ATI Mental Health Proctored Exam 2026/2027 |
ACTUAL-Style Practice Questions & Answers,
Psychiatric Nursing, Clinical Judgment,
Therapeutic Communication, and Detailed
Rationales
Question 1: A nurse is caring for a client who is experiencing acute
mania. Which of the following interventions should the nurse
implement to promote client safety?
A. Encourage the client to participate in a loud, stimulating group activity.
B. Provide a structured environment with minimal external stimuli.
C. Allow the client to skip meals if they are too busy to eat.
D. Restrict the client's fluid intake to prevent excessive urination.
CORRECT ANSWER: B. Provide a structured environment with minimal
external stimuli.
Rationale: Clients in an acute manic state are highly distractible,
hyperactive, and have poor impulse control. A structured, low-stimulation
environment reduces sensory overload, decreases anxiety, and helps
prevent escalation of manic behavior, thereby promoting safety .
Question 2: A nurse is assessing a client who has schizophrenia and is
taking haloperidol. The client presents with a high fever and muscle
rigidity. Which of the following complications should the nurse
suspect?
A. Tardive dyskinesia
B. Acute dystonia
C. Neuroleptic malignant syndrome
D. Serotonin syndrome
CORRECT ANSWER: C. Neuroleptic malignant syndrome
Rationale: Neuroleptic malignant syndrome (NMS) is a rare but life-
threatening adverse effect of antipsychotic medications, particularly
typical antipsychotics like haloperidol. Key manifestations include high
fever, severe muscle rigidity, altered mental status, and autonomic
instability .
Question 3: A client tells a nurse, "I don't remember anything about the
car accident that happened last week." The nurse should recognize that
the client is using which defense mechanism?
,A. Denial
B. Repression
C. Projection
D. Displacement
CORRECT ANSWER: B. Repression
Rationale: Repression is an involuntary defense mechanism where the
mind blocks unpleasant or traumatic memories from conscious
awareness. The client genuinely cannot recall the traumatic event,
distinguishing it from denial, where the client is aware of the facts but
refuses to accept them .
Question 4: A nurse is reviewing the plan of care for a client who has
borderline personality disorder and engages in self-mutilation. Which
of the following group therapies should the nurse recommend?
A. Dialectical behavior therapy
B. Systematic desensitization group
C. Dual diagnosis treatment group
D. Grief support group
CORRECT ANSWER: A. Dialectical behavior therapy
Rationale: Dialectical behavior therapy (DBT) is a cognitive-behavioral
therapy specifically designed for clients with borderline personality
disorder who exhibit self-injurious behaviors. It focuses on gradual
behavior changes, acceptance, and validation, teaching skills in distress
tolerance and emotional regulation .
Question 5: A nurse is caring for a client who has generalized anxiety
disorder and a history of substance use disorder. Which of the
following medications should the nurse expect the provider to
prescribe?
A. Alprazolam
B. Clonazepam
C. Buspirone
D. Chlordiazepoxide
CORRECT ANSWER: C. Buspirone
,Rationale: Buspirone is a non-benzodiazepine anxiolytic that does not
cause physical dependence or tolerance, making it the safest choice for a
client with a history of substance use disorder. Benzodiazepines such as
alprazolam, clonazepam, and chlordiazepoxide carry a risk of dependence
and are generally avoided in this population .
Question 6: A nurse is performing a mental status examination on a
client. Which of the following actions should the nurse take to assess
the client's abstract thinking?
A. Ask the client to count backward from 100 by sevens.
B. Ask the client to interpret a common proverb.
C. Ask the client to name the current president.
D. Ask the client to repeat a list of five objects.
CORRECT ANSWER: B. Ask the client to interpret a common proverb.
Rationale: Abstract thinking is the ability to understand concepts that are
not concrete or physically present. Asking a client to interpret a proverb
(e.g., "A bird in the hand is worth two in the bush") assesses this cognitive
function. Counting backward assesses calculation, naming the president
assesses remote memory, and repeating objects assesses immediate
memory .
Question 7: A client who was sexually abused as a child is unable to
remember the incident. Which defense mechanism should the nurse
identify?
