ATI PN MENTAL HEALTH PROCTORED EXAM WITH NGN –
PRACTICE QUESTIONS
1. A client with schizophrenia tells the nurse, "The FBI is watching my house
because I know the secret to stopping aliens." Which of the following is the most
therapeutic response by the nurse?
A) "The FBI does not watch people for that reason. You are safe here."
B) "I need you to take your medication now so these thoughts will stop."
C) "I understand you are frightened. I do not see the FBI, but I am here with you."
D) "Tell me more about the aliens so I can understand what you are seeing."
Rationale: The correct response acknowledges the client's feelings without validating the
delusion. Arguing (A) or dismissing the belief damages therapeutic rapport. Telling the
client to take medication (B) is nontherapeutic and controlling. Asking for more details
about the delusion (D) reinforces the psychotic thinking rather than grounding the client in
reality.
2. A nurse is caring for a client with major depressive disorder who has been
prescribed phenelzine (Nardil), an MAOI. Which of the following dietary choices
by the client indicates a need for immediate teaching?
A) Grilled chicken breast with steamed rice
B) Aged cheddar cheese on whole wheat crackers
C) Fresh fruit salad with yogurt
D) Pasta with marinara sauce and vegetables
Rationale: MAOIs require a strict tyramine-restricted diet to prevent hypertensive crisis.
Aged cheeses (B) are high in tyramine. The other options (A, C, D) are low in tyramine and
considered safe.
,3. A client with bipolar disorder is experiencing acute mania. Which of the
following nursing interventions should take priority?
A) Encouraging the client to participate in group therapy
B) Placing the client in a private room with minimal stimulation
C) Ensuring the client's safety by decreasing environmental stimuli and providing
frequent high-calorie finger foods
D) Allowing the client to make all decisions about daily activities
Rationale: During acute mania, the priority is safety due to poor judgment, hyperactivity,
and risk of exhaustion. Reducing stimuli (C) helps decrease agitation. Group therapy (A)
would overstimulate the client. A private room (B) is good but incomplete without
nutrition/safety details. Allowing full decision-making (D) is unsafe during mania.
4. A nurse is assessing a client with post-traumatic stress disorder (PTSD). Which
of the following findings is consistent with this diagnosis?
A) Hypervigilance and exaggerated startle response
B) Hypervigilance and exaggerated startle response
C) Grandiose delusions and pressured speech
D) Flat affect and avolition
Rationale: PTSD is characterized by re-experiencing trauma, avoidance, negative mood,
and hyperarousal symptoms including hypervigilance and exaggerated startle response
(B). Grandiose delusions and pressured speech (C) are seen in mania. Flat affect and
avolition (D) are negative symptoms of schizophrenia.
5. A client prescribed lorazepam (Ativan) for anxiety disorder reports that the
medication is no longer working as well as it did. The nurse recognizes this as:
A) Drug tolerance
B) Drug tolerance
C) Drug addiction
D) Drug toxicity
,Rationale: Tolerance (B) occurs when a client requires a higher dose to achieve the same
therapeutic effect after prolonged use. Addiction (C) involves compulsive use despite harm.
Toxicity (D) refers to harmful levels of the drug in the body.
6. A nurse is caring for a client with borderline personality disorder who exhibits
manipulative behaviors. Which of the following is the most appropriate nursing
action?
A) Allowing the client to negotiate consequences for behavior
B) Setting consistent, firm, and clear limits on behavior
C) Ignoring the manipulative behaviors to avoid reinforcing them
D) Discharging the client from the unit if manipulation continues
Rationale: Clients with borderline personality disorder benefit from consistent, firm, and
clear limits (B) to provide structure and safety. Allowing negotiation (A) reinforces
manipulation. Ignoring (C) does not address the behavior. Discharging (D) is punitive and
not therapeutic.
7. A client with alcohol use disorder is admitted with tremors, diaphoresis, and
hallucinations. The nurse should anticipate which of the following orders?
