, ATI Mental Health CMS Exam Prep 2026/2027 | 700+ NCLEX-Style Practice Questions &
Rationales | NGN Case Studies | Psychiatric Nursing Study Guide PDF
1. Which medication should the nurse administer first to a client who is
experiencing alcohol withdrawal? (NCLEX NGN-Style)
A. Haloperidol 5 mg IM
B. Diazepam 5 mg IV bolus
C. Fluoxetine 20 mg PO
D. Diphenhydramine 25 mg IV
Correct Answer: B. Diazepam 5 mg IV bolus
Expert Rationale:
Diazepam is the priority medication because clients experiencing acute alcohol withdrawal are at
the greatest risk for seizures, delirium tremens (DTs), hypertension, and tachycardia. IV
diazepam acts rapidly to stabilize the central nervous system, decrease withdrawal symptoms,
and prevent life-threatening complications. Benzodiazepines are the first-line treatment for
alcohol withdrawal according to ATI Mental Health CMS guidelines.
2. A nurse is caring for a client who has schizophrenia and began taking an
antipsychotic medication yesterday. Which finding indicates that the nurse
should administer benztropine 2 mg IM?
A. Excessive salivation
B. Shuffling gait
C. Dry mouth
D. Weight gain
Correct Answer: B. Shuffling gait
Expert Rationale:
A shuffling gait is an extrapyramidal symptom (EPS) known as drug-induced Parkinsonism,
which commonly occurs with first-generation antipsychotics. Benztropine is an anticholinergic
medication used to reverse Parkinsonian symptoms such as shuffling gait, rigidity, and tremors.
3. A nurse is delegating client care tasks to an LPN and an assistive personnel
(AP). Which task should the nurse assign to the LPN?
A. Initiate suicide precautions for a newly admitted client.
B. Perform the admission assessment for a client with depression.
,C. Change the dressings of a client who has borderline personality disorder and superficial self-
inflicted wounds.
D. Develop the client's discharge teaching plan.
Correct Answer: C. Change the dressings of a client who has borderline personality
disorder and superficial self-inflicted wounds.
Expert Rationale:
Changing dressings, cleansing wounds, and collecting data regarding wound healing are within
the LPN's scope of practice. Initial assessments, care planning, and client education remain the
responsibility of the RN.
4. A nurse is planning care for a 7-year-old child who has ADHD. Which
intervention is the priority?
A. Encourage participation in group activities.
B. Allow the child to select daily activities independently.
C. Remove unnecessary equipment from the child's surroundings.
D. Provide toys that require prolonged concentration.
Correct Answer: C. Remove unnecessary equipment from the child's surroundings.
Expert Rationale:
Using the Safety and Risk Reduction framework, children with ADHD have impaired impulse
control and are at increased risk for injury. Removing hazardous objects reduces the risk for
accidental self-harm.
5. A nurse is discussing home care for a client who has advanced Alzheimer's
disease. The client's partner plans to travel out of town for several days. Which
resource should the nurse recommend?
A. Adult day-care services
B. Home health nursing visits
C. Respite care programs
D. Hospice care
Correct Answer: C. Respite care programs
Expert Rationale:
Respite care temporarily places the client in a care facility while providing caregivers with
needed rest or time away. This service reduces caregiver burden and helps prevent caregiver
burnout.
, 6. A nurse is caring for a client who has antisocial personality disorder and is
receiving behavioral therapy using operant conditioning. Which behavior
indicates that therapy is effective?
A. Avoids eye contact with staff.
B. Refrains from manipulating others to earn dining room privileges.
C. Isolates from peers during group therapy.
D. Refuses to attend counseling sessions.
Correct Answer: B. Refrains from manipulating others to earn dining room privileges.
Expert Rationale:
Operant conditioning reinforces desirable behaviors with positive rewards. Demonstrating
appropriate social behavior without manipulation indicates that positive reinforcement is
successfully modifying behavior.
7. Which finding is considered a negative symptom of schizophrenia?
A. Auditory hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
Correct Answer: C. Flat affect
Expert Rationale:
Negative symptoms represent a loss of normal emotional and social functioning. Examples
include flat affect, anhedonia, avolition, anergia, alogia, and thought blocking. Positive
symptoms include hallucinations, delusions, and disorganized thinking.
8. A nurse is reviewing laboratory results for several clients taking lithium.
Which client requires further assessment for lithium toxicity?
