Virtual ATI Mental Health & Community
Health Review 2026/2027 | ACTUAL-Style
Practice Questions & Answers, RN Nursing
Exam Prep, Psychiatric Nursing, Therapeutic
Communication, Population Health, Disease
Prevention, and 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. Excessive worry occurring more days than not for at least 6 months
B. Fear of social situations with scrutiny by others
C. Recurrent unexpected panic attacks with intense dread
D. Intrusive thoughts accompanied by repetitive ritualistic behaviors
CORRECT ANSWER: A. Excessive worry occurring more days than not
for at least 6 months
Rationale: Generalized anxiety disorder is characterized by excessive,
pervasive worry about multiple events or activities occurring more days
than not for at least 6 months. Social anxiety disorder involves fear of
scrutiny (B), panic disorder involves recurrent unexpected panic attacks
(C), and obsessive-compulsive disorder involves intrusive thoughts with
rituals (D).
Question 2: A client diagnosed with schizophrenia is experiencing
auditory hallucinations. Which nursing intervention is most
appropriate initially?
A. Tell the client the voices are not real and to ignore them
B. Ask the client what the voices are saying
C. Isolate the client in a quiet room until the voices stop
D. Administer an as-needed antipsychotic without further assessment
CORRECT ANSWER: B. Ask the client what the voices are saying
Rationale: Asking what the voices are saying assesses the content and
command nature of the hallucination, which is critical for safety. Directly
challenging the hallucination (A) damages trust. Isolation (C) is punitive
and not therapeutic. Administering medication without assessment (D) is
unsafe and outside the initial nursing priority of assessment.
,Question 3: A nurse is caring for a client who is experiencing alcohol
withdrawal. Which of the following medications should the nurse
anticipate administering?
A. Naltrexone
B. Disulfiram
C. Lorazepam
D. Acamprosate
CORRECT ANSWER: C. Lorazepam
Rationale: Benzodiazepines such as lorazepam are the first-line treatment
for alcohol withdrawal because they prevent seizures and delirium tremens
by enhancing GABA activity. Naltrexone (A) and acamprosate (D) reduce
cravings for maintenance, and disulfiram (B) creates aversion but is not
used for acute withdrawal.
Question 4: A nurse is teaching a client about lithium therapy. Which of
the following statements by the client indicates understanding?
A. "I should increase my sodium intake while taking lithium."
B. "I should maintain a consistent sodium and fluid intake."
C. "I should decrease my fluid intake to prevent lithium toxicity."
D. "I should take lithium only when I feel manic."
CORRECT ANSWER: B. "I should maintain a consistent sodium and
fluid intake."
Rationale: Lithium levels are inversely affected by sodium and fluid
balance; dehydration or low sodium raises lithium levels and risks toxicity.
Consistent sodium and fluid intake is essential. Increasing sodium (A) or
restricting fluids (C) alters levels dangerously, and lithium must be taken
consistently, not PRN (D).
Question 5: A client with major depressive disorder states, "I just want
to go to sleep and never wake up." Which of the following actions
should the nurse take first?
A. Document the statement in the client's record
B. Ask the client if they have a specific suicide plan
C. Notify the provider on the next shift
D. Encourage the client to attend group therapy
,CORRECT ANSWER: B. Ask the client if they have a specific suicide plan
Rationale: When a client expresses suicidal ideation, the priority is to
assess the lethality and specificity of the plan to determine the level of
safety intervention required. Documentation (A) follows assessment,
notification (C) should not be delayed, and group therapy (D) is
inappropriate during acute risk.
Question 6: A nurse is assessing a client who has bipolar disorder with
acute mania. Which of the following findings should the nurse expect?
A. Psychomotor retardation and anergia
B. Decreased need for sleep and pressured speech
C. Flat affect and social withdrawal
D. Obsessive rumination and indecisiveness
CORRECT ANSWER: B. Decreased need for sleep and pressured speech
Rationale: Acute mania presents with decreased need for sleep, pressured
speech, grandiosity, and increased goal-directed activity. Psychomotor
retardation (A) and flat affect (C) suggest depression or negative
symptoms, while rumination and indecisiveness (D) suggest depression or
anxiety.
Question 7: A nurse is reviewing the laboratory results of a client taking
clozapine. Which of the following findings requires immediate
intervention?
