ATI MENTAL HEALTH FINAL EXAM
COMPLETE REVIEW 100 Comprehensive
Psychiatric Nursing Questions with
Answers
**Scenario:** A 32-year-old female is brought to the ED by her roommate, who found her crying and
stating she "can't go on anymore." The patient reports feeling depressed for 6 weeks (loss of appetite,
insomnia, fatigue). She states, "I've been thinking about taking all my pills." She has a history of one
prior suicide attempt 3 years ago.
**1. Recognizing Cues:** Which findings are most concerning for immediate suicide risk? **(Select All
That Apply)**
A. Feeling depressed for 6 weeks
,B. Statement "I've been thinking about taking all my pills"
C. History of a prior suicide attempt
D. Loss of appetite and insomnia
E. The patient is cooperative
**Answer:** B, C
**Rationale:** A specific plan (taking pills) and a history of prior attempt are the strongest predictors of
suicide. While depressive symptoms (A, D) support the diagnosis, they are not the most acute risk
indicators. Cooperation does not eliminate risk.
**2. Prioritize Hypotheses:** What is the priority nursing action upon admission?
A. Administer a prescribed antidepressant
B. Initiate one-to-one constant observation and remove harmful items
C. Schedule a family therapy session
D. Encourage attendance at group therapy
**Answer:** B
**Rationale:** Safety is the highest priority. The nurse must remove dangerous objects (belts,
shoelaces, glass, medications) and place the patient on constant observation until a full risk assessment
is completed.
**3. Generate Solutions:** The patient is started on **Sertraline (Zoloft)** . The nurse should monitor
for which early adverse effects? **(Select All That Apply)**
A. Increased energy with persistent suicidal ideation
B. Gastrointestinal upset (nausea, diarrhea)
C. Hypertensive crisis
D. Sexual dysfunction
,**Answer:** A, B
**Rationale:** SSRIs can cause GI upset initially. The FDA black box warning indicates that
antidepressants may increase suicidal ideation, particularly in young adults, because energy may
improve before mood, giving the patient the energy to act on suicidal plans.
## NGN Case Study 2: Schizophrenia (Psychosis)
**Scenario:** A 24-year-old male with schizophrenia stopped his Risperidone 3 weeks ago. He is pacing,
mumbling to himself, and tells the nurse, "The voices are telling me they are going to poison my food."
**4. Analyze Cues:** What is the most likely reason he is refusing to eat?
A. He is not hungry
B. He has a delusion that the food is contaminated
C. He is protesting the unit rules
D. He has a physical illness
**Answer:** B
**Rationale:** The auditory hallucinations are directly causing a **persecutory delusion** (belief that
food is poisoned). This is a common negative consequence of command or persecutory hallucinations.
**5. Generate Solutions:** The nurse offers the patient oral risperidone. The nurse should monitor for
which **extrapyramidal symptom (EPS)** that can occur within hours of administration?
A. Tardive dyskinesia
B. Acute dystonia (e.g., torticollis, oculogyric crisis)
C. Polyuria
D. Hypertensive crisis
, **Answer:** B
**Rationale:** **Acute dystonia** (muscle spasms of the tongue, face, neck, or back) can occur within
hours to days of starting antipsychotics. Tardive dyskinesia occurs after long-term use.
**6. Therapeutic Communication:** The client states, "The voices are telling me I am worthless." Which
response should the nurse provide?
A. "Those voices aren't real, so you should ignore them."
B. "I don't hear the voices, but I understand they are real to you. What are they saying right now?"
C. "If you keep talking about the voices, I will have to leave."
D. "Try not to think about the voices."
**Answer:** B
**Rationale:** This response acknowledges the client's experience without validating the hallucination
as real. By asking what the voices are saying, the nurse gains insight into the client's thought content
(e.g., command hallucinations) while promoting trust.
## NGN Case Study 3: Bipolar I Disorder (Manic Episode)
**Scenario:** A 28-year-old female has not slept for 3 days, is speaking rapidly with flight of ideas, and
has spent $5,000 on clothing in 24 hours. She states, "I am the most brilliant person on earth."
