ATI PN Mental Health 2026 Proctored Exam
Comprising NGN and all questions and
Answers
Section 1: Foundations of Mental Health Nursing & Therapeutic Communication
(Questions 1–30)
1. A nurse is preparing to conduct an initial mental health assessment on a client
who has been admitted involuntarily. Which action should the nurse take first to
establish a therapeutic alliance?
• A. Explain the client's legal rights and the treatment process.
• B. Ask the client about their reason for hospitalization.
• C. Provide the client with a written copy of unit rules.
• D. Complete the admission paperwork and physical assessment.
Rationale: Beginning the assessment by asking the client about their reason
for hospitalization demonstrates respect for their perspective and initiates
therapeutic communication. While explaining legal rights (A) is important, it
should occur after establishing initial rapport. Providing unit rules (C) can be
perceived as authoritarian. Completing paperwork (D) prioritizes tasks over the
therapeutic relationship.
2. A client with depression says, "I feel like a failure." Which response by the
nurse demonstrates therapeutic communication?
• A. "You're not a failure; you have many strengths."
• B. "Why do you feel that way about yourself?"
• C. "Let's focus on something positive instead."
• D. "Can you tell me more about feeling like a failure?"
, Rationale: Encouraging the client to elaborate (D) uses open-ended
questioning to explore feelings, promoting therapeutic communication.
Reassurance (A), questioning "why" (B), and redirecting (C) may dismiss the
client's emotions.
3. A client with schizophrenia says, "The voices are telling me to leave." What is
the nurse's best response?
• A. "Ignore the voices; they aren't real."
• B. "What are the voices saying right now?"
• C. "You know those voices are just your imagination."
• D. "Let's talk about something else."
Rationale: Asking about the voices (B) acknowledges the client's reality,
facilitating therapeutic communication. Dismissing (A, C) or redirecting (D)
invalidates the client's experience.
4. A client tells the nurse a secret and asks the nurse to promise not to tell.
Which response is most appropriate?
• A. "Go on. Tell me more."
• B. "Why do you want to keep the information a secret?"
• C. "Have you shared your secret with anyone else?"
• D. "I can't promise that I will keep your secret."
Rationale: The nurse cannot promise confidentiality without limits. This
response is honest and establishes appropriate boundaries while acknowledging
the need to maintain safety and report certain information.
,5. Which statement by the nurse is an example of giving advice, which should be
avoided in therapeutic communication?
• A. "Tell me more about what you are feeling."
• B. "It sounds like you are feeling overwhelmed."
• C. "You should try to get out of bed and join the group."
• D. "I noticed you were crying earlier."
Rationale: Giving advice (C) is non-therapeutic because it implies the nurse
knows what is best for the client and takes away the client's autonomy and
decision-making. The other options are examples of therapeutic techniques
(exploring, reflecting, making observations).
6. A client with anxiety becomes tearful during a conversation. What should the
nurse do?
• A. Change the subject to reduce discomfort.
• B. Offer a tissue and remain silent.
• C. Tell the client not to cry.
• D. Leave the room to give privacy.
Rationale: Offering a tissue and staying silent (B) provides support and allows
the client to process emotions. Changing the subject (A), discouraging crying (C),
or leaving (D) hinders therapeutic communication.
7. A nurse is communicating with a client who has a hearing impairment. Which
action should the nurse take to facilitate communication?
• A. Speak loudly and rapidly to ensure the client hears.
• B. Exaggerate lip movements to help the client read lips.
, • C. Face the client directly and speak clearly at a moderate pace.
• D. Use complex medical terminology to be precise.
Rationale: Facing the client directly and speaking clearly at a moderate pace
(C) maximizes the client's ability to see the nurse's face and read lips without
distortion. Speaking loudly or rapidly (A) can distort sound. Exaggerating lip
movements (B) makes lip-reading more difficult. Using complex terminology (D)
can cause confusion.
8. A nurse is caring for a client who is withdrawn and refuses to speak. The nurse
sits with the client quietly for several minutes and then states, "I'll sit with you
for a while. You don't have to talk if you don't want to." This intervention
demonstrates which therapeutic communication technique?
• A. Giving reassurance
• B. Offering self
• C. Making observations
• D. Using silence
Rationale: Offering self involves making oneself available to the client without
imposing expectations. Sitting quietly with a withdrawn client and making
occasional neutral comments demonstrates presence and availability without
pressure to communicate.
9. A nurse is using the technique of reflection when communicating with a
client. Which statement by the nurse demonstrates this technique?
• A. "You should try to get more sleep."
• B. "I notice you are pacing the halls."
