ATI PN Mental Health 2026/2027 Exam Content Mastery Series | NCLEX-PN
ATI PN Mental Health 2026/2027 Exam
Content Mastery Series | NCLEX-PN Test Plan
Psychiatric-Mental Health Nursing Standards for Practical Nurses
2026/2027 Edition
Total Questions 120 Cognitive Distribution 20% Recall / 50% Application / 30% Analysis
Sections 11 Format 75% Scenario-Based / 25% Direct Knowledge
Time Allocation 150 minutes Question Type Multiple Choice (4 options, single best answer)
Instructions to the Candidate: This examination consists of 120 multiple-choice questions divided into eleven
sections. Each question presents a clinical scenario or knowledge statement followed by four options (A-D).
Select the single best answer for each question. The correct answer is indicated with [CORRECT] and
accompanied by a rationale referencing the ATI PN Mental Health Content Mastery Series, NCLEX-PN Test
Plan, and Psychiatric-Mental Health Nursing Standards for Practical Nurses (2026/2027 Edition). This exam is
aligned with ATI Mental Health content including therapeutic communication, mood disorders, anxiety,
psychotic disorders, personality disorders, substance use, eating disorders, cognitive disorders, crisis
intervention, psychopharmacology, and legal/ethical issues.
Section 1: Foundations of Psychiatric Nursing & Therapeutic Communication
Case: A nurse is caring for a patient who states, 'I just don't want to live anymore. Nothing matters.' The nurse
sits down, makes eye contact, and remains silent for a moment before responding.
Q1: Which therapeutic communication technique is the nurse demonstrating by using
silence?
A. Offering self to encourage the patient to continue when ready
B. Broad opening to initiate conversation
C. Active listening through nonverbal presence and allowing the patient time to process and
respond [CORRECT]
D. Focusing to direct the conversation
Correct Answer: C
Rationale: Silence is a therapeutic communication technique that demonstrates active listening and allows the
patient time to collect thoughts and process emotions. ATI PN Mental Health emphasizes that silence is
particularly valuable when a patient is experiencing strong emotions or disclosing difficult information. Offering
self involves the nurse's presence and availability but is verbalized ('I'll sit with you'). Broad openings invite the
patient to set the direction. Focusing redirects a wandering conversation.
Case: A patient tells the nurse, 'I'm a terrible mother. My children would be better off without me.' Which
response by the nurse is therapeutic?
Q2: Which response demonstrates the therapeutic technique of exploring?
A. 'Don't say that. You're a good mother.'
Psychiatric-Mental Health Nursing Standards Page 1 2026/2027 Edition
,ATI PN Mental Health 2026/2027 Exam Content Mastery Series | NCLEX-PN
B. 'Tell me more about what makes you feel that way.' [CORRECT]
C. 'Why do you think your children would be better off?'
D. 'I'm sure your children love you very much.'
Correct Answer: B
Rationale: Exploring ('Tell me more...') encourages the patient to elaborate on feelings and thoughts, facilitating
deeper assessment of suicide risk. ATI PN guidelines emphasize open-ended, exploratory statements when
patients express suicidal ideation. Option A is false reassurance/disapproval; Option C uses 'why,' which can feel
judgmental; Option D is false reassurance. Therapeutic responses encourage the patient to share more without
judgment.
Case: A patient says to the nurse, 'My doctor doesn't care about me. He never has time to listen.' The nurse
responds, 'You feel your doctor doesn't listen to you.'
Q3: Which therapeutic communication technique is the nurse using?
A. Restating
B. Reflecting [CORRECT]
C. Clarifying
D. Summarizing
Correct Answer: B
Rationale: Reflecting paraphrases the patient's feelings or thoughts back to them, encouraging further
exploration. ATI PN Mental Health distinguishes reflecting from restating: reflecting focuses on the emotional
content ('You feel...'), while restating repeats the patient's words verbatim. Clarifying seeks to ensure
understanding. Summarizing condenses key points. Reflecting validates the patient's emotions without judgment.
Case: A patient with depression says, 'There's no use in going to group therapy. It won't help.' The nurse
responds, 'It's hard to believe things will get better when you're feeling so low.'
