Proctored Exam Study Guide & Practice Questions | ATI
Mental Health Nursing Review, Psychiatric Nursing,
Therapeutic Communication, Mental Health Assessment,
Anxiety & Trauma Disorders, Mood Disorders,
Schizophrenia & Psychotic Disorders, Substance Use
Disorders, Psychopharmacology, Crisis Intervention,
Safety, Prioritization, Clinical Judgment, NGN-Style Case
Studies & Detailed Rationales
Question 1: A nurse is assessing a client who has generalized
anxiety disorder. Which of the following findings should the nurse
expect?
A. Fear of gaining weight
B. Excessive worry about multiple events
C. Auditory hallucinations
D. Grandiose delusions
CORRECT ANSWER: B. Excessive worry about multiple events
Rationale: Generalized anxiety disorder is characterized by excessive,
uncontrollable worry about various aspects of life, including work, health,
and relationships. Fear of weight gain suggests anorexia nervosa,
hallucinations suggest psychosis, and grandiosity suggests mania.
Question 2: A nurse is caring for a client who is experiencing a
panic attack. Which of the following actions should the nurse take
first?
A. Administer a PRN benzodiazepine
B. Encourage the client to describe the trigger
C. Stay with the client and remain calm
D. Move the client to a quiet, dimly lit room
CORRECT ANSWER: C. Stay with the client and remain calm
Rationale: During a panic attack, the priority is safety and reassurance.
Staying with the client and remaining calm helps reduce anxiety and
prevents injury. Medication may be given later, and exploring triggers
should occur after the attack subsides.
Question 3: A client is prescribed sertraline for depression. The
nurse should instruct the client that which of the following findings
indicates a therapeutic response?
,A. Increased appetite within 24 hours
B. Improved mood after 4 to 6 weeks
C. Immediate relief of insomnia
D. Decreased suicidal ideation within 48 hours
CORRECT ANSWER: B. Improved mood after 4 to 6 weeks
Rationale: SSRIs such as sertraline typically require 4 to 6 weeks to achieve
full therapeutic effect. Appetite and sleep may improve earlier, but mood
improvement is the key indicator. Suicidal ideation must be monitored
closely, especially early in treatment.
Question 4: A nurse is assessing a client who has major depressive
disorder. Which of the following findings is a priority for the nurse
to address?
A. Feelings of worthlessness
B. Weight loss of 2 lb
C. Statements about wanting to die
D. Difficulty concentrating
CORRECT ANSWER: C. Statements about wanting to die
Rationale: Safety is the priority in mental health nursing. Statements
indicating suicidal ideation require immediate intervention, including
suicide risk assessment and safety precautions. The other findings are
important but do not take precedence over imminent risk of self-harm.
Question 5: A nurse is teaching a client about lithium therapy.
Which of the following instructions should the nurse include?
A. Increase sodium intake during hot weather
B. Maintain consistent sodium and fluid intake
C. Take lithium on an empty stomach
D. Avoid all foods containing tyramine
CORRECT ANSWER: B. Maintain consistent sodium and fluid intake
Rationale: Lithium levels are affected by sodium and fluid balance.
Consistent intake helps prevent toxicity or subtherapeutic levels. Lithium
should be taken with food to reduce GI upset, and tyramine restrictions
apply to MAOIs, not lithium.
,Question 6: A client taking haloperidol develops muscle rigidity,
fever, and altered mental status. The nurse should suspect which of
the following conditions?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Acute dystonia
D. Tardive dyskinesia
CORRECT ANSWER: B. Neuroleptic malignant syndrome
Rationale: Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotics characterized by rigidity, hyperthermia, autonomic
instability, and altered mental status. Serotonin syndrome occurs with
serotonergic drugs, dystonia involves muscle spasms, and tardive
dyskinesia involves involuntary movements.
Question 7: A nurse is caring for a client who has schizophrenia
and is experiencing auditory hallucinations. Which of the following
statements by the nurse is appropriate?
A. "The voices are not real, so ignore them."
B. "I do not hear the voices, but I believe you do."
C. "Why do you think you hear voices?"
D. "You should tell the voices to stop."
CORRECT ANSWER: B. "I do not hear the voices, but I believe you
do."
Rationale: This response validates the client's experience without
reinforcing the hallucination. It builds trust and acknowledges the client's
perception while maintaining reality orientation. Arguing or asking "why"
can increase anxiety.
Question 8: A nurse is assessing a client who has bipolar disorder
and is in the manic phase. Which of the following findings should
the nurse expect?
A. Psychomotor retardation
B. Decreased need for sleep
C. Anhedonia
D. Social withdrawal
CORRECT ANSWER: B. Decreased need for sleep
, Rationale: Mania is characterized by decreased need for sleep, increased
energy, grandiosity, and impulsivity. Psychomotor retardation, anhedonia,
and social withdrawal are associated with depression.
Question 9: A nurse is planning care for a client who has anorexia
nervosa. Which of the following is the priority nursing
intervention?
A. Encourage the client to keep a food diary
B. Monitor weight and vital signs
C. Discuss body image perception
D. Provide a high-fiber diet
CORRECT ANSWER: B. Monitor weight and vital signs
Rationale: Clients with anorexia nervosa are at risk for severe malnutrition,
electrolyte imbalances, and cardiac complications. Monitoring weight and
vital signs is the priority to ensure physical safety. Other interventions are
important but secondary.
Question 10: A nurse is caring for a client who has post-traumatic
stress disorder (PTSD). Which of the following findings should the
nurse expect?
A. Flashbacks and hyperarousal
B. Compulsive rituals
C. Grandiose delusions
D. Flat affect and avolition
CORRECT ANSWER: A. Flashbacks and hyperarousal
Rationale: PTSD is characterized by intrusive memories, flashbacks,
hyperarousal, avoidance, and negative mood. Compulsive rituals suggest
OCD, grandiosity suggests mania, and flat affect with avolition suggests
schizophrenia.
Question 11: A client is admitted with alcohol withdrawal. Which
of the following medications should the nurse anticipate
administering?
A. Lorazepam
B. Naltrexone
C. Disulfiram
D. Acamprosate