A. Absolute neutrophil count of 1,200/mm³
B. Hemoglobin of 13 g/dL
C. Potassium of 4.0 mEq/L
D. Fasting glucose of 95 mg/dL
CORRECT ANSWER: A. Absolute neutrophil count of 1,200/mm³
Rationale: Clozapine carries a risk of severe neutropenia and
agranulocytosis; an ANC below 1,500/mm³ requires immediate
intervention, often discontinuation. The other values (B, C, D) are within
normal limits and do not require urgent action.
Question 8: A client is admitted with anorexia nervosa. Which of the
following nursing interventions is the priority during the initial phase of
treatment?
, A. Encourage the client to select preferred foods
B. Monitor vital signs and weight daily
C. Allow the client to eat alone to reduce anxiety
D. Discuss the client's feelings about body image
CORRECT ANSWER: B. Monitor vital signs and weight daily
Rationale: The priority in the initial phase of anorexia nervosa is
physiological stabilization, including monitoring for complications of
malnutrition such as bradycardia, hypotension, and electrolyte
imbalances. Food selection (A) and body image discussion (D) come later,
and eating alone (C) is unsafe due to purging risk.
Question 9: A nurse is caring for a client diagnosed with posttraumatic
stress disorder (PTSD). Which of the following findings should the nurse
expect?
A. Grandiosity and decreased need for sleep
B. Flashbacks and hypervigilance
C. Compulsive handwashing and checking
D. Anhedonia and psychomotor retardation
CORRECT ANSWER: B. Flashbacks and hypervigilance
Rationale: PTSD is characterized by re-experiencing (flashbacks,
nightmares), hyperarousal (hypervigilance, startle response), and
avoidance. Grandiosity (A) suggests mania, compulsions (C) suggest OCD,
and anhedonia (D) suggests depression.
Question 10: A nurse is administering haloperidol to a client. Which of
the following findings indicates the client is developing neuroleptic
malignant syndrome?
A. Hypertension and tachycardia with fever and muscle rigidity
B. Hypotension and bradycardia with hypothermia
C. Diarrhea and abdominal cramping
D. Polyuria and polydipsia
CORRECT ANSWER: A. Hypertension and tachycardia with fever and
muscle rigidity
Rationale: Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotics manifested by hyperthermia, muscle rigidity, autonomic
Health Review 2026/2027 | ACTUAL-Style
Practice Questions & Answers, RN Nursing
Exam Prep, Psychiatric Nursing, Therapeutic
Communication, Population Health, Disease
Prevention, and 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. Excessive worry occurring more days than not for at least 6 months
B. Fear of social situations with scrutiny by others
C. Recurrent unexpected panic attacks with intense dread
D. Intrusive thoughts accompanied by repetitive ritualistic behaviors
CORRECT ANSWER: A. Excessive worry occurring more days than not
for at least 6 months
Rationale: Generalized anxiety disorder is characterized by excessive,
pervasive worry about multiple events or activities occurring more days
than not for at least 6 months. Social anxiety disorder involves fear of
scrutiny (B), panic disorder involves recurrent unexpected panic attacks
(C), and obsessive-compulsive disorder involves intrusive thoughts with
rituals (D).
Question 2: A client diagnosed with schizophrenia is experiencing
auditory hallucinations. Which nursing intervention is most
appropriate initially?
A. Tell the client the voices are not real and to ignore them
B. Ask the client what the voices are saying
C. Isolate the client in a quiet room until the voices stop
D. Administer an as-needed antipsychotic without further assessment
CORRECT ANSWER: B. Ask the client what the voices are saying
Rationale: Asking what the voices are saying assesses the content and
command nature of the hallucination, which is critical for safety. Directly
challenging the hallucination (A) damages trust. Isolation (C) is punitive
and not therapeutic. Administering medication without assessment (D) is
unsafe and outside the initial nursing priority of assessment.
,Question 3: A nurse is caring for a client who is experiencing alcohol
withdrawal. Which of the following medications should the nurse
anticipate administering?
A. Naltrexone
B. Disulfiram
C. Lorazepam
D. Acamprosate
CORRECT ANSWER: C. Lorazepam
Rationale: Benzodiazepines such as lorazepam are the first-line treatment
for alcohol withdrawal because they prevent seizures and delirium tremens
by enhancing GABA activity. Naltrexone (A) and acamprosate (D) reduce
cravings for maintenance, and disulfiram (B) creates aversion but is not
used for acute withdrawal.