Q4: Which therapeutic communication technique is demonstrated?
A. Validating the patient's feelings without agreeing with the distorted belief [CORRECT]
B. Giving false reassurance that therapy will help
C. Disapproving of the patient's attitude
D. Changing the subject to avoid discomfort
Correct Answer: A
Rationale: Validation acknowledges the patient's feelings as real and understandable, without agreeing with the
cognitive distortion. ATI PN Mental Health teaches that validation builds trust and therapeutic alliance. False
reassurance would say 'It will get better.' Disapproval would criticize the patient's attitude. Changing the subject
avoids the patient's concerns. Validation does NOT endorse hopelessness but acknowledges the feeling behind
it.
Case: A nurse is preparing to interview a newly admitted patient with anxiety. The patient is pacing and wringing
their hands.
Q5: Which phase of the therapeutic nurse-patient relationship involves establishing trust and
setting boundaries?
A. Orientation (introductory) phase [CORRECT]
B. Working phase
Psychiatric-Mental Health Nursing Standards Page 2 2026/2027 Edition
,ATI PN Mental Health 2026/2027 Exam Content Mastery Series | NCLEX-PN
C. Termination phase
D. Pre-interaction phase
Correct Answer: A
Rationale: The orientation (introductory) phase establishes trust, sets boundaries, and clarifies roles and
expectations. ATI PN Mental Health describes three phases: orientation (building trust, contracts, goals), working
(problem-solving, interventions), and termination (reviewing progress, saying goodbye). Pre-interaction occurs
before meeting the patient (gathering information). The orientation phase sets the foundation for the therapeutic
relationship.
Case: A patient with schizophrenia says, 'The FBI is monitoring my thoughts through the TV.' Which nursing
response is MOST therapeutic?
Q6: Which response demonstrates therapeutic communication with a patient experiencing
delusions?
A. 'There is no FBI monitoring. That's not real.'
B. 'I understand the FBI isn't here, but I believe you're feeling frightened. Let's talk about your
anxiety.' [CORRECT]
C. 'Tell me more about what the FBI is doing. I want to know everything.'
D. 'You should stop watching TV if it makes you feel this way.'
Correct Answer: B
Rationale: ATI PN Mental Health teaches nurses to acknowledge the patient's feelings without validating the
delusion. The nurse does not argue (Option A) or reinforce (Option C) the delusion but focuses on the underlying
emotion (fear/anxiety). Option D gives advice and dismisses the patient's experience. The therapeutic approach
addresses feelings while not confirming the false belief.
Case: A patient becomes angry with the nurse and shouts, 'You don't know anything! Get out of my room!'
Q7: Which nursing response is MOST therapeutic when a patient is angry?
A. 'I can see you're upset. I'll come back when you've calmed down.'
B. 'I'll leave, but you need to control your anger.'
C. 'I understand you're angry. I want to help. I'll step out and return in 15 minutes so we can
talk.' [CORRECT]
D. 'You have no right to speak to me that way.'
Correct Answer: C
Rationale: The nurse acknowledges the anger, validates the emotion, sets limits on the behavior, and offers a
specific plan to return. ATI PN Mental Health emphasizes maintaining safety, acknowledging feelings, and setting
boundaries. Option A dismisses the patient. Option B is judgmental. Option D is defensive and confrontational.
The therapeutic response maintains the relationship while ensuring safety.
Case: A patient asks the nurse, 'Should I tell my family about my depression?'
Q8: Which response by the nurse avoids the non-therapeutic communication pattern of giving
advice?
A. 'Yes, I think you should tell them. They need to know.'
B. 'No, keep it private until you're ready.'
Psychiatric-Mental Health Nursing Standards Page 3 2026/2027 Edition
, ATI PN Mental Health 2026/2027 Exam Content Mastery Series | NCLEX-PN
C. 'What do you think might be the benefits and risks of sharing with your family?'
[CORRECT]
D. 'That's a decision only you can make. I can't help you with that.'
Correct Answer: C
Rationale: ATI PN Mental Health teaches that giving advice is non-therapeutic and removes patient autonomy.