**7. Priority Intervention:** What is the priority intervention for the client in acute mania?
A. Encourage participation in competitive group games to burn energy
B. Provide a quiet, low-stimulation environment and offer high-calorie finger foods
C. Ask the client to write down her financial goals
D. Isolate the client in his room until behavior improves
COMPLETE REVIEW 100 Comprehensive
Psychiatric Nursing Questions with
Answers
**Scenario:** A 32-year-old female is brought to the ED by her roommate, who found her crying and
stating she "can't go on anymore." The patient reports feeling depressed for 6 weeks (loss of appetite,
insomnia, fatigue). She states, "I've been thinking about taking all my pills." She has a history of one
prior suicide attempt 3 years ago.
**1. Recognizing Cues:** Which findings are most concerning for immediate suicide risk? **(Select All
That Apply)**
A. Feeling depressed for 6 weeks
,B. Statement "I've been thinking about taking all my pills"
C. History of a prior suicide attempt
D. Loss of appetite and insomnia
E. The patient is cooperative
**Answer:** B, C
**Rationale:** A specific plan (taking pills) and a history of prior attempt are the strongest predictors of
suicide. While depressive symptoms (A, D) support the diagnosis, they are not the most acute risk
indicators. Cooperation does not eliminate risk.
**2. Prioritize Hypotheses:** What is the priority nursing action upon admission?
A. Administer a prescribed antidepressant
B. Initiate one-to-one constant observation and remove harmful items
C. Schedule a family therapy session
D. Encourage attendance at group therapy
**Answer:** B
**Rationale:** Safety is the highest priority. The nurse must remove dangerous objects (belts,
shoelaces, glass, medications) and place the patient on constant observation until a full risk assessment
is completed.
**3. Generate Solutions:** The patient is started on **Sertraline (Zoloft)** . The nurse should monitor
for which early adverse effects? **(Select All That Apply)**
A. Increased energy with persistent suicidal ideation
B. Gastrointestinal upset (nausea, diarrhea)
C. Hypertensive crisis
D. Sexual dysfunction
,**Answer:** A, B
**Rationale:** SSRIs can cause GI upset initially. The FDA black box warning indicates that
antidepressants may increase suicidal ideation, particularly in young adults, because energy may
improve before mood, giving the patient the energy to act on suicidal plans.
## NGN Case Study 2: Schizophrenia (Psychosis)
**Scenario:** A 24-year-old male with schizophrenia stopped his Risperidone 3 weeks ago. He is pacing,
mumbling to himself, and tells the nurse, "The voices are telling me they are going to poison my food."
**4. Analyze Cues:** What is the most likely reason he is refusing to eat?
A. He is not hungry
B. He has a delusion that the food is contaminated
C. He is protesting the unit rules
D. He has a physical illness
**Answer:** B
**Rationale:** The auditory hallucinations are directly causing a **persecutory delusion** (belief that
food is poisoned). This is a common negative consequence of command or persecutory hallucinations.
**5. Generate Solutions:** The nurse offers the patient oral risperidone. The nurse should monitor for
which **extrapyramidal symptom (EPS)** that can occur within hours of administration?
A. Tardive dyskinesia
B. Acute dystonia (e.g., torticollis, oculogyric crisis)
C. Polyuria
D. Hypertensive crisis
, **Answer:** B
**Rationale:** **Acute dystonia** (muscle spasms of the tongue, face, neck, or back) can occur within
hours to days of starting antipsychotics. Tardive dyskinesia occurs after long-term use.
**6. Therapeutic Communication:** The client states, "The voices are telling me I am worthless." Which
response should the nurse provide?
A. "Those voices aren't real, so you should ignore them."
B. "I don't hear the voices, but I understand they are real to you. What are they saying right now?"
C. "If you keep talking about the voices, I will have to leave."
D. "Try not to think about the voices."
**Answer:** B
**Rationale:** This response acknowledges the client's experience without validating the hallucination
as real. By asking what the voices are saying, the nurse gains insight into the client's thought content
(e.g., command hallucinations) while promoting trust.
## NGN Case Study 3: Bipolar I Disorder (Manic Episode)
**Scenario:** A 28-year-old female has not slept for 3 days, is speaking rapidly with flight of ideas, and
has spent $5,000 on clothing in 24 hours. She states, "I am the most brilliant person on earth."
**7. Priority Intervention:** What is the priority intervention for the client in acute mania?
A. Encourage participation in competitive group games to burn energy
B. Provide a quiet, low-stimulation environment and offer high-calorie finger foods
C. Ask the client to write down her financial goals
D. Isolate the client in his room until behavior improves
