ATI RN Mental Health Nursing 2026
Proctored NGN Exam:
Comprehensive Practice Test with
100 Questions and Rationales
SECTION 1: Therapeutic Communication & Nurse-
Client Relationship
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 or
providing advice 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 can be
perceived as accusatory. False reassurance and platitudes 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 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 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 in-service, and completing an
incident report are appropriate follow-up actions but are not the first
step .
Question 6
A nurse is caring for a client who is silent and withdrawn. Which of the
following is an appropriate therapeutic intervention?
A. Leave the client alone and check back later
B. Sit with the client in silence and allow them to speak first
C. Ask the client repeatedly why they are silent
D. Tell the client that silence is unproductive
Answer: B
Rationale: Sitting with the client in silence conveys acceptance and
provides the client with space to speak when ready. Leaving the client
alone may be perceived as abandonment; pressuring the client is
nontherapeutic .
Question 7
A client tells the nurse, "I don't want to attend group therapy today."
Which of the following responses is most therapeutic?
A. "You have to attend group therapy. It's part of your treatment."
B. "What are your feelings about going to group therapy?"
C. "You'll feel better once you get there."
D. "Why don't you want to go?"
Answer: B
Proctored NGN Exam:
Comprehensive Practice Test with
100 Questions and Rationales
SECTION 1: Therapeutic Communication & Nurse-
Client Relationship
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 or
providing advice 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 can be
perceived as accusatory. False reassurance and platitudes 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 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 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 in-service, and completing an
incident report are appropriate follow-up actions but are not the first
step .
Question 6
A nurse is caring for a client who is silent and withdrawn. Which of the
following is an appropriate therapeutic intervention?
A. Leave the client alone and check back later
B. Sit with the client in silence and allow them to speak first
C. Ask the client repeatedly why they are silent
D. Tell the client that silence is unproductive
Answer: B
Rationale: Sitting with the client in silence conveys acceptance and
provides the client with space to speak when ready. Leaving the client
alone may be perceived as abandonment; pressuring the client is
nontherapeutic .
Question 7
A client tells the nurse, "I don't want to attend group therapy today."
Which of the following responses is most therapeutic?
A. "You have to attend group therapy. It's part of your treatment."
B. "What are your feelings about going to group therapy?"
C. "You'll feel better once you get there."
D. "Why don't you want to go?"
Answer: B
