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Details of ATI RN Mental Health Exam 2025 NGN Questions &
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ATI RN Mental Health Exam 2025 NGN Test Bank
Case Study 1 (6 NGN-style questions — Questions 1–6)
Scenario:
A 28-year-old female, Maya J., presents to the psychiatric
emergency department brought in by police after being found
wandering on a freeway ramp shouting that "aliens are sending
messages through the radio." She is disheveled, responding to
internal stimuli, and uncooperative initially. History obtained
from EMS and electronic records indicates a 2-week history of
insomnia, decreased appetite, and increasing paranoia. She has
,a prior diagnosis of schizophrenia spectrum disorder and
stopped taking risperidone 3 months ago because she believed
it was poisoning her. Vitals: T 37.2°C, HR 110, BP 138/86, RR 18,
SpO₂ 98% RA. Labs: BMP normal, CBC normal, urine tox
positive for cocaine. On arrival she is pacing, clutching her head,
and repeatedly says, “They’re in my head.” She refuses to sit.
You are the RN assigned to triage and initial assessment.
Question 1 (NGN — Priority/Clinical Judgment: Recognize &
Prioritize Cues)
Task: Identify the single highest-priority nursing action in the
first 5 minutes.
Options:
A. Attempt to persuade Maya to sit down and answer
orientation questions.
B. Conduct a focused neurological assessment (pupils, strength,
coordination).
C. Place Maya on suicide precautions (one-to-one observation).
D. Offer oral lorazepam 1 mg for agitation.
Correct Answer: C
Rationale:
Maya's presentation (disorganized behavior, commands/voices,
severe psychosis, recent stimulant use) raises immediate safety
risk for self-harm or harm to others. The highest-priority action
is establishing safety—suicide precautions/one-to-one
,observation—until risk can be fully assessed. Option A delays
safety and is unlikely effective with active psychosis. B is
reasonable but not highest priority; it can follow once safety is
established. D (lorazepam) is an option for agitation but
requires assessment and often prescriber order plus
consideration of substance use; medication should not precede
placing the client on precautions.
Teaching Tip: Always prioritize immediate safety (clients, staff,
public) — safety alerts override other assessments.
Question 2 (NGN — Analysis/Interpretation of Cues)
Task: From the vignette, select three cues that most strongly
suggest stimulant intoxication contributing to her presentation.
(SATA)
Options:
A. Pacing and agitation
B. Insomnia for 2 weeks
C. Urine toxicology positive for cocaine
D. Decreased appetite
E. Hearing voices saying “They’re in my head”
Correct Answers: A, C, D
Rationale:
Cocaine intoxication commonly causes agitation/pacing (A),
decreased appetite (D), and positive urine tox (C). Insomnia (B)
could be due to psychosis or stimulant but is nonspecific.
, Auditory hallucinations (E) suggest psychosis but are not
specific to stimulant intoxication—could be primary
schizophrenia spectrum disorder.
Teaching Tip: Combine objective data (labs/tox) with behavioral
cues for substance-related presentations.
Question 3 (NGN — Clinical Reasoning: Plan/Implement)
Task: Choose the best immediate nursing intervention to de-
escalate agitation while maintaining safety (single best action).
Options:
A. Move Maya to a quiet room and offer headphones and a
warm blanket.
B. Restrain Maya with soft ties until she calms.
C. Call for security to physically remove Maya to a seclusion
room.
D. Offer a PRN dose of intramuscular haloperidol 5 mg and
diphenhydramine 50 mg.
Correct Answer: A
Rationale:
Least restrictive measures come first. Moving to a quiet room,
offering calming items (A) is an appropriate first-line de-
escalation. Physical restraints/seclusion (B, C) are last resort
and require safety protocols and justification. Medication (D)
may be needed if nonpharmacologic measures fail and the
client is an imminent danger; also intramuscular antipsychotic