ATI Mental Health Nursing Practice Exam |
2026–2027|Original Multiple-Choice Questions
with Detailed Answers And Rationales
1. A nurse is caring for a client diagnosed with major depressive disorder who
states, "Everyone would be better off without me." What is the nurse's priority
response?
A. "Why do you feel that way?"
B. "Tell me more about what you're thinking."
C. "You shouldn't think like that."
D. "Let's discuss something more positive."
CORRECT ANSWER: B. "Tell me more about what you're thinking."
RATIONALE:
B is correct because the statement may indicate suicidal ideation. The nurse should use
therapeutic communication to assess the client's thoughts, intent, and risk before taking further
action.
2. Which client should the psychiatric nurse assess first?
A. A client with generalized anxiety disorder requesting medication
B. A client with schizophrenia who reports hearing voices commanding self-harm
C. A client with insomnia requesting a sleep aid
D. A client asking about discharge instructions
CORRECT ANSWER: B. A client with schizophrenia who reports hearing voices
commanding self-harm
RATIONALE:
B is correct because command hallucinations directing self-harm place the client at immediate
risk for injury and require urgent assessment and intervention.
,3. Which statement by the nurse best demonstrates therapeutic communication?
A. "Everything will be okay."
B. "I know exactly how you feel."
C. "Can you tell me more about what's troubling you?"
D. "You shouldn't worry so much."
CORRECT ANSWER: C. "Can you tell me more about what's troubling you?"
RATIONALE:
C is correct because open-ended questions encourage clients to express feelings and promote
therapeutic communication.
4. A client experiencing a panic attack arrives in the emergency department.
What is the nurse's priority intervention?
A. Teach relaxation exercises immediately.
B. Stay with the client and speak calmly using short, simple statements.
C. Ask the client to complete an anxiety questionnaire.
D. Leave the client alone in a quiet room.
CORRECT ANSWER: B. Stay with the client and speak calmly using short, simple
statements.
RATIONALE:
B is correct because clients experiencing panic attacks have difficulty processing information. A
calm presence and simple communication help reduce anxiety and promote safety.
5. Which behavior is most characteristic of mania?
A. Social withdrawal and slowed speech
B. Flat affect and poor eye contact
C. Grandiosity, decreased need for sleep, and excessive energy
, D. Persistent fear of contamination
CORRECT ANSWER: C. Grandiosity, decreased need for sleep, and excessive energy
RATIONALE:
C is correct because manic episodes are characterized by elevated mood, inflated self-esteem,
increased activity, rapid speech, impulsivity, and reduced need for sleep.
6. A nurse is caring for a client prescribed lithium carbonate. Which laboratory
value requires the closest monitoring?
A. Serum lithium level
B. White blood cell count
C. Hemoglobin level
D. Platelet count
CORRECT ANSWER: A. Serum lithium level
RATIONALE:
A is correct because lithium has a narrow therapeutic range, and elevated levels can lead to
toxicity. Regular monitoring helps ensure safe and effective therapy.
7. A client diagnosed with schizophrenia says, "The television is sending me
secret messages." Which response by the nurse is most appropriate?
A. "Yes, I noticed that too."
B. "The television is not sending messages, but I understand that this feels real to you."
C. "Stop talking about those ideas."
D. "Why do you believe that?"
CORRECT ANSWER: B. "The television is not sending messages, but I understand that this
feels real to you."
RATIONALE:
B is correct because the nurse acknowledges the client's feelings without reinforcing the delusion
and gently presents reality.
2026–2027|Original Multiple-Choice Questions
with Detailed Answers And Rationales
1. A nurse is caring for a client diagnosed with major depressive disorder who
states, "Everyone would be better off without me." What is the nurse's priority
response?
A. "Why do you feel that way?"
B. "Tell me more about what you're thinking."
C. "You shouldn't think like that."
D. "Let's discuss something more positive."
CORRECT ANSWER: B. "Tell me more about what you're thinking."
RATIONALE:
B is correct because the statement may indicate suicidal ideation. The nurse should use
therapeutic communication to assess the client's thoughts, intent, and risk before taking further
action.
2. Which client should the psychiatric nurse assess first?
A. A client with generalized anxiety disorder requesting medication
B. A client with schizophrenia who reports hearing voices commanding self-harm
C. A client with insomnia requesting a sleep aid
D. A client asking about discharge instructions
CORRECT ANSWER: B. A client with schizophrenia who reports hearing voices
commanding self-harm
RATIONALE:
B is correct because command hallucinations directing self-harm place the client at immediate
risk for injury and require urgent assessment and intervention.
,3. Which statement by the nurse best demonstrates therapeutic communication?
A. "Everything will be okay."
B. "I know exactly how you feel."
C. "Can you tell me more about what's troubling you?"
D. "You shouldn't worry so much."
CORRECT ANSWER: C. "Can you tell me more about what's troubling you?"
RATIONALE:
C is correct because open-ended questions encourage clients to express feelings and promote
therapeutic communication.
4. A client experiencing a panic attack arrives in the emergency department.
What is the nurse's priority intervention?
A. Teach relaxation exercises immediately.
B. Stay with the client and speak calmly using short, simple statements.
C. Ask the client to complete an anxiety questionnaire.
D. Leave the client alone in a quiet room.
CORRECT ANSWER: B. Stay with the client and speak calmly using short, simple
statements.
RATIONALE:
B is correct because clients experiencing panic attacks have difficulty processing information. A
calm presence and simple communication help reduce anxiety and promote safety.
5. Which behavior is most characteristic of mania?
A. Social withdrawal and slowed speech
B. Flat affect and poor eye contact
C. Grandiosity, decreased need for sleep, and excessive energy
, D. Persistent fear of contamination
CORRECT ANSWER: C. Grandiosity, decreased need for sleep, and excessive energy
RATIONALE:
C is correct because manic episodes are characterized by elevated mood, inflated self-esteem,
increased activity, rapid speech, impulsivity, and reduced need for sleep.
6. A nurse is caring for a client prescribed lithium carbonate. Which laboratory
value requires the closest monitoring?
A. Serum lithium level
B. White blood cell count
C. Hemoglobin level
D. Platelet count
CORRECT ANSWER: A. Serum lithium level
RATIONALE:
A is correct because lithium has a narrow therapeutic range, and elevated levels can lead to
toxicity. Regular monitoring helps ensure safe and effective therapy.
7. A client diagnosed with schizophrenia says, "The television is sending me
secret messages." Which response by the nurse is most appropriate?
A. "Yes, I noticed that too."
B. "The television is not sending messages, but I understand that this feels real to you."
C. "Stop talking about those ideas."
D. "Why do you believe that?"
CORRECT ANSWER: B. "The television is not sending messages, but I understand that this
feels real to you."
RATIONALE:
B is correct because the nurse acknowledges the client's feelings without reinforcing the delusion
and gently presents reality.
