ATI RN Mental Health 2026 Updated
Examination Blueprint: A Definitive
Compendium of 150 Curated Practice
Questions, Precise Correct Answers,
and Evidence-Based Clinical
Rationales for Guaranteed Nursing
Mastery and NCLEX-RN Readiness
1.
A nurse is caring for a client who has a new prescription for fluoxetine. Which of
the following adverse effects should the nurse instruct the client to report
immediately?
o Answer: Suicidal ideation.
o Rationale: Fluoxetine is an SSRI antidepressant that carries a black box warning
for an increased risk of suicidal thinking and behavior, particularly in children,
adolescents, and young adults. The client should be instructed to report any new
or worsening suicidal thoughts immediately.
2. A nurse is assessing a client who has schizophrenia. Which of the following
findings should the nurse identify as a positive symptom?
o Answer: Hallucinations.
o Rationale: Positive symptoms of schizophrenia are characterized by the presence
of abnormal behaviors or experiences, such as hallucinations, delusions, and
disorganized speech. Negative symptoms involve the absence of normal
functions, such as flat affect or avolition.
,3. A nurse is planning care for a client who has major depressive disorder. Which of
the following interventions should the nurse include to address the client's low
self-esteem?
o Answer: Encourage the client to identify personal strengths and
accomplishments.
o Rationale: Helping the client recognize their own strengths and past successes
can directly challenge negative self-perceptions and build self-esteem, which is
often diminished in major depressive disorder.
4. A nurse is teaching a client who has a new prescription for lithium carbonate.
Which of the following statements indicates an understanding of the teaching?
o Answer: "I should maintain a consistent daily salt intake."
o Rationale: Lithium levels can be affected by sodium levels. A low sodium intake
can increase lithium levels and risk toxicity, while a high intake can decrease its
efficacy. Maintaining a consistent salt intake helps keep lithium levels stable.
5. A nurse is caring for a client who has borderline personality disorder. Which of the
following behaviors is the client most likely to exhibit?
o Answer: Impulsive behavior.
o Rationale: Impulsivity is a core feature of borderline personality disorder, often
manifesting as risky behaviors, substance abuse, or self-harm. This is driven by
emotional dysregulation and an unstable sense of self.
6. A nurse is preparing to administer electroconvulsive therapy (ECT) to a client.
Which of the following client statements indicates a need for further teaching?
o Answer: "I will be awake during the procedure."
o Rationale: ECT is performed under general anesthesia with a muscle relaxant. The
client is not awake during the procedure. The most common adverse effect is
temporary short-term memory loss.
7. A nurse is assessing a client for risk factors for suicide. Which of the following
findings should the nurse identify as the highest risk factor?
o Answer: A previous suicide attempt.
,o Rationale: A history of a previous suicide attempt is one of the strongest
predictors of future suicide completion. This history indicates a significant risk that
requires immediate and intensive intervention.
8. A nurse is caring for a client who has anorexia nervosa. Which of the following
findings should the nurse expect?
o Answer: Lanugo.
o Rationale: Lanugo, a fine, downy hair growth on the body, is a physiological
adaptation to starvation and is a common finding in clients with anorexia nervosa.
It is the body's attempt to conserve heat.
9. A nurse is providing discharge teaching to a client who has a new prescription for
diazepam. Which of the following instructions should the nurse include?
o Answer: Avoid consuming alcohol while taking this medication.
o Rationale: Diazepam is a benzodiazepine that depresses the central nervous
system. Combining it with alcohol can lead to severe CNS depression, respiratory
depression, and even death.
10. A nurse is caring for a client who is experiencing a panic attack. Which of the
following actions should the nurse take first?
o Answer: Remain with the client and provide a calm, quiet environment.
o Rationale: During a panic attack, the client's anxiety is at its peak. The priority is
to provide a safe, non-stimulating environment and the presence of a calm nurse
to prevent the escalation of fear and promote a sense of security.