Question 4: A nurse is teaching a client about lithium therapy. Which of
the following statements by the client indicates understanding?
A. "I should increase my sodium intake while taking lithium."
B. "I should maintain a consistent sodium and fluid intake."
C. "I should decrease my fluid intake to prevent lithium toxicity."
D. "I should take lithium only when I feel manic."
CORRECT ANSWER: B. "I should maintain a consistent sodium and
fluid intake."
Rationale: Lithium levels are inversely affected by sodium and fluid
balance; dehydration or low sodium raises lithium levels and risks toxicity.
Consistent sodium and fluid intake is essential. Increasing sodium (A) or
restricting fluids (C) alters levels dangerously, and lithium must be taken
consistently, not PRN (D).
Question 5: A client with major depressive disorder states, "I just want
to go to sleep and never wake up." Which of the following actions
should the nurse take first?
A. Document the statement in the client's record
B. Ask the client if they have a specific suicide plan
C. Notify the provider on the next shift
D. Encourage the client to attend group therapy
,CORRECT ANSWER: B. Ask the client if they have a specific suicide plan
Rationale: When a client expresses suicidal ideation, the priority is to
assess the lethality and specificity of the plan to determine the level of
safety intervention required. Documentation (A) follows assessment,
notification (C) should not be delayed, and group therapy (D) is
inappropriate during acute risk.
Question 6: A nurse is assessing a client who has bipolar disorder with
acute mania. Which of the following findings should the nurse expect?
A. Psychomotor retardation and anergia
B. Decreased need for sleep and pressured speech
C. Flat affect and social withdrawal
D. Obsessive rumination and indecisiveness
CORRECT ANSWER: B. Decreased need for sleep and pressured speech
Rationale: Acute mania presents with decreased need for sleep, pressured
speech, grandiosity, and increased goal-directed activity. Psychomotor
retardation (A) and flat affect (C) suggest depression or negative
symptoms, while rumination and indecisiveness (D) suggest depression or
anxiety.
Question 7: A nurse is reviewing the laboratory results of a client taking
clozapine. Which of the following findings requires immediate
intervention?
A. Absolute neutrophil count of 1,200/mm³
B. Hemoglobin of 13 g/dL
C. Potassium of 4.0 mEq/L
D. Fasting glucose of 95 mg/dL
CORRECT ANSWER: A. Absolute neutrophil count of 1,200/mm³
Rationale: Clozapine carries a risk of severe neutropenia and
agranulocytosis; an ANC below 1,500/mm³ requires immediate
intervention, often discontinuation. The other values (B, C, D) are within
normal limits and do not require urgent action.
Question 8: A client is admitted with anorexia nervosa. Which of the
following nursing interventions is the priority during the initial phase of
treatment?
, A. Encourage the client to select preferred foods
B. Monitor vital signs and weight daily
C. Allow the client to eat alone to reduce anxiety
D. Discuss the client's feelings about body image
CORRECT ANSWER: B. Monitor vital signs and weight daily
Rationale: The priority in the initial phase of anorexia nervosa is
physiological stabilization, including monitoring for complications of
malnutrition such as bradycardia, hypotension, and electrolyte
imbalances. Food selection (A) and body image discussion (D) come later,
and eating alone (C) is unsafe due to purging risk.
Question 9: A nurse is caring for a client diagnosed with posttraumatic
stress disorder (PTSD). Which of the following findings should the nurse
expect?
A. Grandiosity and decreased need for sleep
B. Flashbacks and hypervigilance
C. Compulsive handwashing and checking
D. Anhedonia and psychomotor retardation
CORRECT ANSWER: B. Flashbacks and hypervigilance
Rationale: PTSD is characterized by re-experiencing (flashbacks,
nightmares), hyperarousal (hypervigilance, startle response), and
avoidance. Grandiosity (A) suggests mania, compulsions (C) suggest OCD,
and anhedonia (D) suggests depression.
Question 10: A nurse is administering haloperidol to a client. Which of
the following findings indicates the client is developing neuroleptic
malignant syndrome?
A. Hypertension and tachycardia with fever and muscle rigidity
B. Hypotension and bradycardia with hypothermia
C. Diarrhea and abdominal cramping
D. Polyuria and polydipsia
CORRECT ANSWER: A. Hypertension and tachycardia with fever and
muscle rigidity
Rationale: Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotics manifested by hyperthermia, muscle rigidity, autonomic