• C. "You feel that no one understands what you are going through."
Comprising NGN and all questions and
Answers
Section 1: Foundations of Mental Health Nursing & Therapeutic Communication
(Questions 1–30)
1. A nurse is preparing to conduct an initial mental health assessment on a client
who has been admitted involuntarily. Which action should the nurse take first to
establish a therapeutic alliance?
• A. Explain the client's legal rights and the treatment process.
• B. Ask the client about their reason for hospitalization.
• C. Provide the client with a written copy of unit rules.
• D. Complete the admission paperwork and physical assessment.
Rationale: Beginning the assessment by asking the client about their reason
for hospitalization demonstrates respect for their perspective and initiates
therapeutic communication. While explaining legal rights (A) is important, it
should occur after establishing initial rapport. Providing unit rules (C) can be
perceived as authoritarian. Completing paperwork (D) prioritizes tasks over the
therapeutic relationship.
2. A client with depression says, "I feel like a failure." Which response by the
nurse demonstrates therapeutic communication?
• A. "You're not a failure; you have many strengths."
• B. "Why do you feel that way about yourself?"
• C. "Let's focus on something positive instead."
• D. "Can you tell me more about feeling like a failure?"
, Rationale: Encouraging the client to elaborate (D) uses open-ended
questioning to explore feelings, promoting therapeutic communication.
Reassurance (A), questioning "why" (B), and redirecting (C) may dismiss the
client's emotions.
3. A client with schizophrenia says, "The voices are telling me to leave." What is
the nurse's best response?
• A. "Ignore the voices; they aren't real."
• B. "What are the voices saying right now?"
• C. "You know those voices are just your imagination."
• D. "Let's talk about something else."
Rationale: Asking about the voices (B) acknowledges the client's reality,
facilitating therapeutic communication. Dismissing (A, C) or redirecting (D)
invalidates the client's experience.
4. A client tells the nurse a secret and asks the nurse to promise not to tell.
Which response is most appropriate?
• A. "Go on. Tell me more."
• B. "Why do you want to keep the information a secret?"
• C. "Have you shared your secret with anyone else?"
• D. "I can't promise that I will keep your secret."
Rationale: The nurse cannot promise confidentiality without limits. This
response is honest and establishes appropriate boundaries while acknowledging
the need to maintain safety and report certain information.
,5. Which statement by the nurse is an example of giving advice, which should be
avoided in therapeutic communication?
• A. "Tell me more about what you are feeling."
• B. "It sounds like you are feeling overwhelmed."
• C. "You should try to get out of bed and join the group."
• D. "I noticed you were crying earlier."
Rationale: Giving advice (C) is non-therapeutic because it implies the nurse
knows what is best for the client and takes away the client's autonomy and
decision-making. The other options are examples of therapeutic techniques
(exploring, reflecting, making observations).
6. A client with anxiety becomes tearful during a conversation. What should the
nurse do?
• A. Change the subject to reduce discomfort.
• B. Offer a tissue and remain silent.
• C. Tell the client not to cry.
• D. Leave the room to give privacy.
Rationale: Offering a tissue and staying silent (B) provides support and allows
the client to process emotions. Changing the subject (A), discouraging crying (C),
or leaving (D) hinders therapeutic communication.
7. A nurse is communicating with a client who has a hearing impairment. Which
action should the nurse take to facilitate communication?
• A. Speak loudly and rapidly to ensure the client hears.
• B. Exaggerate lip movements to help the client read lips.
, • C. Face the client directly and speak clearly at a moderate pace.
• D. Use complex medical terminology to be precise.
Rationale: Facing the client directly and speaking clearly at a moderate pace
(C) maximizes the client's ability to see the nurse's face and read lips without
distortion. Speaking loudly or rapidly (A) can distort sound. Exaggerating lip
movements (B) makes lip-reading more difficult. Using complex terminology (D)
can cause confusion.
8. A nurse is caring for a client who is withdrawn and refuses to speak. The nurse
sits with the client quietly for several minutes and then states, "I'll sit with you
for a while. You don't have to talk if you don't want to." This intervention
demonstrates which therapeutic communication technique?
• A. Giving reassurance
• B. Offering self
• C. Making observations
• D. Using silence
Rationale: Offering self involves making oneself available to the client without
imposing expectations. Sitting quietly with a withdrawn client and making
occasional neutral comments demonstrates presence and availability without
pressure to communicate.
9. A nurse is using the technique of reflection when communicating with a
client. Which statement by the nurse demonstrates this technique?
• A. "You should try to get more sleep."
• B. "I notice you are pacing the halls."
• C. "You feel that no one understands what you are going through."