11. A nurse is assessing a client who has post-traumatic stress disorder (PTSD). Which
of the following findings should the nurse expect?
o Answer: Hypervigilance.
o Rationale: Hypervigilance, or being constantly on guard for potential threats, is a
common symptom of PTSD. It is a manifestation of the persistent state of
heightened arousal associated with the disorder.
12. A nurse is providing care for a client who has dementia. Which of the following
communication techniques should the nurse use?
, o Answer: Speak in a calm, clear, and low-pitched voice.
o Rationale: Clients with dementia may have difficulty processing complex
information. Using a calm, clear, and low-pitched voice reduces environmental
stimuli and helps the client focus on the message.
13. A nurse is caring for a client who is taking haloperidol. Which of the following
findings should the nurse identify as an adverse effect requiring immediate
intervention?
o Answer: Tardive dyskinesia.
o Rationale: Tardive dyskinesia is a potentially irreversible neurological syndrome
characterized by involuntary movements of the face and tongue. It is a serious
adverse effect of long-term antipsychotic use and requires immediate evaluation
by the provider.
14. A nurse is teaching a client who has a new diagnosis of generalized anxiety
disorder (GAD). Which of the following statements should the nurse include?
o Answer: "This disorder is characterized by excessive worry about everyday
events."
o Rationale: GAD is defined by chronic, excessive, and uncontrollable worry about
various aspects of daily life, such as work, health, or finances, for a period of at
least six months.
15. A nurse is caring for a client who has a history of alcohol use disorder and is now
in the acute withdrawal phase. Which of the following findings should the nurse
anticipate?
o Answer: Tremors.
o Rationale: Tremors (the "shakes") are a hallmark sign of acute alcohol withdrawal.
This is due to the hyperexcitability of the central nervous system when alcohol, a
CNS depressant, is removed.
16. A nurse is assessing a client who has bipolar I disorder and is currently
experiencing a manic episode. Which of the following findings should the nurse
expect?
Examination Blueprint: A Definitive
Compendium of 150 Curated Practice
Questions, Precise Correct Answers,
and Evidence-Based Clinical
Rationales for Guaranteed Nursing
Mastery and NCLEX-RN Readiness
1.
A nurse is caring for a client who has a new prescription for fluoxetine. Which of
the following adverse effects should the nurse instruct the client to report
immediately?
o Answer: Suicidal ideation.
o Rationale: Fluoxetine is an SSRI antidepressant that carries a black box warning
for an increased risk of suicidal thinking and behavior, particularly in children,
adolescents, and young adults. The client should be instructed to report any new
or worsening suicidal thoughts immediately.
2. A nurse is assessing a client who has schizophrenia. Which of the following
findings should the nurse identify as a positive symptom?
o Answer: Hallucinations.
o Rationale: Positive symptoms of schizophrenia are characterized by the presence
of abnormal behaviors or experiences, such as hallucinations, delusions, and
disorganized speech. Negative symptoms involve the absence of normal
functions, such as flat affect or avolition.
,3. A nurse is planning care for a client who has major depressive disorder. Which of
the following interventions should the nurse include to address the client's low
self-esteem?
o Answer: Encourage the client to identify personal strengths and
accomplishments.
o Rationale: Helping the client recognize their own strengths and past successes
can directly challenge negative self-perceptions and build self-esteem, which is
often diminished in major depressive disorder.
4. A nurse is teaching a client who has a new prescription for lithium carbonate.
Which of the following statements indicates an understanding of the teaching?
o Answer: "I should maintain a consistent daily salt intake."
o Rationale: Lithium levels can be affected by sodium levels. A low sodium intake
can increase lithium levels and risk toxicity, while a high intake can decrease its
efficacy. Maintaining a consistent salt intake helps keep lithium levels stable.
