, so that seems unlikely."
C. "It must be frightening to think that someone is reading your mail."
D. "Why do you think the government wants to read your mail?"
Correct Answer: C
Rationale: This response validates the client's feelings without reinforcing or
challenging the delusion. Arguing (A, B) damages trust, and asking "why" (D) is probing
and non-therapeutic.
, 2. A client tells the nurse, "I don't think I can go on anymore." What is the nurse's
priority response?
A. "Don't worry, things will get better."
B. "Are you thinking about harming yourself?"
C. "Tell me more about what you're feeling."
D. "Let me get the doctor to talk with you."
Correct Answer: B
Rationale: The priority is to perform a suicide risk assessment by directly asking about
suicidal ideation, plan, and means. Safety is always the priority.
3. A nurse is talking to a client following a group session. The client says another
member made an inappropriate comment. Which response should the nurse
make?
A. "I think you should ignore the comment."
B. "You sound upset about today's session."
C. "Why do you think he said that to you?"
D. "I agree that the comment was inappropriate."
Correct Answer: B
Rationale: Reflecting feelings (B) acknowledges the client's emotional state and
encourages further discussion. Giving advice (A), using "why" (C), or agreeing (D) are
non-therapeutic.
4. A charge nurse is discussing care of a client with substance use disorder with a
staff nurse. Which statement indicates countertransference?
A. "The client is just like my brother who finally overcame his habit."
B. "The client needs to accept responsibility for his substance use."
C. "The client generally shares his feelings during group therapy."
D. "The client asked me on a date, but I refused."
, Correct Answer: A
Rationale: Countertransference occurs when the nurse projects personal feelings or
experiences onto the client. Comparing the client to the nurse's brother indicates
personal bias affecting objectivity.
5. A client says, "I feel like no one cares about me." Which therapeutic response
should the nurse make?
A. "That's not true. I care about you."
B. "What makes you say that no one cares?"
C. "You feel like no one cares about you right now."
D. "You shouldn't feel that way."
Correct Answer: C
Rationale: This uses restatement and validation of feelings. It acknowledges the client's
perception without judging, agreeing, or offering false reassurance.
6. A nurse is setting limits with a manipulative client. Which statement is most
appropriate?
A. "If you continue this behavior, you will be discharged."
B. "Stop trying to control the staff."
C. "I will not allow you to speak to me that way."
D. "Why are you acting this way?"
Correct Answer: C
Rationale: Clear, firm limit-setting using "I" statements is therapeutic. It sets boundaries
without threatening (A), labeling (B), or probing (D).
7. A client refuses to take medication. Which response is most therapeutic?
A. "You have to take this or we'll give you a shot."
, B. "I understand you don't want it. Can you tell me why?"
C. "Your doctor ordered this, so you must take it."
D. "If you don't take it, you'll get sick again."
Correct Answer: B
Rationale: Exploring the client's reasons for refusal respects autonomy and opens
dialogue. Threats (A, D) and authority statements (C) damage therapeutic alliance.
8. A nurse is using silence during a client interaction. When is silence therapeutic?
A. When the client is hostile and angry
B. When the client is experiencing hallucinations
C. When the client needs time to process thoughts and feelings
D. When the client asks a direct question
Correct Answer: C
Rationale: Silence provides space for reflection and can encourage the client to
continue speaking. It is not appropriate when the client is psychotic, hostile, or asking
for information.
9. A client says, "I'm so stupid. I failed my nursing exam." Which response
demonstrates cognitive reframing?
A. "You are not stupid. You are very intelligent."
B. "Failing an exam doesn't mean you're stupid. Let's look at how you studied."
C. "Why do you think you failed?"
D. "Don't be so hard on yourself."
Correct Answer: B
Rationale: Cognitive reframing helps the client identify and change negative thought
patterns by separating the behavior (failing) from self-worth (stupid).
RN ATI
PROCTORED EXAM
2025/2026
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-
CLIENT RELATIONSHIP (Questions 1-10)
1. A nurse is caring for a client who has schizophrenia and tells the nurse, "The
government is reading my mail." Which response should the nurse make?