A. Suppression
B. Denial
C. Repression
D. Rationalization
CORRECT ANSWER: C. Repression
Rationale: Repression is the involuntary blocking of unpleasant thoughts or
memories from conscious awareness. The client is not deliberately
choosing not to think about the event (which would be suppression); rather,
the memory is automatically inaccessible .
Question 8: A nurse is caring for a client who has just returned to the
unit after receiving electroconvulsive therapy. Which of the following
assessments is the nurse's priority?
, A. Presence of gag reflex
B. Short-term memory
C. First voiding
D. Return of bowel sounds
CORRECT ANSWER: A. Presence of gag reflex
Rationale: Following electroconvulsive therapy (ECT), the client is at risk for
aspiration due to the effects of anesthesia and muscle relaxation. The
nurse must first verify the return of the gag reflex before allowing the client
to eat or drink. Memory, voiding, and bowel sounds are important but not
immediately life-threatening .
Question 9: A nurse is teaching a client who has bipolar disorder and a
new prescription for lithium carbonate. Which of the following
statements by the client indicates an understanding of the teaching?
A. "I should drink at least 6 liters of water per day."
B. "I should be on a low-sodium diet."
C. "I will call my doctor if I have diarrhea."
D. "I will see my doctor to check my lithium levels annually."
CORRECT ANSWER: C. "I will call my doctor if I have diarrhea."
Rationale: Diarrhea can lead to dehydration, which causes sodium
depletion and increases the risk of lithium toxicity. The client should notify
the provider if diarrhea occurs. Clients on lithium should maintain
adequate (not excessive) fluid intake, maintain normal sodium intake, and
have lithium levels checked every 3 to 6 months or more frequently as
needed .
Question 10: A nurse in an emergency department is caring for a client
who reports experiencing intimate partner violence. Which of the
following actions should the nurse take first?
A. Determine what the client did to trigger the incident.
B. Request permission from the client to take photographs of the injuries.
C. Help the client devise a safety plan.
D. Tell the client that staying with the partner shows poor judgment.
CORRECT ANSWER: C. Help the client devise a safety plan.
ACTUAL-Style Practice Questions & Answers,
Psychiatric Nursing, Clinical Judgment,
Therapeutic Communication, and Detailed
Rationales
Question 1: A nurse is caring for a client who is experiencing acute
mania. Which of the following interventions should the nurse
implement to promote client safety?
A. Encourage the client to participate in a loud, stimulating group activity.
B. Provide a structured environment with minimal external stimuli.
C. Allow the client to skip meals if they are too busy to eat.
D. Restrict the client's fluid intake to prevent excessive urination.
CORRECT ANSWER: B. Provide a structured environment with minimal
external stimuli.
Rationale: Clients in an acute manic state are highly distractible,
hyperactive, and have poor impulse control. A structured, low-stimulation
environment reduces sensory overload, decreases anxiety, and helps
prevent escalation of manic behavior, thereby promoting safety .
Question 2: A nurse is assessing a client who has schizophrenia and is
taking haloperidol. The client presents with a high fever and muscle
rigidity. Which of the following complications should the nurse
suspect?
A. Tardive dyskinesia
B. Acute dystonia
C. Neuroleptic malignant syndrome
D. Serotonin syndrome
CORRECT ANSWER: C. Neuroleptic malignant syndrome
Rationale: Neuroleptic malignant syndrome (NMS) is a rare but life-
threatening adverse effect of antipsychotic medications, particularly
typical antipsychotics like haloperidol. Key manifestations include high
fever, severe muscle rigidity, altered mental status, and autonomic
instability .
Question 3: A client tells a nurse, "I don't remember anything about the
car accident that happened last week." The nurse should recognize that
the client is using which defense mechanism?
,A. Denial
B. Repression
C. Projection
D. Displacement
CORRECT ANSWER: B. Repression
Rationale: Repression is an involuntary defense mechanism where the
mind blocks unpleasant or traumatic memories from conscious
awareness. The client genuinely cannot recall the traumatic event,
distinguishing it from denial, where the client is aware of the facts but
refuses to accept them .
