ATI Mental Health – ATI RN Mental Health Nursing
Study Guide, Original Practice Questions &
Answers, Comprehensive ATI Mental Health Exam
Preparation, Psychiatric Nursing Review, Mental
Health Disorders, Therapeutic Communication,
Mental Status Examination, Anxiety & Trauma-
Related Disorders, Depression, Bipolar Disorder,
Schizophrenia, Psychopharmacology, Substance Use
Disorders, Crisis Intervention, Patient Safety, Legal
& Ethical Nursing & Clinical Judgment
Question 1: A nurse is caring for a client who has borderline personality
disorder. Which of the following behavioral symptoms is the nurse most likely
to observe in this client?
A. Grandiose sense of self-importance
B. Fear of abandonment and frantic efforts to avoid it
C. Lack of remorse for harmful actions
D. Preoccupation with orderliness and perfectionism
CORRECT ANSWER: B. Fear of abandonment and frantic efforts to avoid it
Rationale: Borderline personality disorder is characterized by a pervasive pattern of
instability in interpersonal relationships, self-image, and affects, along with marked
impulsivity. A core feature is a frantic effort to avoid real or imagined abandonment.
Grandiose self-importance is associated with narcissistic personality disorder, lack of
remorse with antisocial personality disorder, and preoccupation with orderliness with
obsessive-compulsive personality disorder.
Question 2: A client diagnosed with major depressive disorder tells the nurse,
"I don't see the point in trying anymore. Nothing will ever get better." Which of
the following is the nurse's priority response?
A. "Let's focus on the positive aspects of your life."
B. "Are you having thoughts of harming yourself ?"
C. "I understand, but things will get better with treatment."
D. "Why do you feel that nothing will ever get better?"
CORRECT ANSWER: B. "Are you having thoughts of harming yourself ?"
Rationale: The client's statement indicates hopelessness, which is a significant risk factor
for suicide. The nurse's priority is to conduct a direct and non-judgmental suicide risk
assessment. Focusing on positives or giving false reassurance dismisses the client's
feelings and does not address the immediate safety concern. Asking "why" is therapeutic
but should not supersede the safety assessment.
,Question 3: A client is experiencing a panic attack. Which of the following
nursing interventions should be implemented first?
A. Encourage the client to discuss the cause of the anxiety
B. Stay with the client and provide a quiet environment
C. Administer a prescribed PRN benzodiazepine
D. Teach the client deep breathing exercises
CORRECT ANSWER: B. Stay with the client and provide a quiet environment
Rationale: During a panic attack, the client feels a sense of impending doom and fear of
dying or losing control. The immediate priority is to ensure client safety and reduce
stimulation by staying with the client and providing a calm, quiet environment to
prevent the escalation of anxiety. Teaching or discussing causes is ineffective during a
panic state, and medication administration is an intervention after the initial supportive
measures are in place.
Question 4: A nurse is reviewing the medical record of a client with
schizophrenia who is prescribed clozapine. Which of the following laboratory
values requires the most immediate attention by the nurse?
A. Absolute neutrophil count (ANC) of 1200/mm³
B. Serum sodium of 135 mEq/L
C. Fasting blood glucose of 110 mg/dL
D. Aspartate aminotransferase (AST) of 25 units/L
CORRECT ANSWER: A. Absolute neutrophil count (ANC) of 1200/mm³
Rationale: Clozapine has a black box warning for severe neutropenia and
agranulocytosis. An ANC below 1500/mm³ requires immediate action, and the
medication is typically held or discontinued based on protocol, especially if it drops
below 1000/mm³. An ANC of 1200 is critically low and requires the nurse to notify the
provider immediately. The other values are within normal limits.
Question 5: A client with Alzheimer's disease is wandering and attempting to
leave the unit. Which of the following interventions is most appropriate for the
nurse to implement?