The nurse should explore the patient's thoughts and concerns to facilitate decision-making. Option C helps the
patient weigh pros and cons without directing the decision. Options A and B give direct advice. Option D
dismisses the patient and abandons the therapeutic role.
Case: A patient is admitted to the psychiatric unit. The nurse must establish a therapeutic relationship.
Q9: Which factor is ESSENTIAL for establishing a therapeutic nurse-patient relationship?
A. The nurse shares personal experiences to build rapport
B. The nurse maintains professional boundaries and self-disclosure is limited to purposeful,
therapeutic use [CORRECT]
C. The nurse develops a friendship with the patient to enhance trust
D. The nurse gives the patient their personal phone number for support
Correct Answer: B
Rationale: ATI PN Mental Health emphasizes that therapeutic relationships maintain professional boundaries.
Self-disclosure is used only when it serves a therapeutic purpose, not to meet the nurse's needs. Friendship
crosses professional boundaries. Sharing personal contact information is a boundary violation. The therapeutic
relationship is purposeful, time-limited, and patient-centered.
Case: A nurse is assessing a patient's psychiatric history using the nursing process.
Q10: Which step of the nursing process involves identifying patient strengths and coping
mechanisms?
A. Diagnosis
B. Planning
C. Assessment [CORRECT]
D. Implementation
Correct Answer: C
Rationale: Assessment is the systematic collection of data, including patient strengths, coping mechanisms,
support systems, and risk factors. ATI PN Mental Health emphasizes a holistic assessment including biological,
psychological, social, and spiritual dimensions. Diagnosis identifies nursing problems. Planning sets goals.
Implementation carries out interventions. Assessment informs all subsequent steps of the nursing process.
Case: A nurse is caring for a patient with schizophrenia. The patient has auditory hallucinations telling them
they are worthless.
Q11: Which neurotransmitter imbalance is PRIMARILY associated with the positive symptoms
of schizophrenia?
A. Decreased serotonin
B. Increased dopamine activity in the mesolimbic pathway [CORRECT]
C. Decreased GABA
Psychiatric-Mental Health Nursing Standards Page 4 2026/2027 Edition
ATI PN Mental Health 2026/2027 Exam
Content Mastery Series | NCLEX-PN Test Plan
Psychiatric-Mental Health Nursing Standards for Practical Nurses
2026/2027 Edition
Total Questions 120 Cognitive Distribution 20% Recall / 50% Application / 30% Analysis
Sections 11 Format 75% Scenario-Based / 25% Direct Knowledge
Time Allocation 150 minutes Question Type Multiple Choice (4 options, single best answer)
Instructions to the Candidate: This examination consists of 120 multiple-choice questions divided into eleven
sections. Each question presents a clinical scenario or knowledge statement followed by four options (A-D).
Select the single best answer for each question. The correct answer is indicated with [CORRECT] and
accompanied by a rationale referencing the ATI PN Mental Health Content Mastery Series, NCLEX-PN Test
Plan, and Psychiatric-Mental Health Nursing Standards for Practical Nurses (2026/2027 Edition). This exam is
aligned with ATI Mental Health content including therapeutic communication, mood disorders, anxiety,
psychotic disorders, personality disorders, substance use, eating disorders, cognitive disorders, crisis
intervention, psychopharmacology, and legal/ethical issues.
Section 1: Foundations of Psychiatric Nursing & Therapeutic Communication
Case: A nurse is caring for a patient who states, 'I just don't want to live anymore. Nothing matters.' The nurse
sits down, makes eye contact, and remains silent for a moment before responding.
Q1: Which therapeutic communication technique is the nurse demonstrating by using
silence?
A. Offering self to encourage the patient to continue when ready
B. Broad opening to initiate conversation
C. Active listening through nonverbal presence and allowing the patient time to process and
respond [CORRECT]
D. Focusing to direct the conversation
Correct Answer: C
Rationale: Silence is a therapeutic communication technique that demonstrates active listening and allows the
patient time to collect thoughts and process emotions. ATI PN Mental Health emphasizes that silence is
particularly valuable when a patient is experiencing strong emotions or disclosing difficult information. Offering
self involves the nurse's presence and availability but is verbalized ('I'll sit with you'). Broad openings invite the
patient to set the direction. Focusing redirects a wandering conversation.
