ATI RN Mental Health Proctored-2019 (Questions
and Answers, Download for an A score)
Section 1: Foundations of Psychiatric Mental Health Nursing
1. A nurse is performing a mental status assessment on an older adult client who
has dementia. Which of the following questions should the nurse ask to assess
the client's remote memory?
A. "What year did you graduate from high school?"
B. "What did you eat for breakfast this morning?"
C. "Can you count backward from 20 by twos?"
D. "Do you know what today's date is?"
Rationale: Remote memory refers to the ability to remember distant past
events. Asking about high school graduation assesses long-term memory that can
be validated. Recent memory is assessed by asking about breakfast, calculation by
counting backward, and orientation by asking the date.
2. A nurse is assessing a client's judgment. Which of the following questions
should the nurse ask?
A. "Can you tell me the name of the current president?"
B. "What would you do if you found a wallet on the ground?"
C. "Can you repeat these three words: apple, table, penny?"
D. "Do you know where you are right now?"
B. "What would you do if you found a wallet on the ground?"
Rationale: Judgment is the ability to make logical decisions and solve
problems. Asking what the client would do in a hypothetical situation assesses
judgment. Option A assesses orientation, Option C assesses immediate recall, and
Option D assesses orientation to place.
3. A nurse is conducting an admission interview with a client. Which of the
following actions should the nurse take to establish trust?
,A. Avoid direct eye contact to prevent intimidating the client
B. Use medical terminology to demonstrate expertise
C. Introduce oneself and explain the purpose of the interview
D. Complete the interview as quickly as possible to respect the client's time
C. Introduce oneself and explain the purpose of the interview
Rationale: Trust is established by being honest, consistent, and respectful.
Introducing oneself and explaining the purpose of the interview sets clear
expectations and demonstrates respect for the client. Avoiding eye contact may
appear disinterested, medical jargon can confuse, and rushing the interview
hinders rapport building.
4. A nurse is assessing a client who has been diagnosed with mild anxiety. Which
of the following findings should the nurse expect?
A. Inability to focus on the environment
B. Enhanced learning and problem-solving
C. Complete disorganization of thought processes
D. Decreased perceptual field
B. Enhanced learning and problem-solving
Rationale: Mild anxiety heightens awareness and enhances learning and
problem-solving. Moderate anxiety narrows the perceptual field, severe anxiety
significantly reduces it, and panic causes complete disorganization.
5. A nurse is reviewing the medical record of a client who has a new prescription
for an antipsychotic medication. The nurse should identify that which of the
following findings places the client at increased risk for adverse effects?
A. The client is 35 years old
B. The client has a history of hypertension
C. The client has impaired liver function
D. The client has a history of migraines
C. The client has impaired liver function
, Rationale: Most antipsychotic medications are metabolized by the liver.
Impaired liver function can lead to increased serum levels of the medication and
increased risk of adverse effects. Age, hypertension, and migraines do not directly
increase risk for antipsychotic adverse effects.
6. A nurse is planning care for a client who is experiencing acute mania. Which
of the following interventions should the nurse include to promote sleep?
A. Encourage the client to participate in group activities before bedtime
B. Provide a stimulating environment to distract the client
C. Offer a high-carbohydrate snack at bedtime
D. Dim the lights and decrease noise in the client's room
D. Dim the lights and decrease noise in the client's room
Rationale: A client experiencing mania is easily stimulated and has difficulty
sleeping. Decreasing environmental stimulation promotes relaxation and sleep.
Group activities and a stimulating environment increase arousal, which is
counterproductive.
7. A nurse is caring for a client who is diagnosed with severe anxiety. Which of
the following behaviors should the nurse expect?
A. The client is able to follow simple directions
B. The client has a narrowed perceptual field
C. The client is unable to focus on any details
D. The client demonstrates enhanced problem-solving
C. The client is unable to focus on any details
Rationale: Severe anxiety significantly reduces the perceptual field. The client
is unable to focus on details and may have difficulty following directions. The
ability to follow simple directions occurs with moderate anxiety, not severe.
8. A nurse is assessing a client who has been taking a benzodiazepine for
anxiety. Which of the following findings should the nurse identify as an adverse
effect?
, A. Increased energy
B. Excessive sedation
C. Weight loss
D. Hypertension
B. Excessive sedation
Rationale: Benzodiazepines are central nervous system depressants that can
cause sedation, drowsiness, and dizziness. They do not typically cause increased
energy, weight loss, or hypertension.
9. A nurse is caring for a client who has just been admitted to the mental health
unit. The client refuses to sign the admission paperwork. Which of the following
actions should the nurse take?
A. Inform the client that signing is mandatory for treatment
B. Sign the paperwork on the client's behalf
C. Document the refusal and notify the provider
D. Discharge the client immediately
C. Document the refusal and notify the provider
Rationale: Clients have the right to refuse treatment. The nurse should respect
the client's autonomy, document the refusal, and notify the provider. Signing on
the client's behalf is falsification and illegal.
10. A nurse is assessing a client who is experiencing moderate anxiety. Which of
the following findings should the nurse expect?
A. The client is unable to communicate effectively
B. The client has difficulty concentrating
C. The client is completely unaware of their surroundings
D. The client demonstrates improved problem-solving ability
B. The client has difficulty concentrating
Rationale: Moderate anxiety causes a narrowing of the perceptual field, and
the client may have difficulty concentrating but can still follow directions with
and Answers, Download for an A score)
Section 1: Foundations of Psychiatric Mental Health Nursing
1. A nurse is performing a mental status assessment on an older adult client who
has dementia. Which of the following questions should the nurse ask to assess
the client's remote memory?