A. Restrain the client in a geriatric chair to prevent falls
B. Place a locked security bracelet on the client's ankle
C. Redirect the client to a safe, structured activity
D. Administer a sedative medication to calm the client
CORRECT ANSWER: C. Redirect the client to a safe, structured activity
,Rationale: Wandering is a common behavior in clients with Alzheimer's disease. The
most appropriate initial intervention is to redirect the client to a safe, structured, and
engaging activity to meet their need for movement and reduce agitation. Restraints and
sedatives are restrictive and should only be used as a last resort when safety is an
immediate concern. While a security bracelet may be part of a safety plan, redirection is
the initial therapeutic intervention.
Question 6: A nurse is assessing a client with antisocial personality disorder.
Which of the following findings is consistent with this diagnosis?
A. Fear of social rejection and being embarrassed
B. Lack of empathy and disregard for the rights of others
C. Submissive behavior and a need to be cared for
D. Excessive emotionality and attention-seeking behavior
CORRECT ANSWER: B. Lack of empathy and disregard for the rights of others
Rationale: Antisocial personality disorder is characterized by a pervasive pattern of
disregard for and violation of the rights of others, deceitfulness, impulsivity, irritability,
and a lack of remorse. Fear of social rejection is seen in avoidant personality disorder,
submissive behavior in dependent personality disorder, and attention-seeking behavior
in histrionic personality disorder.
Question 7: A client is prescribed sertraline for major depressive disorder.
Which of the following statements by the client indicates a need for further
teaching?
A. "I will take this medication with food to help with stomach upset."
B. "I can stop taking this medication once I start feeling better."
C. "I should avoid drinking grapefruit juice while taking this medication."
D. "This medication may take a few weeks to reach its full effect."
CORRECT ANSWER: B. "I can stop taking this medication once I start feeling
better."
Rationale: Sertraline, an SSRI, should not be stopped abruptly once the client feels
better, as this can lead to discontinuation syndrome and an increased risk of relapse.
The client must be taught to take the medication as prescribed and to discuss any
changes with the provider. Taking with food, avoiding grapefruit juice, and
understanding the delayed onset of action are all accurate statements.
Question 8: A nurse is planning care for a client with severe anxiety. Which of
the following is an appropriate short-term goal for this client?
, A. The client will discuss their anxiety triggers in detail
B. The client will identify and use one coping mechanism to manage anxiety within 24
hours
C. The client will eliminate all feelings of anxiety
D. The client will maintain a therapeutic relationship with all staff members
CORRECT ANSWER: B. The client will identify and use one coping mechanism
to manage anxiety within 24 hours
Rationale: Short-term goals must be realistic and measurable. Eliminating all feelings of
anxiety is not realistic. Discussing triggers in detail may be overwhelming and is not a
short-term goal. Maintaining relationships is important but broad and not a specific
short-term goal for anxiety. Identifying and using a coping mechanism is a specific,
measurable, and achievable goal.
Question 9: A client with bipolar disorder is in a manic phase. Which of the
following nutritional interventions is most important for the nurse to
implement?
A. Restrict fluid intake to avoid hyponatremia
B. Provide high-protein, low-carbohydrate snacks
C. Offer frequent high-calorie, high-protein finger foods
D. Encourage a high-fiber diet to prevent constipation
CORRECT ANSWER: C. Offer frequent high-calorie, high-protein finger foods
Rationale: Clients in a manic phase are often hyperactive, consume excessive energy,
and have a decreased attention span and poor appetite. Offering frequent, high-calorie,
high-protein finger foods allows the client to eat while walking or engaged in activity,
meeting their nutritional needs. Fluid restriction is not indicated; in fact, clients are at
risk for dehydration and need encouragement to drink fluids.
Question 10: A nurse is caring for a client with post-traumatic stress disorder
(PTSD) who is experiencing flashbacks. Which of the following is the priority
nursing intervention?