Case: A patient tells the nurse, 'I'm a terrible mother. My children would be better off without me.' Which
response by the nurse is therapeutic?
Q2: Which response demonstrates the therapeutic technique of exploring?
A. 'Don't say that. You're a good mother.'
Psychiatric-Mental Health Nursing Standards Page 1 2026/2027 Edition
,ATI PN Mental Health 2026/2027 Exam Content Mastery Series | NCLEX-PN
B. 'Tell me more about what makes you feel that way.' [CORRECT]
C. 'Why do you think your children would be better off?'
D. 'I'm sure your children love you very much.'
Correct Answer: B
Rationale: Exploring ('Tell me more...') encourages the patient to elaborate on feelings and thoughts, facilitating
deeper assessment of suicide risk. ATI PN guidelines emphasize open-ended, exploratory statements when
patients express suicidal ideation. Option A is false reassurance/disapproval; Option C uses 'why,' which can feel
judgmental; Option D is false reassurance. Therapeutic responses encourage the patient to share more without
judgment.
Case: A patient says to the nurse, 'My doctor doesn't care about me. He never has time to listen.' The nurse
responds, 'You feel your doctor doesn't listen to you.'
Q3: Which therapeutic communication technique is the nurse using?
A. Restating
B. Reflecting [CORRECT]
C. Clarifying
D. Summarizing
Correct Answer: B
Rationale: Reflecting paraphrases the patient's feelings or thoughts back to them, encouraging further
exploration. ATI PN Mental Health distinguishes reflecting from restating: reflecting focuses on the emotional
content ('You feel...'), while restating repeats the patient's words verbatim. Clarifying seeks to ensure
understanding. Summarizing condenses key points. Reflecting validates the patient's emotions without judgment.
Case: A patient with depression says, 'There's no use in going to group therapy. It won't help.' The nurse
responds, 'It's hard to believe things will get better when you're feeling so low.'
Q4: Which therapeutic communication technique is demonstrated?
A. Validating the patient's feelings without agreeing with the distorted belief [CORRECT]
B. Giving false reassurance that therapy will help
C. Disapproving of the patient's attitude
D. Changing the subject to avoid discomfort
Correct Answer: A
Rationale: Validation acknowledges the patient's feelings as real and understandable, without agreeing with the
cognitive distortion. ATI PN Mental Health teaches that validation builds trust and therapeutic alliance. False
reassurance would say 'It will get better.' Disapproval would criticize the patient's attitude. Changing the subject
avoids the patient's concerns. Validation does NOT endorse hopelessness but acknowledges the feeling behind
it.
Case: A nurse is preparing to interview a newly admitted patient with anxiety. The patient is pacing and wringing
their hands.
Q5: Which phase of the therapeutic nurse-patient relationship involves establishing trust and
setting boundaries?
A. Orientation (introductory) phase [CORRECT]
B. Working phase
Psychiatric-Mental Health Nursing Standards Page 2 2026/2027 Edition
,ATI PN Mental Health 2026/2027 Exam Content Mastery Series | NCLEX-PN
C. Termination phase
D. Pre-interaction phase
Correct Answer: A
Rationale: The orientation (introductory) phase establishes trust, sets boundaries, and clarifies roles and
expectations. ATI PN Mental Health describes three phases: orientation (building trust, contracts, goals), working
(problem-solving, interventions), and termination (reviewing progress, saying goodbye). Pre-interaction occurs
before meeting the patient (gathering information). The orientation phase sets the foundation for the therapeutic
relationship.
Case: A patient with schizophrenia says, 'The FBI is monitoring my thoughts through the TV.' Which nursing
response is MOST therapeutic?
Q6: Which response demonstrates therapeutic communication with a patient experiencing
delusions?
