ATI Mental Health A Proctored Exam 2026/2027
Questions and Answers | Psychiatric Mental
Health Nursing Practice Assessment | Complete
Study Guide | Level 2/3 Preparation
DOMAIN DISTRIBUTION
Table
Wei Questi
Domain Key Focus Areas
ght ons
Foundations of Therapeutic communication, ethics, legal
10% 1-6
Psychiatric Nursing issues, patient rights
MDD, bipolar disorder, suicide assessment,
Mood Disorders 15% 7-16
mood stabilizers
Anxiety Disorders 12% 17-24 GAD, panic, OCD, PTSD, defense mechanisms
Psychotic Disorders 12% 25-32 Schizophrenia, antipsychotics, EPS, NMS
Personality Disorders 10% 33-38 BPD, antisocial, nursing interventions, DBT
, Eating Disorders 8% 39-43 Anorexia, bulimia, refeeding syndrome
Substance Use Disorders 8% 44-48 Alcohol/opioid withdrawal, CIWA, COWS, detox
Neurocognitive Disorders 8% 49-53 Delirium, dementia, Alzheimer's, sundowning
Sexual assault, IPV, abuse reporting, crisis
Crisis and Trauma 7% 54-58
intervention
Antidepressants, mood stabilizers,
Psychopharmacology 10% 59-65
antipsychotics, side effects
Integrated Scenarios — 66-70 Critical thinking, prioritization, delegation
SECTION 1: FOUNDATIONS OF PSYCHIATRIC NURSING
Questions 1-6 | 10% of Exam
Q1. A nurse is caring for a patient who was voluntarily admitted for major depressive
disorder. The patient approaches the nurse and states, "I want to leave the hospital
immediately. I don't need to be here anymore." Which of the following actions should the
nurse take first?
A. Place the patient on one-to-one observation
B. Notify the healthcare provider of the patient's request
C. Inform the patient of their right to request discharge and explain the process
,D. Administer PRN anxiolytic medication to reduce agitation
Correct Answer: C
Rationale:
Voluntarily admitted patients have the legal right to request discharge against medical
advice (AMA). The nurse's first action is to inform the patient of this right and explain
the process, which typically involves the provider evaluating the patient for continued
danger to self or others.
● A is incorrect because one-to-one observation is implemented only if the patient
is deemed at imminent risk after assessment, not merely for requesting
discharge.
● B is incorrect because while the provider must be notified, the nurse should first
acknowledge the patient's rights.
● D is incorrect because medication is not indicated solely for requesting
discharge and could be considered chemical restraint without clinical indication.
Key Concept: Voluntary vs. Involuntary Admission — Voluntary patients can request
discharge; involuntary requires court order for continued hold.
Q2. A 28-year-old patient requires seclusion due to violent behavior toward staff.
According to current CMS and Joint Commission regulations, how often must a provider
or licensed independent practitioner (LIP) conduct an in-person assessment of the
patient in seclusion?
A. Every 4 hours for adults
B. Every 1 hour of the initiation of seclusion
C. Every 2 hours for adults
D. Every 24 hours
, Correct Answer: B
Rationale:
CMS regulations require that a provider or LIP see and evaluate the patient in person
within 1 hour of the initiation of seclusion or restraint. Renewal orders are required every
4 hours for adults (every 2 hours for ages 9-17, every 1 hour for under 9).
● A refers to the renewal order interval, not the initial assessment.
● C and D do not meet regulatory requirements for initial assessment.
Key Concept: Seclusion/Restraint — Order within 1 hour, renewal q4h adults, continuous
monitoring, release q2h for ROM/toileting/fluids.
Q3. A patient with paranoid schizophrenia tells the nurse, "If my girlfriend leaves me, I'm
going to make sure she never leaves the house again. I know where she works and
where her family lives." The nurse recognizes this as a potential Tarasoff situation.
Which action should the nurse take first?