A) Naloxone (Narcan) IV push
B) Chlordiazepoxide (Librium) as per CIWA-Ar protocol
C) Disulfiram (Antabuse) 250 mg daily
D) Acamprosate (Campral) 666 mg three times daily
Rationale: The client is exhibiting alcohol withdrawal symptoms, which are managed with
benzodiazepines like chlordiazepoxide (B) using the CIWA-Ar scale. Naloxone (A) is for
opioid overdose. Disulfiram (C) and acamprosate (D) are for maintaining sobriety, not
acute withdrawal.
8. A nurse is providing education to a client prescribed fluoxetine (Prozac) for
depression. Which statement by the client indicates understanding?
, A) "I can stop this medication once I feel better."
B) "I will notify my provider if I experience increased anxiety or suicidal thoughts."
C) "I can take this medication with St. John's wort for better results."
D) "I should expect to feel better within 24 hours."
Rationale: Fluoxetine can increase anxiety and suicidal ideation, especially in young
adults, and the client should report these (B). The medication takes 4-6 weeks for full effect
(D) and should not be stopped abruptly (A). St. John's wort (C) can cause serotonin
syndrome when combined with SSRIs.
9. A client with anorexia nervosa refuses to eat, stating, "I feel fat and I need to
lose more weight." Which of the following is the most appropriate nursing
response?
A) "You are not fat. You are dangerously underweight."
B) "I am concerned about your health. Let's sit together and you can start with a
small meal."
C) "If you do not eat, we will have to place a feeding tube."
D) "You will gain weight if you keep refusing to eat."
Rationale: The therapeutic response acknowledges concern while offering support and a
manageable goal (B). Arguing about weight (A) or threatening (C) damages rapport.
Stating the obvious (D) is nontherapeutic and increases anxiety.
10. A nurse is assessing a client with dementia who is wandering and attempting
to leave the unit. Which of the following interventions should the nurse
implement first?
A) Apply physical restraints to prevent elopement
B) Accompany the client on a supervised walk
C) Administer haloperidol (Haldol) to calm the client
D) Redirect the client to a quiet room with the door closed
Rationale: Wandering is common in dementia, and the least restrictive intervention is to
accompany the client on a supervised walk (B) to meet the need to move. Restraints (A)
PRACTICE QUESTIONS
1. A client with schizophrenia tells the nurse, "The FBI is watching my house
because I know the secret to stopping aliens." Which of the following is the most
therapeutic response by the nurse?
A) "The FBI does not watch people for that reason. You are safe here."
B) "I need you to take your medication now so these thoughts will stop."
C) "I understand you are frightened. I do not see the FBI, but I am here with you."
D) "Tell me more about the aliens so I can understand what you are seeing."
Rationale: The correct response acknowledges the client's feelings without validating the
delusion. Arguing (A) or dismissing the belief damages therapeutic rapport. Telling the
client to take medication (B) is nontherapeutic and controlling. Asking for more details
about the delusion (D) reinforces the psychotic thinking rather than grounding the client in
reality.
2. A nurse is caring for a client with major depressive disorder who has been
prescribed phenelzine (Nardil), an MAOI. Which of the following dietary choices
by the client indicates a need for immediate teaching?
A) Grilled chicken breast with steamed rice
B) Aged cheddar cheese on whole wheat crackers
C) Fresh fruit salad with yogurt
D) Pasta with marinara sauce and vegetables
Rationale: MAOIs require a strict tyramine-restricted diet to prevent hypertensive crisis.
Aged cheeses (B) are high in tyramine. The other options (A, C, D) are low in tyramine and
considered safe.
,3. A client with bipolar disorder is experiencing acute mania. Which of the
following nursing interventions should take priority?
A) Encouraging the client to participate in group therapy
B) Placing the client in a private room with minimal stimulation
C) Ensuring the client's safety by decreasing environmental stimuli and providing
frequent high-calorie finger foods
D) Allowing the client to make all decisions about daily activities
Rationale: During acute mania, the priority is safety due to poor judgment, hyperactivity,
and risk of exhaustion. Reducing stimuli (C) helps decrease agitation. Group therapy (A)
would overstimulate the client. A private room (B) is good but incomplete without
nutrition/safety details. Allowing full decision-making (D) is unsafe during mania.