A. 'There is no FBI monitoring. That's not real.'
B. 'I understand the FBI isn't here, but I believe you're feeling frightened. Let's talk about your
anxiety.' [CORRECT]
C. 'Tell me more about what the FBI is doing. I want to know everything.'
D. 'You should stop watching TV if it makes you feel this way.'
Correct Answer: B
Rationale: ATI PN Mental Health teaches nurses to acknowledge the patient's feelings without validating the
delusion. The nurse does not argue (Option A) or reinforce (Option C) the delusion but focuses on the underlying
emotion (fear/anxiety). Option D gives advice and dismisses the patient's experience. The therapeutic approach
addresses feelings while not confirming the false belief.
Case: A patient becomes angry with the nurse and shouts, 'You don't know anything! Get out of my room!'
Q7: Which nursing response is MOST therapeutic when a patient is angry?
A. 'I can see you're upset. I'll come back when you've calmed down.'
B. 'I'll leave, but you need to control your anger.'
C. 'I understand you're angry. I want to help. I'll step out and return in 15 minutes so we can
talk.' [CORRECT]
D. 'You have no right to speak to me that way.'
Correct Answer: C
Rationale: The nurse acknowledges the anger, validates the emotion, sets limits on the behavior, and offers a
specific plan to return. ATI PN Mental Health emphasizes maintaining safety, acknowledging feelings, and setting
boundaries. Option A dismisses the patient. Option B is judgmental. Option D is defensive and confrontational.
The therapeutic response maintains the relationship while ensuring safety.
Case: A patient asks the nurse, 'Should I tell my family about my depression?'
Q8: Which response by the nurse avoids the non-therapeutic communication pattern of giving
advice?
A. 'Yes, I think you should tell them. They need to know.'
B. 'No, keep it private until you're ready.'
Psychiatric-Mental Health Nursing Standards Page 3 2026/2027 Edition
, ATI PN Mental Health 2026/2027 Exam Content Mastery Series | NCLEX-PN
C. 'What do you think might be the benefits and risks of sharing with your family?'
[CORRECT]
D. 'That's a decision only you can make. I can't help you with that.'
Correct Answer: C
Rationale: ATI PN Mental Health teaches that giving advice is non-therapeutic and removes patient autonomy.
The nurse should explore the patient's thoughts and concerns to facilitate decision-making. Option C helps the
patient weigh pros and cons without directing the decision. Options A and B give direct advice. Option D
dismisses the patient and abandons the therapeutic role.
Case: A patient is admitted to the psychiatric unit. The nurse must establish a therapeutic relationship.
Q9: Which factor is ESSENTIAL for establishing a therapeutic nurse-patient relationship?
A. The nurse shares personal experiences to build rapport
B. The nurse maintains professional boundaries and self-disclosure is limited to purposeful,
therapeutic use [CORRECT]
C. The nurse develops a friendship with the patient to enhance trust
D. The nurse gives the patient their personal phone number for support
Correct Answer: B
Rationale: ATI PN Mental Health emphasizes that therapeutic relationships maintain professional boundaries.
Self-disclosure is used only when it serves a therapeutic purpose, not to meet the nurse's needs. Friendship
crosses professional boundaries. Sharing personal contact information is a boundary violation. The therapeutic
relationship is purposeful, time-limited, and patient-centered.
Case: A nurse is assessing a patient's psychiatric history using the nursing process.
Q10: Which step of the nursing process involves identifying patient strengths and coping
mechanisms?
A. Diagnosis
B. Planning
C. Assessment [CORRECT]
D. Implementation
Correct Answer: C
Rationale: Assessment is the systematic collection of data, including patient strengths, coping mechanisms,
support systems, and risk factors. ATI PN Mental Health emphasizes a holistic assessment including biological,
psychological, social, and spiritual dimensions. Diagnosis identifies nursing problems. Planning sets goals.
Implementation carries out interventions. Assessment informs all subsequent steps of the nursing process.
Case: A nurse is caring for a patient with schizophrenia. The patient has auditory hallucinations telling them
they are worthless.
Q11: Which neurotransmitter imbalance is PRIMARILY associated with the positive symptoms
of schizophrenia?
A. Decreased serotonin
B. Increased dopamine activity in the mesolimbic pathway [CORRECT]
C. Decreased GABA
Psychiatric-Mental Health Nursing Standards Page 4 2026/2027 Edition