A. Sodium level 140 mEq/L
B. Potassium level 4.0 mEq/L
C. Sodium level 128 mEq/L
D. Calcium level 9.2 mg/dL
Correct Answer: C. Sodium level 128 mEq/L
Rationales | NGN Case Studies | Psychiatric Nursing Study Guide PDF
1. Which medication should the nurse administer first to a client who is
experiencing alcohol withdrawal? (NCLEX NGN-Style)
A. Haloperidol 5 mg IM
B. Diazepam 5 mg IV bolus
C. Fluoxetine 20 mg PO
D. Diphenhydramine 25 mg IV
Correct Answer: B. Diazepam 5 mg IV bolus
Expert Rationale:
Diazepam is the priority medication because clients experiencing acute alcohol withdrawal are at
the greatest risk for seizures, delirium tremens (DTs), hypertension, and tachycardia. IV
diazepam acts rapidly to stabilize the central nervous system, decrease withdrawal symptoms,
and prevent life-threatening complications. Benzodiazepines are the first-line treatment for
alcohol withdrawal according to ATI Mental Health CMS guidelines.
2. A nurse is caring for a client who has schizophrenia and began taking an
antipsychotic medication yesterday. Which finding indicates that the nurse
should administer benztropine 2 mg IM?
A. Excessive salivation
B. Shuffling gait
C. Dry mouth
D. Weight gain
Correct Answer: B. Shuffling gait
Expert Rationale:
A shuffling gait is an extrapyramidal symptom (EPS) known as drug-induced Parkinsonism,
which commonly occurs with first-generation antipsychotics. Benztropine is an anticholinergic
medication used to reverse Parkinsonian symptoms such as shuffling gait, rigidity, and tremors.
3. A nurse is delegating client care tasks to an LPN and an assistive personnel
(AP). Which task should the nurse assign to the LPN?
A. Initiate suicide precautions for a newly admitted client.
B. Perform the admission assessment for a client with depression.
,C. Change the dressings of a client who has borderline personality disorder and superficial self-
inflicted wounds.
D. Develop the client's discharge teaching plan.
Correct Answer: C. Change the dressings of a client who has borderline personality
disorder and superficial self-inflicted wounds.
Expert Rationale:
Changing dressings, cleansing wounds, and collecting data regarding wound healing are within
the LPN's scope of practice. Initial assessments, care planning, and client education remain the
responsibility of the RN.
4. A nurse is planning care for a 7-year-old child who has ADHD. Which
intervention is the priority?
A. Encourage participation in group activities.
B. Allow the child to select daily activities independently.
C. Remove unnecessary equipment from the child's surroundings.
D. Provide toys that require prolonged concentration.
Correct Answer: C. Remove unnecessary equipment from the child's surroundings.
Expert Rationale:
Using the Safety and Risk Reduction framework, children with ADHD have impaired impulse
control and are at increased risk for injury. Removing hazardous objects reduces the risk for
accidental self-harm.
5. A nurse is discussing home care for a client who has advanced Alzheimer's
disease. The client's partner plans to travel out of town for several days. Which
resource should the nurse recommend?
A. Adult day-care services
B. Home health nursing visits
C. Respite care programs
D. Hospice care
Correct Answer: C. Respite care programs
Expert Rationale:
Respite care temporarily places the client in a care facility while providing caregivers with
needed rest or time away. This service reduces caregiver burden and helps prevent caregiver
burnout.
, 6. A nurse is caring for a client who has antisocial personality disorder and is
receiving behavioral therapy using operant conditioning. Which behavior
indicates that therapy is effective?
A. Avoids eye contact with staff.
B. Refrains from manipulating others to earn dining room privileges.
C. Isolates from peers during group therapy.
D. Refuses to attend counseling sessions.
Correct Answer: B. Refrains from manipulating others to earn dining room privileges.
Expert Rationale:
Operant conditioning reinforces desirable behaviors with positive rewards. Demonstrating
appropriate social behavior without manipulation indicates that positive reinforcement is
successfully modifying behavior.
7. Which finding is considered a negative symptom of schizophrenia?
A. Auditory hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
Correct Answer: C. Flat affect
Expert Rationale:
Negative symptoms represent a loss of normal emotional and social functioning. Examples
include flat affect, anhedonia, avolition, anergia, alogia, and thought blocking. Positive
symptoms include hallucinations, delusions, and disorganized thinking.
8. A nurse is reviewing laboratory results for several clients taking lithium.
Which client requires further assessment for lithium toxicity?
A. Sodium level 140 mEq/L
B. Potassium level 4.0 mEq/L
C. Sodium level 128 mEq/L
D. Calcium level 9.2 mg/dL
Correct Answer: C. Sodium level 128 mEq/L
