ATI RN Mental Health Proctored
Exam 2026: Complete Practice
Questions with Verified Answers &
NGN-Style Rationales
Section 1: Therapeutic Communication & Nurse-Client
Relationship
Question 1
A nurse is conducting a mental status examination with a newly admitted
client. Which statement by the nurse indicates an understanding of how
to assess cognitive ability?
A) "To assess cognitive ability, I should ask the client to count backward
by sevens."
B) "To assess affect, I should observe the client's facial expression."
C) "To assess language ability, I should instruct the client to write a
sentence."
D) "To assess remote memory, I should have the client repeat a list of
objects."
Answer: A
Rationale: Asking the client to count backward by sevens is an
appropriate assessment of cognitive ability and concentration. Observing
facial expression assesses affect, writing a sentence assesses language
ability, and repeating a list of objects assesses immediate (not remote)
memory. Remote memory would involve recalling past events or
personal history .
Question 2
A nurse is caring for a client who states, "I feel like my life has no
purpose anymore." Which response by the nurse is most therapeutic?
,A) "You should focus on the positive things in your life."
B) "Why do you feel that way?"
C) "Can you tell me more about what makes you feel this way?"
D) "Everyone feels this way sometimes."
Answer: C
Rationale: Encouraging the client to elaborate using an open-ended
question promotes therapeutic communication and allows the nurse to
assess the client's feelings. Giving advice (A) dismisses the client's
feelings, asking "why" questions (B) can be perceived as confrontational,
and minimizing feelings (D) is nontherapeutic .
Question 3
A nurse hears a newly licensed nurse discussing a client's hallucinations
in the hallway with another nurse. Which action should the nurse take
first?
A) Notify the nurse manager
B) Tell the nurse to stop discussing the behavior
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, providing an in-service program, and
completing an incident report are appropriate follow-up actions but are
not the first step .
Section 2: Mood Disorders
,Question 4
A client with major depressive disorder states, "I don't have anything to
live for. Everyone would be better off without me." Which response by
the nurse is most therapeutic?
A) "You have so much to live for. Think about your family."
B) "Are you thinking of harming yourself?"
C) "I know how you feel. I've been depressed before."
D) "Let's focus on positive thoughts instead."
Answer: B
Rationale: Direct assessment of suicidal ideation is essential. Asking
about suicide does not increase the risk—it allows the nurse to assess
lethality, plan, means, and intent. Options A and D are false reassurance
and dismiss the client's feelings. Option C is inappropriate because the
nurse cannot know exactly how the client feels .
Question 5
A nurse is caring for a client with depression. Which finding requires
immediate intervention?
A) Fatigue
B) Poor appetite
C) Thoughts of self-harm
D) Difficulty concentrating
Answer: C
Rationale: Safety is the priority. Thoughts of self-harm require
immediate assessment and intervention to prevent injury. While fatigue,
poor appetite, and difficulty concentrating are symptoms of depression,
they do not represent an immediate safety risk .
, Question 6
A client with bipolar disorder is experiencing a manic episode. Which
interventions should the nurse include in the plan of care? (Select all that
apply)
A) Provide a structured, low-stimulation environment
B) Offer high-calorie finger foods
C) Encourage the client to make complex decisions about their care
D) Maintain consistent staff assignments
E) Allow the client to stay awake as long as they want
Answer: A, B, D
Rationale: Clients in a manic episode need a structured, low-stimulation
environment to decrease agitation. High-calorie finger foods
accommodate the client's inability to sit for meals. Consistent staff
assignments help build trust and provide stability. Making complex
decisions is overwhelming during mania, and sleep should be
encouraged, not discouraged .
Question 7
A nurse is teaching a client prescribed lithium for bipolar disorder. Which
statement indicates the client understands the teaching?
A) "I should restrict my fluid intake to prevent toxicity."
B) "I should take lithium on an empty stomach."
C) "I need to have regular blood tests to check my lithium level."
D) "I can stop taking lithium when I feel better."
Answer: C
Rationale: Regular blood tests are essential to monitor lithium levels
and prevent toxicity. Lithium should be taken with food to prevent
gastrointestinal upset. Fluid intake should be adequate (not restricted),
and lithium must be taken consistently even when feeling better to
maintain therapeutic levels .