A. Encourage the client to describe the traumatic event in detail
B. Remind the client of the current time, place, and situation
C. Place the client in seclusion to reduce external stimuli
D. Administer a PRN dose of haloperidol for agitation
CORRECT ANSWER: B. Remind the client of the current time, place, and
situation
Rationale: During a flashback, the client re-experiences the traumatic event as if it is
happening in the present. The priority intervention is to use grounding techniques to
Study Guide, Original Practice Questions &
Answers, Comprehensive ATI Mental Health Exam
Preparation, Psychiatric Nursing Review, Mental
Health Disorders, Therapeutic Communication,
Mental Status Examination, Anxiety & Trauma-
Related Disorders, Depression, Bipolar Disorder,
Schizophrenia, Psychopharmacology, Substance Use
Disorders, Crisis Intervention, Patient Safety, Legal
& Ethical Nursing & Clinical Judgment
Question 1: A nurse is caring for a client who has borderline personality
disorder. Which of the following behavioral symptoms is the nurse most likely
to observe in this client?
A. Grandiose sense of self-importance
B. Fear of abandonment and frantic efforts to avoid it
C. Lack of remorse for harmful actions
D. Preoccupation with orderliness and perfectionism
CORRECT ANSWER: B. Fear of abandonment and frantic efforts to avoid it
Rationale: Borderline personality disorder is characterized by a pervasive pattern of
instability in interpersonal relationships, self-image, and affects, along with marked
impulsivity. A core feature is a frantic effort to avoid real or imagined abandonment.
Grandiose self-importance is associated with narcissistic personality disorder, lack of
remorse with antisocial personality disorder, and preoccupation with orderliness with
obsessive-compulsive personality disorder.
Question 2: A client diagnosed with major depressive disorder tells the nurse,
"I don't see the point in trying anymore. Nothing will ever get better." Which of
the following is the nurse's priority response?
A. "Let's focus on the positive aspects of your life."
B. "Are you having thoughts of harming yourself ?"
C. "I understand, but things will get better with treatment."
D. "Why do you feel that nothing will ever get better?"
CORRECT ANSWER: B. "Are you having thoughts of harming yourself ?"
Rationale: The client's statement indicates hopelessness, which is a significant risk factor
for suicide. The nurse's priority is to conduct a direct and non-judgmental suicide risk
assessment. Focusing on positives or giving false reassurance dismisses the client's
feelings and does not address the immediate safety concern. Asking "why" is therapeutic
but should not supersede the safety assessment.
,Question 3: A client is experiencing a panic attack. Which of the following
nursing interventions should be implemented first?
A. Encourage the client to discuss the cause of the anxiety
B. Stay with the client and provide a quiet environment
C. Administer a prescribed PRN benzodiazepine
D. Teach the client deep breathing exercises
CORRECT ANSWER: B. Stay with the client and provide a quiet environment
Rationale: During a panic attack, the client feels a sense of impending doom and fear of
dying or losing control. The immediate priority is to ensure client safety and reduce
stimulation by staying with the client and providing a calm, quiet environment to
prevent the escalation of anxiety. Teaching or discussing causes is ineffective during a
panic state, and medication administration is an intervention after the initial supportive
measures are in place.
Question 4: A nurse is reviewing the medical record of a client with
schizophrenia who is prescribed clozapine. Which of the following laboratory
values requires the most immediate attention by the nurse?
A. Absolute neutrophil count (ANC) of 1200/mm³
B. Serum sodium of 135 mEq/L
C. Fasting blood glucose of 110 mg/dL
D. Aspartate aminotransferase (AST) of 25 units/L
CORRECT ANSWER: A. Absolute neutrophil count (ANC) of 1200/mm³
Rationale: Clozapine has a black box warning for severe neutropenia and
agranulocytosis. An ANC below 1500/mm³ requires immediate action, and the
medication is typically held or discontinued based on protocol, especially if it drops
below 1000/mm³. An ANC of 1200 is critically low and requires the nurse to notify the
provider immediately. The other values are within normal limits.
Question 5: A client with Alzheimer's disease is wandering and attempting to
leave the unit. Which of the following interventions is most appropriate for the
nurse to implement?