Question 4: A nurse is reviewing the plan of care for a client who has
borderline personality disorder and engages in self-mutilation. Which
of the following group therapies should the nurse recommend?
A. Dialectical behavior therapy
B. Systematic desensitization group
C. Dual diagnosis treatment group
D. Grief support group
CORRECT ANSWER: A. Dialectical behavior therapy
Rationale: Dialectical behavior therapy (DBT) is a cognitive-behavioral
therapy specifically designed for clients with borderline personality
disorder who exhibit self-injurious behaviors. It focuses on gradual
behavior changes, acceptance, and validation, teaching skills in distress
tolerance and emotional regulation .
Question 5: A nurse is caring for a client who has generalized anxiety
disorder and a history of substance use disorder. Which of the
following medications should the nurse expect the provider to
prescribe?
A. Alprazolam
B. Clonazepam
C. Buspirone
D. Chlordiazepoxide
CORRECT ANSWER: C. Buspirone
,Rationale: Buspirone is a non-benzodiazepine anxiolytic that does not
cause physical dependence or tolerance, making it the safest choice for a
client with a history of substance use disorder. Benzodiazepines such as
alprazolam, clonazepam, and chlordiazepoxide carry a risk of dependence
and are generally avoided in this population .
Question 6: A nurse is performing a mental status examination on a
client. Which of the following actions should the nurse take to assess
the client's abstract thinking?
A. Ask the client to count backward from 100 by sevens.
B. Ask the client to interpret a common proverb.
C. Ask the client to name the current president.
D. Ask the client to repeat a list of five objects.
CORRECT ANSWER: B. Ask the client to interpret a common proverb.
Rationale: Abstract thinking is the ability to understand concepts that are
not concrete or physically present. Asking a client to interpret a proverb
(e.g., "A bird in the hand is worth two in the bush") assesses this cognitive
function. Counting backward assesses calculation, naming the president
assesses remote memory, and repeating objects assesses immediate
memory .
Question 7: A client who was sexually abused as a child is unable to
remember the incident. Which defense mechanism should the nurse
identify?
A. Suppression
B. Denial
C. Repression
D. Rationalization
CORRECT ANSWER: C. Repression
Rationale: Repression is the involuntary blocking of unpleasant thoughts or
memories from conscious awareness. The client is not deliberately
choosing not to think about the event (which would be suppression); rather,
the memory is automatically inaccessible .
Question 8: A nurse is caring for a client who has just returned to the
unit after receiving electroconvulsive therapy. Which of the following
assessments is the nurse's priority?
, A. Presence of gag reflex
B. Short-term memory
C. First voiding
D. Return of bowel sounds
CORRECT ANSWER: A. Presence of gag reflex
Rationale: Following electroconvulsive therapy (ECT), the client is at risk for
aspiration due to the effects of anesthesia and muscle relaxation. The
nurse must first verify the return of the gag reflex before allowing the client
to eat or drink. Memory, voiding, and bowel sounds are important but not
immediately life-threatening .
Question 9: A nurse is teaching a client who has bipolar disorder and a
new prescription for lithium carbonate. Which of the following
statements by the client indicates an understanding of the teaching?
A. "I should drink at least 6 liters of water per day."
B. "I should be on a low-sodium diet."
C. "I will call my doctor if I have diarrhea."
D. "I will see my doctor to check my lithium levels annually."
CORRECT ANSWER: C. "I will call my doctor if I have diarrhea."
Rationale: Diarrhea can lead to dehydration, which causes sodium
depletion and increases the risk of lithium toxicity. The client should notify
the provider if diarrhea occurs. Clients on lithium should maintain
adequate (not excessive) fluid intake, maintain normal sodium intake, and
have lithium levels checked every 3 to 6 months or more frequently as
needed .
Question 10: A nurse in an emergency department is caring for a client
who reports experiencing intimate partner violence. Which of the
following actions should the nurse take first?
A. Determine what the client did to trigger the incident.
B. Request permission from the client to take photographs of the injuries.
C. Help the client devise a safety plan.
D. Tell the client that staying with the partner shows poor judgment.
CORRECT ANSWER: C. Help the client devise a safety plan.