5. A nurse is caring for a client who has borderline personality disorder. Which of the
following behaviors is the client most likely to exhibit?
o Answer: Impulsive behavior.
o Rationale: Impulsivity is a core feature of borderline personality disorder, often
manifesting as risky behaviors, substance abuse, or self-harm. This is driven by
emotional dysregulation and an unstable sense of self.
6. A nurse is preparing to administer electroconvulsive therapy (ECT) to a client.
Which of the following client statements indicates a need for further teaching?
o Answer: "I will be awake during the procedure."
o Rationale: ECT is performed under general anesthesia with a muscle relaxant. The
client is not awake during the procedure. The most common adverse effect is
temporary short-term memory loss.
7. A nurse is assessing a client for risk factors for suicide. Which of the following
findings should the nurse identify as the highest risk factor?
o Answer: A previous suicide attempt.
,o Rationale: A history of a previous suicide attempt is one of the strongest
predictors of future suicide completion. This history indicates a significant risk that
requires immediate and intensive intervention.
8. A nurse is caring for a client who has anorexia nervosa. Which of the following
findings should the nurse expect?
o Answer: Lanugo.
o Rationale: Lanugo, a fine, downy hair growth on the body, is a physiological
adaptation to starvation and is a common finding in clients with anorexia nervosa.
It is the body's attempt to conserve heat.
9. A nurse is providing discharge teaching to a client who has a new prescription for
diazepam. Which of the following instructions should the nurse include?
o Answer: Avoid consuming alcohol while taking this medication.
o Rationale: Diazepam is a benzodiazepine that depresses the central nervous
system. Combining it with alcohol can lead to severe CNS depression, respiratory
depression, and even death.
10. A nurse is caring for a client who is experiencing a panic attack. Which of the
following actions should the nurse take first?
o Answer: Remain with the client and provide a calm, quiet environment.
o Rationale: During a panic attack, the client's anxiety is at its peak. The priority is
to provide a safe, non-stimulating environment and the presence of a calm nurse
to prevent the escalation of fear and promote a sense of security.
11. A nurse is assessing a client who has post-traumatic stress disorder (PTSD). Which
of the following findings should the nurse expect?
o Answer: Hypervigilance.
o Rationale: Hypervigilance, or being constantly on guard for potential threats, is a
common symptom of PTSD. It is a manifestation of the persistent state of
heightened arousal associated with the disorder.
12. A nurse is providing care for a client who has dementia. Which of the following
communication techniques should the nurse use?
, o Answer: Speak in a calm, clear, and low-pitched voice.
o Rationale: Clients with dementia may have difficulty processing complex
information. Using a calm, clear, and low-pitched voice reduces environmental
stimuli and helps the client focus on the message.
13. A nurse is caring for a client who is taking haloperidol. Which of the following
findings should the nurse identify as an adverse effect requiring immediate
intervention?
o Answer: Tardive dyskinesia.
o Rationale: Tardive dyskinesia is a potentially irreversible neurological syndrome
characterized by involuntary movements of the face and tongue. It is a serious
adverse effect of long-term antipsychotic use and requires immediate evaluation
by the provider.
14. A nurse is teaching a client who has a new diagnosis of generalized anxiety
disorder (GAD). Which of the following statements should the nurse include?
o Answer: "This disorder is characterized by excessive worry about everyday
events."
o Rationale: GAD is defined by chronic, excessive, and uncontrollable worry about
various aspects of daily life, such as work, health, or finances, for a period of at
least six months.
15. A nurse is caring for a client who has a history of alcohol use disorder and is now
in the acute withdrawal phase. Which of the following findings should the nurse
anticipate?
o Answer: Tremors.
o Rationale: Tremors (the "shakes") are a hallmark sign of acute alcohol withdrawal.
This is due to the hyperexcitability of the central nervous system when alcohol, a
CNS depressant, is removed.
16. A nurse is assessing a client who has bipolar I disorder and is currently
experiencing a manic episode. Which of the following findings should the nurse
expect?
