ATI RN Mental Health Proctored Exam 2025/2026: 100
Practice Questions with Rationales
**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.
- B. Establish clear boundaries.
- C. Explore past traumatic events.
- D. Provide advice on daily routines.
**Correct Answer: B. Establish clear boundaries.**
*Rationale:* The first phase of the therapeutic relationship is the
orientation phase, where boundaries, confidentiality, and expectations
are established. Exploring trauma or giving advice occurs later in the
working phase.
---
**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."
**Correct Answer: C. "Tell me more about what makes you feel that
way."**
*Rationale:* "Tell me more" is an open-ended, therapeutic response
that encourages expression. "Why" questions can be perceived as
accusatory, and false reassurance is nontherapeutic.
---
**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. Splitting
- B. Projection
- C. Reaction formation
- D. Rationalization
**Correct Answer: A. Splitting**
,*Rationale:* Splitting is a primitive defense mechanism where the
client views people as all good or all bad, common in borderline
personality disorder.
---
**4. A nurse overhears a client saying "I am a spy, a spy for the FBI. I
am an I, an eye for an eye in the sky. Sky is up high." The nurse should
document the client's statement as which of the following speech
alterations?**
- A. Echolalia
- B. Word salad
- C. Neologism
- D. Clang association
**Correct Answer: D. Clang association**
*Rationale:* Clang association involves stringing words together based
on their sound rather than meaning, often rhyming. This is commonly
seen in manic episodes or schizophrenia.
---
, **5. A nurse is caring for a client who has personality disorder and is
using transference to cope. Which of the following behaviors should
the nurse expect?**
- A. Talking negatively about other staff members
- B. Expressing frustration regarding unit rules
- C. Reacting to the nurse as though she were his mother
- D. Refusing to participate in group activities
**Correct Answer: C. Reacting to the nurse as though she were his
mother**
*Rationale:* Transference occurs when a client unconsciously redirects
feelings from a significant person in their past onto the nurse.
---
**6. A charge nurse is discussing the care of a client who has a
substance use disorder with a staff nurse. Which of the following
statements by the staff nurse should the charge nurse identify as
countertransference?**
- A. "The client is just like my brother who finally overcame his habit"
- B. "The client needs to accept responsibility for his substance use"
- C. "The client generally shares his feelings during group therapy
session"
Practice Questions with Rationales
**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.
- B. Establish clear boundaries.
- C. Explore past traumatic events.
- D. Provide advice on daily routines.
**Correct Answer: B. Establish clear boundaries.**
*Rationale:* The first phase of the therapeutic relationship is the
orientation phase, where boundaries, confidentiality, and expectations
are established. Exploring trauma or giving advice occurs later in the
working phase.
---
**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."
**Correct Answer: C. "Tell me more about what makes you feel that
way."**
*Rationale:* "Tell me more" is an open-ended, therapeutic response
that encourages expression. "Why" questions can be perceived as
accusatory, and false reassurance is nontherapeutic.
---
**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. Splitting
- B. Projection
- C. Reaction formation
- D. Rationalization
**Correct Answer: A. Splitting**
,*Rationale:* Splitting is a primitive defense mechanism where the
client views people as all good or all bad, common in borderline
personality disorder.
---
**4. A nurse overhears a client saying "I am a spy, a spy for the FBI. I
am an I, an eye for an eye in the sky. Sky is up high." The nurse should
document the client's statement as which of the following speech
alterations?**
- A. Echolalia
- B. Word salad
- C. Neologism
- D. Clang association
**Correct Answer: D. Clang association**
*Rationale:* Clang association involves stringing words together based
on their sound rather than meaning, often rhyming. This is commonly
seen in manic episodes or schizophrenia.
---
, **5. A nurse is caring for a client who has personality disorder and is
using transference to cope. Which of the following behaviors should
the nurse expect?**
- A. Talking negatively about other staff members
- B. Expressing frustration regarding unit rules
- C. Reacting to the nurse as though she were his mother
- D. Refusing to participate in group activities
**Correct Answer: C. Reacting to the nurse as though she were his
mother**
*Rationale:* Transference occurs when a client unconsciously redirects
feelings from a significant person in their past onto the nurse.
---
**6. A charge nurse is discussing the care of a client who has a
substance use disorder with a staff nurse. Which of the following
statements by the staff nurse should the charge nurse identify as
countertransference?**
- A. "The client is just like my brother who finally overcame his habit"
- B. "The client needs to accept responsibility for his substance use"
- C. "The client generally shares his feelings during group therapy
session"