A. "What year did you graduate from high school?"
B. "What did you eat for breakfast this morning?"
C. "Can you count backward from 20 by twos?"
D. "Do you know what today's date is?"
Rationale: Remote memory refers to the ability to remember distant past
events. Asking about high school graduation assesses long-term memory that can
be validated. Recent memory is assessed by asking about breakfast, calculation by
counting backward, and orientation by asking the date.
2. A nurse is assessing a client's judgment. Which of the following questions
should the nurse ask?
A. "Can you tell me the name of the current president?"
B. "What would you do if you found a wallet on the ground?"
C. "Can you repeat these three words: apple, table, penny?"
D. "Do you know where you are right now?"
B. "What would you do if you found a wallet on the ground?"
Rationale: Judgment is the ability to make logical decisions and solve
problems. Asking what the client would do in a hypothetical situation assesses
judgment. Option A assesses orientation, Option C assesses immediate recall, and
Option D assesses orientation to place.
3. A nurse is conducting an admission interview with a client. Which of the
following actions should the nurse take to establish trust?
,A. Avoid direct eye contact to prevent intimidating the client
B. Use medical terminology to demonstrate expertise
C. Introduce oneself and explain the purpose of the interview
D. Complete the interview as quickly as possible to respect the client's time
C. Introduce oneself and explain the purpose of the interview
Rationale: Trust is established by being honest, consistent, and respectful.
Introducing oneself and explaining the purpose of the interview sets clear
expectations and demonstrates respect for the client. Avoiding eye contact may
appear disinterested, medical jargon can confuse, and rushing the interview
hinders rapport building.
4. A nurse is assessing a client who has been diagnosed with mild anxiety. Which
of the following findings should the nurse expect?
A. Inability to focus on the environment
B. Enhanced learning and problem-solving
C. Complete disorganization of thought processes
D. Decreased perceptual field
B. Enhanced learning and problem-solving
Rationale: Mild anxiety heightens awareness and enhances learning and
problem-solving. Moderate anxiety narrows the perceptual field, severe anxiety
significantly reduces it, and panic causes complete disorganization.
5. A nurse is reviewing the medical record of a client who has a new prescription
for an antipsychotic medication. The nurse should identify that which of the
following findings places the client at increased risk for adverse effects?
A. The client is 35 years old
B. The client has a history of hypertension
C. The client has impaired liver function
D. The client has a history of migraines
C. The client has impaired liver function
, Rationale: Most antipsychotic medications are metabolized by the liver.
Impaired liver function can lead to increased serum levels of the medication and
increased risk of adverse effects. Age, hypertension, and migraines do not directly
increase risk for antipsychotic adverse effects.
6. A nurse is planning care for a client who is experiencing acute mania. Which
of the following interventions should the nurse include to promote sleep?
A. Encourage the client to participate in group activities before bedtime
B. Provide a stimulating environment to distract the client
C. Offer a high-carbohydrate snack at bedtime
D. Dim the lights and decrease noise in the client's room
D. Dim the lights and decrease noise in the client's room
Rationale: A client experiencing mania is easily stimulated and has difficulty
sleeping. Decreasing environmental stimulation promotes relaxation and sleep.
Group activities and a stimulating environment increase arousal, which is
counterproductive.
7. A nurse is caring for a client who is diagnosed with severe anxiety. Which of
the following behaviors should the nurse expect?
A. The client is able to follow simple directions
B. The client has a narrowed perceptual field
C. The client is unable to focus on any details
D. The client demonstrates enhanced problem-solving
C. The client is unable to focus on any details
Rationale: Severe anxiety significantly reduces the perceptual field. The client
is unable to focus on details and may have difficulty following directions. The
ability to follow simple directions occurs with moderate anxiety, not severe.
8. A nurse is assessing a client who has been taking a benzodiazepine for
anxiety. Which of the following findings should the nurse identify as an adverse
effect?
, A. Increased energy
B. Excessive sedation
C. Weight loss
D. Hypertension
B. Excessive sedation
Rationale: Benzodiazepines are central nervous system depressants that can
cause sedation, drowsiness, and dizziness. They do not typically cause increased
energy, weight loss, or hypertension.
9. A nurse is caring for a client who has just been admitted to the mental health
unit. The client refuses to sign the admission paperwork. Which of the following
actions should the nurse take?
A. Inform the client that signing is mandatory for treatment
B. Sign the paperwork on the client's behalf
C. Document the refusal and notify the provider
D. Discharge the client immediately
C. Document the refusal and notify the provider
Rationale: Clients have the right to refuse treatment. The nurse should respect
the client's autonomy, document the refusal, and notify the provider. Signing on
the client's behalf is falsification and illegal.
10. A nurse is assessing a client who is experiencing moderate anxiety. Which of
the following findings should the nurse expect?
A. The client is unable to communicate effectively
B. The client has difficulty concentrating
C. The client is completely unaware of their surroundings
D. The client demonstrates improved problem-solving ability
B. The client has difficulty concentrating
Rationale: Moderate anxiety causes a narrowing of the perceptual field, and
the client may have difficulty concentrating but can still follow directions with
