ATI RN Mental Health
Proctored Exam: 100 Practice
Questions and Answer
Explanations
Part One: Foundations, Therapeutic Communication, and the Nurse-Client Relationship (1–
25)
1. A nurse is assessing a client's cognitive ability. Which action should the nurse take?
A. Observe the client's facial expression
B. Ask the client to count backward by sevens
C. Evaluate the client's speech pattern
D. Ask the client to interpret a proverb
Answer: B
Explanation: Counting backward by sevens assesses concentration and attention, which are
cognitive functions. Observing facial expression assesses affect; evaluating speech pattern
assesses thought process; interpreting a proverb assesses abstract thinking .
2. A nurse is performing an admission assessment for a client who appears withdrawn and
fearful. Which action should the nurse take first?
A. Ask the client directly about the source of their fear
B. Sit quietly with the client to establish trust
C. Begin the physical assessment immediately
D. Request that the client's family leave the room
Answer: B
Explanation: A withdrawn, fearful client may feel overwhelmed by direct questioning. Sitting
quietly demonstrates acceptance and allows the client to set the pace. Trust must be
established before assessment can proceed effectively .
3. A client says, "I'm worthless and everyone would be better off without me." Which
response by the nurse is the priority?
A. "You shouldn't say things like that."
B. "Are you thinking about hurting yourself?"
C. "I'm sure your family loves you."
D. "Let's go to group therapy; you'll feel better."
Answer: B
Explanation: Directly asking about suicidal ideation is essential to assess safety and is the
priority nursing action .
,4. A nurse is using therapeutic communication with a client who has anxiety. Which
response by the nurse is most appropriate?
A. "You shouldn't feel anxious; everything will be fine."
B. "Tell me what you are feeling right now."
C. "Why are you always so nervous?"
D. "Let's talk about something else to distract you."
Answer: B
Explanation: An open-ended statement encourages the client to express feelings and
promotes therapeutic communication .
5. A nurse is establishing a therapeutic relationship with a newly admitted client
experiencing severe anxiety. The nurse demonstrates genuineness by which action?
A. Sharing personal experiences with anxiety to build rapport
B. Responding authentically without pretending to have all answers
C. Maintaining a strictly professional distance at all times
D. Agreeing with the client's statements regardless of accuracy
Answer: B
Explanation: Genuineness involves being authentic, honest, and congruent rather than
putting on a professional facade. Sharing personal experiences can blur boundaries .
6. A nurse is using therapeutic communication. Which phrase represents the technique of
reflection?
A. "Tell me more about that."
B. "You feel angry when they criticize you."
C. "I'm here to help you."
D. "That must be very difficult."
Answer: B
Explanation: Reflection restates feelings or content back to the client to confirm
understanding .
7. A nurse is discussing mental status examinations with a newly licensed nurse. Which
statement indicates understanding of assessing cognitive ability?
A. "To assess cognitive ability, I should observe the client's facial expression."
B. "To assess cognitive ability, I should count backward by sevens."
C. "To assess cognitive ability, I should evaluate the client's speech pattern."
D. "To assess cognitive ability, I should ask the client to interpret a proverb."
Answer: B
Explanation: Counting backward by sevens assesses concentration and attention, which are
cognitive functions .
8. A nurse is reviewing the concept of bias with a newly licensed nurse. Which scenario
demonstrates biased treatment?
A. A nurse provides the same level of care to all clients regardless of background
, B. A nurse assumes a client with a history of substance use is drug-seeking
C. A nurse asks a client about their cultural preferences for meals
D. A nurse seeks an interpreter for a client who speaks a different language
Answer: B
Explanation: Bias involves prejudging a client based on stereotypes. Assuming a client with
substance use history is drug-seeking can lead to inadequate pain management .
9. A nurse is presenting information on mental health services over the last 50 years.
Which statement should the nurse include?
A. "Deinstitutionalization led to increased funding for community mental health services."
B. "The Mental Health Parity Act mandated equal insurance coverage for mental and
physical health conditions."
C. "Electroconvulsive therapy is no longer used in mental health treatment."
D. "Antipsychotic medications were first introduced in the 1990s."
Answer: B
Explanation: The Mental Health Parity Act mandated equal insurance coverage for mental
and physical health conditions .
10. A nurse is told during change of shift report that a client is stuporous. Which finding
should the nurse expect?
A. The client arouses briefly in response to a sternal rub.
B. The client has a Glasgow Coma Scale score less than 7.
C. The client is alert and oriented to person, place, and time.
D. The client responds appropriately to verbal commands.
Answer: A
Explanation: Stuporous clients arouse only briefly in response to vigorous or painful
stimulation such as a sternal rub .
11. A nurse is discussing acute vs prolonged stress with a client. Which effects should the
nurse identify as an acute stress response? (Select all that apply)
A. Chronic pain
B. Depressed immune system
C. Increased blood pressure
D. Panic attacks
E. Unhappiness
Answer: B, C, E
Explanation: Acute stress responses include depressed immune system, increased blood
pressure, and unhappiness. Chronic pain is associated with prolonged stress; panic attacks
are a manifestation of anxiety disorders .
12. A nurse is teaching a client about stress-reduction techniques. Which client statement
indicates understanding of the teaching?