A. Document the threat thoroughly in the electronic health record
B. Maintain strict confidentiality as required by HIPAA
C. Notify law enforcement and the potential victim immediately
D. Discuss the statement with the treatment team and follow facility protocol for duty to
warn
Correct Answer: D
Rationale:
Questions and Answers | Psychiatric Mental
Health Nursing Practice Assessment | Complete
Study Guide | Level 2/3 Preparation
DOMAIN DISTRIBUTION
Table
Wei Questi
Domain Key Focus Areas
ght ons
Foundations of Therapeutic communication, ethics, legal
10% 1-6
Psychiatric Nursing issues, patient rights
MDD, bipolar disorder, suicide assessment,
Mood Disorders 15% 7-16
mood stabilizers
Anxiety Disorders 12% 17-24 GAD, panic, OCD, PTSD, defense mechanisms
Psychotic Disorders 12% 25-32 Schizophrenia, antipsychotics, EPS, NMS
Personality Disorders 10% 33-38 BPD, antisocial, nursing interventions, DBT
, Eating Disorders 8% 39-43 Anorexia, bulimia, refeeding syndrome
Substance Use Disorders 8% 44-48 Alcohol/opioid withdrawal, CIWA, COWS, detox
Neurocognitive Disorders 8% 49-53 Delirium, dementia, Alzheimer's, sundowning
Sexual assault, IPV, abuse reporting, crisis
Crisis and Trauma 7% 54-58
intervention
Antidepressants, mood stabilizers,
Psychopharmacology 10% 59-65
antipsychotics, side effects
Integrated Scenarios — 66-70 Critical thinking, prioritization, delegation
SECTION 1: FOUNDATIONS OF PSYCHIATRIC NURSING
Questions 1-6 | 10% of Exam
Q1. A nurse is caring for a patient who was voluntarily admitted for major depressive
disorder. The patient approaches the nurse and states, "I want to leave the hospital
immediately. I don't need to be here anymore." Which of the following actions should the
nurse take first?
A. Place the patient on one-to-one observation
B. Notify the healthcare provider of the patient's request
C. Inform the patient of their right to request discharge and explain the process
,D. Administer PRN anxiolytic medication to reduce agitation
Correct Answer: C
Rationale:
Voluntarily admitted patients have the legal right to request discharge against medical
advice (AMA). The nurse's first action is to inform the patient of this right and explain
the process, which typically involves the provider evaluating the patient for continued
danger to self or others.
● A is incorrect because one-to-one observation is implemented only if the patient
is deemed at imminent risk after assessment, not merely for requesting
discharge.
● B is incorrect because while the provider must be notified, the nurse should first
acknowledge the patient's rights.
● D is incorrect because medication is not indicated solely for requesting
discharge and could be considered chemical restraint without clinical indication.
Key Concept: Voluntary vs. Involuntary Admission — Voluntary patients can request
discharge; involuntary requires court order for continued hold.
Q2. A 28-year-old patient requires seclusion due to violent behavior toward staff.
According to current CMS and Joint Commission regulations, how often must a provider
or licensed independent practitioner (LIP) conduct an in-person assessment of the
patient in seclusion?
A. Every 4 hours for adults
B. Every 1 hour of the initiation of seclusion
C. Every 2 hours for adults
D. Every 24 hours
, Correct Answer: B
Rationale:
CMS regulations require that a provider or LIP see and evaluate the patient in person
within 1 hour of the initiation of seclusion or restraint. Renewal orders are required every
4 hours for adults (every 2 hours for ages 9-17, every 1 hour for under 9).
● A refers to the renewal order interval, not the initial assessment.
● C and D do not meet regulatory requirements for initial assessment.
Key Concept: Seclusion/Restraint — Order within 1 hour, renewal q4h adults, continuous
monitoring, release q2h for ROM/toileting/fluids.
Q3. A patient with paranoid schizophrenia tells the nurse, "If my girlfriend leaves me, I'm
going to make sure she never leaves the house again. I know where she works and
where her family lives." The nurse recognizes this as a potential Tarasoff situation.
Which action should the nurse take first?
A. Document the threat thoroughly in the electronic health record
B. Maintain strict confidentiality as required by HIPAA
C. Notify law enforcement and the potential victim immediately
D. Discuss the statement with the treatment team and follow facility protocol for duty to
warn
Correct Answer: D
Rationale:
