ATI RN Mental Health Nursing Proctored Exam NGN 2026 Updated
Version | Ultimate Exam Preparation Package Featuring 100+ Practice
Questions, Psychiatric Disorders Review, Psychotropic Medications,
Safety Priorities, Clinical Judgment Case Studies, and Comprehensive
Rationales
Question 1
A nurse is establishing a therapeutic relationship with a client diagnosed with
major depressive disorder. Which of the following actions should the nurse take
first?
A. Discuss coping strategies for managing depressive symptoms
B. Establish clear boundaries and explain confidentiality
C. Explore the client's past traumatic experiences
D. Provide advice on establishing a daily routine
Answer: B
Rationale: The first phase of the therapeutic relationship is the orientation phase,
during which the nurse establishes boundaries, explains confidentiality, and sets
expectations. Exploring trauma (C) or providing advice (A, D) occurs later in the
working phase.
Question 2
A client tells the nurse, "I don't think I'll ever get better." Which of the following is
an example of a therapeutic response?
A. "You'll feel better soon, just wait."
B. "Why do you feel that way?"
C. "Tell me more about what makes you feel that way."
D. "Many people recover from this illness."
Answer: C
Rationale: "Tell me more" is an open-ended, therapeutic response that
encourages the client to express feelings. "Why" questions (B) can be perceived as
accusatory. False reassurance (A) and platitudes (D) are nontherapeutic.
,Question 3
A nurse is working with a client who has borderline personality disorder. The
client says, "You're the only nurse who understands me. The others are all mean."
This statement reflects which defense mechanism?
A. Projection
B. Splitting
C. Reaction formation
D. Rationalization
Answer: B
Rationale: Splitting is a primitive defense mechanism where the client views
people as all good or all bad, commonly seen in borderline personality
disorder. Projection (A) involves attributing one's own unacceptable feelings to
others.
Question 4
A charge nurse is conducting a class on therapeutic communication for newly
licensed nurses. Which response by a newly licensed nurse indicates a need for
additional teaching regarding nonverbal communication?
A. "Personal space is a component of nonverbal communication."
B. "Posture can communicate a client's emotional state."
C. "Eye contact is an important nonverbal behavior."
D. "Intonation is considered a nonverbal communication element."
Answer: D
Rationale: Intonation (tone of voice) is considered a verbal communication
element, not nonverbal. Personal space, posture, and eye contact are all
components of nonverbal behavior.
Question 5
A nurse hears a newly licensed nurse discussing a client's hallucinations in the
,hallway with another nurse. Which of the following actions should the nurse
take first?
A. Notify the nurse manager
B. Tell the nurse to stop discussing the client's behavior immediately
C. Provide an in-service program about confidentiality
D. Complete an incident report
Answer: B
Rationale: The nurse should first tell the newly licensed nurse to stop discussing
the client's behavior, as this is a breach of confidentiality. Notifying the nurse
manager (A), providing in-service education (C), and completing an incident
report (D) are appropriate follow-up actions but are not the first step.
Question 6
A client with major depressive disorder tells the nurse, "I don't have anything to
live for anymore." What is the nurse's best response?
A. "Everything will be fine."
B. "You have so much to live for."
C. "Are you thinking of hurting yourself?"
D. "Let's focus on the positive things in your life."
Answer: C
Rationale: Direct questioning about suicidal ideation is essential and does not
increase the risk of suicide. The nurse must assess for intent, plan, and means.
False reassurance (A, B) or minimizing the statement (D) is not therapeutic.
Question 7
A nurse is caring for a client who is withdrawn and fearful. Which of the following
actions should the nurse take first during the admission assessment?
A. Ask the client about their medical history
B. Inform the client that this admission is confidential
, C. Complete a physical assessment
D. Contact the client's family
Answer: B
Rationale: According to evidence-based practice, the nurse should first inform
the client about confidentiality during the orientation phase of the nurse-client
relationship. This action establishes trust between the client and the nurse, which
in turn decreases the client's anxiety level.
Question 8
A client tells the nurse, "I'm so worried about my surgery tomorrow. I can't
sleep." Which of the following is the most therapeutic response?
A. "Don't worry. The surgeon is very experienced."
B. "You seem very anxious. Tell me more about your concerns."
C. "Why are you worried? The surgery is routine."
D. "You should take a sleeping pill tonight."
Answer: B
Rationale: This response uses validation and reflection, acknowledging the
client's feelings and inviting further expression of concerns. False reassurance (A),
"why" questions (C), and giving advice (D) are nontherapeutic.
Question 9
A nurse is caring for a client who is angry and shouting. Which of the following
actions should the nurse take?
A. Shout back to establish authority
B. Leave the client alone to calm down
C. Maintain a calm voice and speak slowly
D. Tell the client to stop shouting immediately
Answer: C
Rationale: Maintaining a calm voice and speaking slowly can help de-escalate the
situation. Shouting back (A) escalates the situation; leaving the client alone (B)
Version | Ultimate Exam Preparation Package Featuring 100+ Practice
Questions, Psychiatric Disorders Review, Psychotropic Medications,
Safety Priorities, Clinical Judgment Case Studies, and Comprehensive
Rationales
Question 1
A nurse is establishing a therapeutic relationship with a client diagnosed with
major depressive disorder. Which of the following actions should the nurse take
first?
A. Discuss coping strategies for managing depressive symptoms
B. Establish clear boundaries and explain confidentiality
C. Explore the client's past traumatic experiences
D. Provide advice on establishing a daily routine
Answer: B
Rationale: The first phase of the therapeutic relationship is the orientation phase,
during which the nurse establishes boundaries, explains confidentiality, and sets
expectations. Exploring trauma (C) or providing advice (A, D) occurs later in the
working phase.
Question 2
A client tells the nurse, "I don't think I'll ever get better." Which of the following is
an example of a therapeutic response?
A. "You'll feel better soon, just wait."
B. "Why do you feel that way?"
C. "Tell me more about what makes you feel that way."
D. "Many people recover from this illness."
Answer: C
Rationale: "Tell me more" is an open-ended, therapeutic response that
encourages the client to express feelings. "Why" questions (B) can be perceived as
accusatory. False reassurance (A) and platitudes (D) are nontherapeutic.
,Question 3
A nurse is working with a client who has borderline personality disorder. The
client says, "You're the only nurse who understands me. The others are all mean."
This statement reflects which defense mechanism?
A. Projection
B. Splitting
C. Reaction formation
D. Rationalization
Answer: B
Rationale: Splitting is a primitive defense mechanism where the client views
people as all good or all bad, commonly seen in borderline personality
disorder. Projection (A) involves attributing one's own unacceptable feelings to
others.
Question 4
A charge nurse is conducting a class on therapeutic communication for newly
licensed nurses. Which response by a newly licensed nurse indicates a need for
additional teaching regarding nonverbal communication?
A. "Personal space is a component of nonverbal communication."
B. "Posture can communicate a client's emotional state."
C. "Eye contact is an important nonverbal behavior."
D. "Intonation is considered a nonverbal communication element."
Answer: D
Rationale: Intonation (tone of voice) is considered a verbal communication
element, not nonverbal. Personal space, posture, and eye contact are all
components of nonverbal behavior.
Question 5
A nurse hears a newly licensed nurse discussing a client's hallucinations in the
,hallway with another nurse. Which of the following actions should the nurse
take first?
A. Notify the nurse manager
B. Tell the nurse to stop discussing the client's behavior immediately
C. Provide an in-service program about confidentiality
D. Complete an incident report
Answer: B
Rationale: The nurse should first tell the newly licensed nurse to stop discussing
the client's behavior, as this is a breach of confidentiality. Notifying the nurse
manager (A), providing in-service education (C), and completing an incident
report (D) are appropriate follow-up actions but are not the first step.
Question 6
A client with major depressive disorder tells the nurse, "I don't have anything to
live for anymore." What is the nurse's best response?
A. "Everything will be fine."
B. "You have so much to live for."
C. "Are you thinking of hurting yourself?"
D. "Let's focus on the positive things in your life."
Answer: C
Rationale: Direct questioning about suicidal ideation is essential and does not
increase the risk of suicide. The nurse must assess for intent, plan, and means.
False reassurance (A, B) or minimizing the statement (D) is not therapeutic.
Question 7
A nurse is caring for a client who is withdrawn and fearful. Which of the following
actions should the nurse take first during the admission assessment?
A. Ask the client about their medical history
B. Inform the client that this admission is confidential
, C. Complete a physical assessment
D. Contact the client's family
Answer: B
Rationale: According to evidence-based practice, the nurse should first inform
the client about confidentiality during the orientation phase of the nurse-client
relationship. This action establishes trust between the client and the nurse, which
in turn decreases the client's anxiety level.
Question 8
A client tells the nurse, "I'm so worried about my surgery tomorrow. I can't
sleep." Which of the following is the most therapeutic response?
A. "Don't worry. The surgeon is very experienced."
B. "You seem very anxious. Tell me more about your concerns."
C. "Why are you worried? The surgery is routine."
D. "You should take a sleeping pill tonight."
Answer: B
Rationale: This response uses validation and reflection, acknowledging the
client's feelings and inviting further expression of concerns. False reassurance (A),
"why" questions (C), and giving advice (D) are nontherapeutic.
Question 9
A nurse is caring for a client who is angry and shouting. Which of the following
actions should the nurse take?
A. Shout back to establish authority
B. Leave the client alone to calm down
C. Maintain a calm voice and speak slowly
D. Tell the client to stop shouting immediately
Answer: C
Rationale: Maintaining a calm voice and speaking slowly can help de-escalate the
situation. Shouting back (A) escalates the situation; leaving the client alone (B)