4. A nurse is assessing a client with post-traumatic stress disorder (PTSD). Which
of the following findings is consistent with this diagnosis?
A) Hypervigilance and exaggerated startle response
B) Hypervigilance and exaggerated startle response
C) Grandiose delusions and pressured speech
D) Flat affect and avolition
Rationale: PTSD is characterized by re-experiencing trauma, avoidance, negative mood,
and hyperarousal symptoms including hypervigilance and exaggerated startle response
(B). Grandiose delusions and pressured speech (C) are seen in mania. Flat affect and
avolition (D) are negative symptoms of schizophrenia.
5. A client prescribed lorazepam (Ativan) for anxiety disorder reports that the
medication is no longer working as well as it did. The nurse recognizes this as:
A) Drug tolerance
B) Drug tolerance
C) Drug addiction
D) Drug toxicity
,Rationale: Tolerance (B) occurs when a client requires a higher dose to achieve the same
therapeutic effect after prolonged use. Addiction (C) involves compulsive use despite harm.
Toxicity (D) refers to harmful levels of the drug in the body.
6. A nurse is caring for a client with borderline personality disorder who exhibits
manipulative behaviors. Which of the following is the most appropriate nursing
action?
A) Allowing the client to negotiate consequences for behavior
B) Setting consistent, firm, and clear limits on behavior
C) Ignoring the manipulative behaviors to avoid reinforcing them
D) Discharging the client from the unit if manipulation continues
Rationale: Clients with borderline personality disorder benefit from consistent, firm, and
clear limits (B) to provide structure and safety. Allowing negotiation (A) reinforces
manipulation. Ignoring (C) does not address the behavior. Discharging (D) is punitive and
not therapeutic.
7. A client with alcohol use disorder is admitted with tremors, diaphoresis, and
hallucinations. The nurse should anticipate which of the following orders?
A) Naloxone (Narcan) IV push
B) Chlordiazepoxide (Librium) as per CIWA-Ar protocol
C) Disulfiram (Antabuse) 250 mg daily
D) Acamprosate (Campral) 666 mg three times daily
Rationale: The client is exhibiting alcohol withdrawal symptoms, which are managed with
benzodiazepines like chlordiazepoxide (B) using the CIWA-Ar scale. Naloxone (A) is for
opioid overdose. Disulfiram (C) and acamprosate (D) are for maintaining sobriety, not
acute withdrawal.
8. A nurse is providing education to a client prescribed fluoxetine (Prozac) for
depression. Which statement by the client indicates understanding?
, A) "I can stop this medication once I feel better."
B) "I will notify my provider if I experience increased anxiety or suicidal thoughts."
C) "I can take this medication with St. John's wort for better results."
D) "I should expect to feel better within 24 hours."
Rationale: Fluoxetine can increase anxiety and suicidal ideation, especially in young
adults, and the client should report these (B). The medication takes 4-6 weeks for full effect
(D) and should not be stopped abruptly (A). St. John's wort (C) can cause serotonin
syndrome when combined with SSRIs.
9. A client with anorexia nervosa refuses to eat, stating, "I feel fat and I need to
lose more weight." Which of the following is the most appropriate nursing
response?
A) "You are not fat. You are dangerously underweight."
B) "I am concerned about your health. Let's sit together and you can start with a
small meal."
C) "If you do not eat, we will have to place a feeding tube."
D) "You will gain weight if you keep refusing to eat."
Rationale: The therapeutic response acknowledges concern while offering support and a
manageable goal (B). Arguing about weight (A) or threatening (C) damages rapport.
Stating the obvious (D) is nontherapeutic and increases anxiety.
10. A nurse is assessing a client with dementia who is wandering and attempting
to leave the unit. Which of the following interventions should the nurse
implement first?
A) Apply physical restraints to prevent elopement
B) Accompany the client on a supervised walk
C) Administer haloperidol (Haldol) to calm the client
D) Redirect the client to a quiet room with the door closed
Rationale: Wandering is common in dementia, and the least restrictive intervention is to
accompany the client on a supervised walk (B) to meet the need to move. Restraints (A)