Exam 2026: Complete Practice
Questions with Verified Answers &
NGN-Style Rationales
Section 1: Therapeutic Communication & Nurse-Client
Relationship
Question 1
A nurse is conducting a mental status examination with a newly admitted
client. Which statement by the nurse indicates an understanding of how
to assess cognitive ability?
A) "To assess cognitive ability, I should ask the client to count backward
by sevens."
B) "To assess affect, I should observe the client's facial expression."
C) "To assess language ability, I should instruct the client to write a
sentence."
D) "To assess remote memory, I should have the client repeat a list of
objects."
Answer: A
Rationale: Asking the client to count backward by sevens is an
appropriate assessment of cognitive ability and concentration. Observing
facial expression assesses affect, writing a sentence assesses language
ability, and repeating a list of objects assesses immediate (not remote)
memory. Remote memory would involve recalling past events or
personal history .
Question 2
A nurse is caring for a client who states, "I feel like my life has no
purpose anymore." Which response by the nurse is most therapeutic?
,A) "You should focus on the positive things in your life."
B) "Why do you feel that way?"
C) "Can you tell me more about what makes you feel this way?"
D) "Everyone feels this way sometimes."
Answer: C
Rationale: Encouraging the client to elaborate using an open-ended
question promotes therapeutic communication and allows the nurse to
assess the client's feelings. Giving advice (A) dismisses the client's
feelings, asking "why" questions (B) can be perceived as confrontational,
and minimizing feelings (D) is nontherapeutic .
Question 3
A nurse hears a newly licensed nurse discussing a client's hallucinations
in the hallway with another nurse. Which action should the nurse take
first?
A) Notify the nurse manager
B) Tell the nurse to stop discussing the behavior
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, providing an in-service program, and
completing an incident report are appropriate follow-up actions but are
not the first step .
Section 2: Mood Disorders
,Question 4
A client with major depressive disorder states, "I don't have anything to
live for. Everyone would be better off without me." Which response by
the nurse is most therapeutic?
A) "You have so much to live for. Think about your family."
B) "Are you thinking of harming yourself?"
C) "I know how you feel. I've been depressed before."
D) "Let's focus on positive thoughts instead."
Answer: B
Rationale: Direct assessment of suicidal ideation is essential. Asking
about suicide does not increase the risk—it allows the nurse to assess
lethality, plan, means, and intent. Options A and D are false reassurance
and dismiss the client's feelings. Option C is inappropriate because the
nurse cannot know exactly how the client feels .
Question 5
A nurse is caring for a client with depression. Which finding requires
immediate intervention?
A) Fatigue
B) Poor appetite
C) Thoughts of self-harm
D) Difficulty concentrating
Answer: C
Rationale: Safety is the priority. Thoughts of self-harm require
immediate assessment and intervention to prevent injury. While fatigue,
poor appetite, and difficulty concentrating are symptoms of depression,
they do not represent an immediate safety risk .
, Question 6
A client with bipolar disorder is experiencing a manic episode. Which
interventions should the nurse include in the plan of care? (Select all that
apply)
A) Provide a structured, low-stimulation environment
B) Offer high-calorie finger foods
C) Encourage the client to make complex decisions about their care
D) Maintain consistent staff assignments
E) Allow the client to stay awake as long as they want
Answer: A, B, D
Rationale: Clients in a manic episode need a structured, low-stimulation
environment to decrease agitation. High-calorie finger foods
accommodate the client's inability to sit for meals. Consistent staff
assignments help build trust and provide stability. Making complex
decisions is overwhelming during mania, and sleep should be
encouraged, not discouraged .
Question 7
A nurse is teaching a client prescribed lithium for bipolar disorder. Which
statement indicates the client understands the teaching?
A) "I should restrict my fluid intake to prevent toxicity."
B) "I should take lithium on an empty stomach."
C) "I need to have regular blood tests to check my lithium level."
D) "I can stop taking lithium when I feel better."
Answer: C
Rationale: Regular blood tests are essential to monitor lithium levels
and prevent toxicity. Lithium should be taken with food to prevent
gastrointestinal upset. Fluid intake should be adequate (not restricted),
and lithium must be taken consistently even when feeling better to
maintain therapeutic levels .