A. "You know that's not true because it's against the law."
B. "All of your letters come sealed, so that seems unlikely."
C. "It must be frightening to think that someone is reading your mail."
D. "Why do you think the government wants to read your mail?"
Correct Answer: C
Rationale: This response validates the client's feelings without reinforcing or
challenging the delusion. Arguing (A, B) damages trust, and asking "why" (D) is probing
and non-therapeutic.
, 2. A client tells the nurse, "I don't think I can go on anymore." What is the nurse's
priority response?
A. "Don't worry, things will get better."
B. "Are you thinking about harming yourself?"
C. "Tell me more about what you're feeling."
D. "Let me get the doctor to talk with you."
Correct Answer: B
Rationale: The priority is to perform a suicide risk assessment by directly asking about
suicidal ideation, plan, and means. Safety is always the priority.
3. A nurse is talking to a client following a group session. The client says another
member made an inappropriate comment. Which response should the nurse
make?
A. "I think you should ignore the comment."
B. "You sound upset about today's session."
C. "Why do you think he said that to you?"
D. "I agree that the comment was inappropriate."
Correct Answer: B
Rationale: Reflecting feelings (B) acknowledges the client's emotional state and
encourages further discussion. Giving advice (A), using "why" (C), or agreeing (D) are
non-therapeutic.
4. A charge nurse is discussing care of a client with substance use disorder with a
staff nurse. Which statement indicates countertransference?
A. "The client is just like my brother who finally overcame his habit."
B. "The client needs to accept responsibility for his substance use."
C. "The client generally shares his feelings during group therapy."
D. "The client asked me on a date, but I refused."
, Correct Answer: A
Rationale: Countertransference occurs when the nurse projects personal feelings or
experiences onto the client. Comparing the client to the nurse's brother indicates
personal bias affecting objectivity.
5. A client says, "I feel like no one cares about me." Which therapeutic response
should the nurse make?
A. "That's not true. I care about you."
B. "What makes you say that no one cares?"
C. "You feel like no one cares about you right now."
D. "You shouldn't feel that way."
Correct Answer: C
Rationale: This uses restatement and validation of feelings. It acknowledges the client's
perception without judging, agreeing, or offering false reassurance.
6. A nurse is setting limits with a manipulative client. Which statement is most
appropriate?
A. "If you continue this behavior, you will be discharged."
B. "Stop trying to control the staff."
C. "I will not allow you to speak to me that way."
D. "Why are you acting this way?"
Correct Answer: C
Rationale: Clear, firm limit-setting using "I" statements is therapeutic. It sets boundaries
without threatening (A), labeling (B), or probing (D).
7. A client refuses to take medication. Which response is most therapeutic?
A. "You have to take this or we'll give you a shot."
, B. "I understand you don't want it. Can you tell me why?"
C. "Your doctor ordered this, so you must take it."
D. "If you don't take it, you'll get sick again."
Correct Answer: B
Rationale: Exploring the client's reasons for refusal respects autonomy and opens
dialogue. Threats (A, D) and authority statements (C) damage therapeutic alliance.
8. A nurse is using silence during a client interaction. When is silence therapeutic?
A. When the client is hostile and angry
B. When the client is experiencing hallucinations
C. When the client needs time to process thoughts and feelings
D. When the client asks a direct question
Correct Answer: C
Rationale: Silence provides space for reflection and can encourage the client to
continue speaking. It is not appropriate when the client is psychotic, hostile, or asking
for information.
9. A client says, "I'm so stupid. I failed my nursing exam." Which response
demonstrates cognitive reframing?
A. "You are not stupid. You are very intelligent."
B. "Failing an exam doesn't mean you're stupid. Let's look at how you studied."
C. "Why do you think you failed?"
D. "Don't be so hard on yourself."
Correct Answer: B
Rationale: Cognitive reframing helps the client identify and change negative thought
patterns by separating the behavior (failing) from self-worth (stupid).