A. "Cognitive reframing will help me change my irrational thoughts to something positive."
Proctored Exam: 100 Practice
Questions and Answer
Explanations
Part One: Foundations, Therapeutic Communication, and the Nurse-Client Relationship (1–
25)
1. A nurse is assessing a client's cognitive ability. Which action should the nurse take?
A. Observe the client's facial expression
B. Ask the client to count backward by sevens
C. Evaluate the client's speech pattern
D. Ask the client to interpret a proverb
Answer: B
Explanation: Counting backward by sevens assesses concentration and attention, which are
cognitive functions. Observing facial expression assesses affect; evaluating speech pattern
assesses thought process; interpreting a proverb assesses abstract thinking .
2. A nurse is performing an admission assessment for a client who appears withdrawn and
fearful. Which action should the nurse take first?
A. Ask the client directly about the source of their fear
B. Sit quietly with the client to establish trust
C. Begin the physical assessment immediately
D. Request that the client's family leave the room
Answer: B
Explanation: A withdrawn, fearful client may feel overwhelmed by direct questioning. Sitting
quietly demonstrates acceptance and allows the client to set the pace. Trust must be
established before assessment can proceed effectively .
3. A client says, "I'm worthless and everyone would be better off without me." Which
response by the nurse is the priority?
A. "You shouldn't say things like that."
B. "Are you thinking about hurting yourself?"
C. "I'm sure your family loves you."
D. "Let's go to group therapy; you'll feel better."
Answer: B
Explanation: Directly asking about suicidal ideation is essential to assess safety and is the
priority nursing action .
,4. A nurse is using therapeutic communication with a client who has anxiety. Which
response by the nurse is most appropriate?
A. "You shouldn't feel anxious; everything will be fine."
B. "Tell me what you are feeling right now."
C. "Why are you always so nervous?"
D. "Let's talk about something else to distract you."
Answer: B
Explanation: An open-ended statement encourages the client to express feelings and
promotes therapeutic communication .
5. A nurse is establishing a therapeutic relationship with a newly admitted client
experiencing severe anxiety. The nurse demonstrates genuineness by which action?
A. Sharing personal experiences with anxiety to build rapport
B. Responding authentically without pretending to have all answers
C. Maintaining a strictly professional distance at all times
D. Agreeing with the client's statements regardless of accuracy
Answer: B
Explanation: Genuineness involves being authentic, honest, and congruent rather than
putting on a professional facade. Sharing personal experiences can blur boundaries .
6. A nurse is using therapeutic communication. Which phrase represents the technique of
reflection?
A. "Tell me more about that."
B. "You feel angry when they criticize you."
C. "I'm here to help you."
D. "That must be very difficult."
Answer: B
Explanation: Reflection restates feelings or content back to the client to confirm
understanding .
7. A nurse is discussing mental status examinations with a newly licensed nurse. Which
statement indicates understanding of assessing cognitive ability?
A. "To assess cognitive ability, I should observe the client's facial expression."
B. "To assess cognitive ability, I should count backward by sevens."
C. "To assess cognitive ability, I should evaluate the client's speech pattern."
D. "To assess cognitive ability, I should ask the client to interpret a proverb."
Answer: B
Explanation: Counting backward by sevens assesses concentration and attention, which are
cognitive functions .
8. A nurse is reviewing the concept of bias with a newly licensed nurse. Which scenario
demonstrates biased treatment?
A. A nurse provides the same level of care to all clients regardless of background
, B. A nurse assumes a client with a history of substance use is drug-seeking
C. A nurse asks a client about their cultural preferences for meals
D. A nurse seeks an interpreter for a client who speaks a different language
Answer: B
Explanation: Bias involves prejudging a client based on stereotypes. Assuming a client with
substance use history is drug-seeking can lead to inadequate pain management .
9. A nurse is presenting information on mental health services over the last 50 years.
Which statement should the nurse include?
A. "Deinstitutionalization led to increased funding for community mental health services."
B. "The Mental Health Parity Act mandated equal insurance coverage for mental and
physical health conditions."
C. "Electroconvulsive therapy is no longer used in mental health treatment."
D. "Antipsychotic medications were first introduced in the 1990s."
Answer: B
Explanation: The Mental Health Parity Act mandated equal insurance coverage for mental
and physical health conditions .
10. A nurse is told during change of shift report that a client is stuporous. Which finding
should the nurse expect?
A. The client arouses briefly in response to a sternal rub.
B. The client has a Glasgow Coma Scale score less than 7.
C. The client is alert and oriented to person, place, and time.
D. The client responds appropriately to verbal commands.
Answer: A
Explanation: Stuporous clients arouse only briefly in response to vigorous or painful
stimulation such as a sternal rub .
11. A nurse is discussing acute vs prolonged stress with a client. Which effects should the
nurse identify as an acute stress response? (Select all that apply)
A. Chronic pain
B. Depressed immune system
C. Increased blood pressure
D. Panic attacks
E. Unhappiness
Answer: B, C, E
Explanation: Acute stress responses include depressed immune system, increased blood
pressure, and unhappiness. Chronic pain is associated with prolonged stress; panic attacks
are a manifestation of anxiety disorders .
12. A nurse is teaching a client about stress-reduction techniques. Which client statement
indicates understanding of the teaching?
A. "Cognitive reframing will help me change my irrational thoughts to something positive."