A. Restrain the client in a geriatric chair to prevent falls
B. Place a locked security bracelet on the client's ankle
C. Redirect the client to a safe, structured activity
D. Administer a sedative medication to calm the client
CORRECT ANSWER: C. Redirect the client to a safe, structured activity
,Rationale: Wandering is a common behavior in clients with Alzheimer's disease. The
most appropriate initial intervention is to redirect the client to a safe, structured, and
engaging activity to meet their need for movement and reduce agitation. Restraints and
sedatives are restrictive and should only be used as a last resort when safety is an
immediate concern. While a security bracelet may be part of a safety plan, redirection is
the initial therapeutic intervention.
Question 6: A nurse is assessing a client with antisocial personality disorder.
Which of the following findings is consistent with this diagnosis?
A. Fear of social rejection and being embarrassed
B. Lack of empathy and disregard for the rights of others
C. Submissive behavior and a need to be cared for
D. Excessive emotionality and attention-seeking behavior
CORRECT ANSWER: B. Lack of empathy and disregard for the rights of others
Rationale: Antisocial personality disorder is characterized by a pervasive pattern of
disregard for and violation of the rights of others, deceitfulness, impulsivity, irritability,
and a lack of remorse. Fear of social rejection is seen in avoidant personality disorder,
submissive behavior in dependent personality disorder, and attention-seeking behavior
in histrionic personality disorder.
Question 7: A client is prescribed sertraline for major depressive disorder.
Which of the following statements by the client indicates a need for further
teaching?
A. "I will take this medication with food to help with stomach upset."
B. "I can stop taking this medication once I start feeling better."
C. "I should avoid drinking grapefruit juice while taking this medication."
D. "This medication may take a few weeks to reach its full effect."
CORRECT ANSWER: B. "I can stop taking this medication once I start feeling
better."
Rationale: Sertraline, an SSRI, should not be stopped abruptly once the client feels
better, as this can lead to discontinuation syndrome and an increased risk of relapse.
The client must be taught to take the medication as prescribed and to discuss any
changes with the provider. Taking with food, avoiding grapefruit juice, and
understanding the delayed onset of action are all accurate statements.
Question 8: A nurse is planning care for a client with severe anxiety. Which of
the following is an appropriate short-term goal for this client?
, A. The client will discuss their anxiety triggers in detail
B. The client will identify and use one coping mechanism to manage anxiety within 24
hours
C. The client will eliminate all feelings of anxiety
D. The client will maintain a therapeutic relationship with all staff members
CORRECT ANSWER: B. The client will identify and use one coping mechanism
to manage anxiety within 24 hours
Rationale: Short-term goals must be realistic and measurable. Eliminating all feelings of
anxiety is not realistic. Discussing triggers in detail may be overwhelming and is not a
short-term goal. Maintaining relationships is important but broad and not a specific
short-term goal for anxiety. Identifying and using a coping mechanism is a specific,
measurable, and achievable goal.
Question 9: A client with bipolar disorder is in a manic phase. Which of the
following nutritional interventions is most important for the nurse to
implement?
A. Restrict fluid intake to avoid hyponatremia
B. Provide high-protein, low-carbohydrate snacks
C. Offer frequent high-calorie, high-protein finger foods
D. Encourage a high-fiber diet to prevent constipation
CORRECT ANSWER: C. Offer frequent high-calorie, high-protein finger foods
Rationale: Clients in a manic phase are often hyperactive, consume excessive energy,
and have a decreased attention span and poor appetite. Offering frequent, high-calorie,
high-protein finger foods allows the client to eat while walking or engaged in activity,
meeting their nutritional needs. Fluid restriction is not indicated; in fact, clients are at
risk for dehydration and need encouragement to drink fluids.
Question 10: A nurse is caring for a client with post-traumatic stress disorder
(PTSD) who is experiencing flashbacks. Which of the following is the priority
nursing intervention?
A. Encourage the client to describe the traumatic event in detail
B. Remind the client of the current time, place, and situation
C. Place the client in seclusion to reduce external stimuli
D. Administer a PRN dose of haloperidol for agitation
CORRECT ANSWER: B. Remind the client of the current time, place, and
situation
Rationale: During a flashback, the client re-experiences the traumatic event as if it is
happening in the present. The priority intervention is to use grounding techniques to
