ATI Mental Health Proctored Exam(10
Versions)(New, 2023)(Verified)
Section 1: Foundations of Psychiatric Nursing & Therapeutic Communication (Q1–15)
1. A nurse is caring for a client admitted to the inpatient psychiatric unit. Which action best
demonstrates the ethical principle of autonomy?
A. Restraining the client when agitated
B. Allowing the client to refuse a prescribed antipsychotic after being informed of consequences
C. Withholding information about side effects to prevent refusal
D. Making treatment decisions on the client's behalf
Correct: B
Rationale: Autonomy respects the client's right to make informed decisions about care,
including refusal. Restraints (A) limit autonomy; withholding information (C) violates informed
consent; making decisions for the client (D) is paternalism.
2. Which statement by the nurse demonstrates the therapeutic communication technique of
reflection?
A. "You seem to be saying that you feel hopeless about your future."
B. "Why did you stop taking your medication?"
C. "Everything will be fine, don't worry."
D. "I think you should attend group therapy."
Correct: A
Rationale: Reflection mirrors the client's feelings/content back to promote insight. "Why"
questions (B) can be defensive; false reassurance (C) blocks communication; advice-giving (D) is
nontherapeutic.
3. A client says, "I can't go on anymore." Which is the nurse's priority response?
A. "You have so much to live for."
B. "Are you thinking about hurting yourself?"
C. "Let's talk about something more pleasant."
D. "That's just the medication talking."
, Correct: B
Rationale: Directly assessing suicidal ideation is the priority when a client expresses
hopelessness. It does not "plant" the idea. The other options minimize or avoid the concern.
4. Which of the following are components of a therapeutic nurse-client relationship? SATA
A. Genuineness
B. Empathy
C. Sympathy
D. Positive regard
E. Self-disclosure of intimate details
Correct: A, B, D
Rationale: Genuineness, empathy, and positive regard are core therapeutic conditions.
Sympathy (C) implies pity and blurs boundaries; intimate self-disclosure (E) is nontherapeutic.
5. During the orientation phase of the nurse-client relationship, the nurse should primarily:
A. Evaluate goal attainment
B. Establish trust and formulate a contract
C. Terminate the relationship
D. Explore the client's childhood in depth
Correct: B
Rationale: The orientation phase establishes trust, rapport, and the therapeutic contract.
Evaluation (A) occurs in the working/termination phases; termination (C) is the final phase;
deep childhood exploration (D) occurs only as appropriate in the working phase.
6. A client diagnosed with borderline personality disorder tells the nurse, "You're the only one
who understands me." This is an example of:
A. Transference
B. Countertransference
C. Splitting
D. Projection
Correct: C
Rationale: Splitting is viewing people as all good or all bad, often idealizing one staff
member while devaluing others. Transference (A) is the client's projection of feelings onto the
,nurse; countertransference (B) is the nurse's reaction to the client; projection (D) is attributing
one's own feelings to others.
7. Which nursing action demonstrates the ethical principle of beneficence?
A. Reporting suspected abuse
B. Administering pain medication as ordered to relieve suffering
C. Keeping a client's information confidential
D. Respecting a client's refusal of treatment
Correct: B
Rationale: Beneficence is doing good and promoting the client's well-being. Reporting
abuse (A) reflects nonmaleficence/legal duty; confidentiality (C) reflects fidelity; respecting
refusal (D) reflects autonomy.
8. A nurse is teaching a client about the Health Insurance Portability and Accountability Act
(HIPAA). Which statement indicates understanding?
A. "My family can access my records anytime."
B. "My information can be shared with anyone who asks."
C. "My protected health information will be kept confidential."
D. "I cannot see my own medical record."
Correct: C
Rationale: HIPAA protects the privacy and confidentiality of health information. Clients
generally have the right to access their own records (D is false); disclosure requires
authorization (A, B are false).
9. Which is an example of a nontherapeutic communication technique?
A. Offering self
B. Giving false reassurance
C. Using silence
D. Restating
Correct: B
Rationale: False reassurance ("It'll be okay") minimizes feelings and blocks further
expression. Offering self, silence, and restating are therapeutic.
, 10. A client is admitted involuntarily. The nurse understands that involuntary commitment
requires:
A. The client's written consent
B. A court order or legal hold based on danger to self or others
C. Family permission only
D. The client's ability to pay
Correct: B
Rationale: Involuntary commitment requires legal justification—typically danger to
self/others or grave disability—and is authorized by a court or statutorily defined hold. Consent
(A), family permission (C), and finances (D) are not the basis.
11. The nurse is assessing a client's mental status. Which finding suggests impaired reality
testing?
A. Client states, "I feel sad today."
B. Client states, "The voices tell me to hurt myself."
C. Client states, "I'm worried about my job."
D. Client states, "I have trouble sleeping."
Correct: B
Rationale: Command hallucinations indicate impaired reality testing and are a safety
priority. Sadness, worry, and insomnia are mood/sleep findings, not reality-testing deficits.
12. Which defense mechanism is the client using when they blame the nurse for their own
angry feelings?
A. Denial
B. Projection
C. Regression
D. Sublimation
Correct: B
Rationale: Projection is attributing one's own unacceptable feelings to another. Denial (A)
refuses reality; regression (C) reverts to earlier behavior; sublimation (D) channels impulses
constructively.
Versions)(New, 2023)(Verified)
Section 1: Foundations of Psychiatric Nursing & Therapeutic Communication (Q1–15)
1. A nurse is caring for a client admitted to the inpatient psychiatric unit. Which action best
demonstrates the ethical principle of autonomy?
A. Restraining the client when agitated
B. Allowing the client to refuse a prescribed antipsychotic after being informed of consequences
C. Withholding information about side effects to prevent refusal
D. Making treatment decisions on the client's behalf
Correct: B
Rationale: Autonomy respects the client's right to make informed decisions about care,
including refusal. Restraints (A) limit autonomy; withholding information (C) violates informed
consent; making decisions for the client (D) is paternalism.
2. Which statement by the nurse demonstrates the therapeutic communication technique of
reflection?
A. "You seem to be saying that you feel hopeless about your future."
B. "Why did you stop taking your medication?"
C. "Everything will be fine, don't worry."
D. "I think you should attend group therapy."
Correct: A
Rationale: Reflection mirrors the client's feelings/content back to promote insight. "Why"
questions (B) can be defensive; false reassurance (C) blocks communication; advice-giving (D) is
nontherapeutic.
3. A client says, "I can't go on anymore." Which is the nurse's priority response?
A. "You have so much to live for."
B. "Are you thinking about hurting yourself?"
C. "Let's talk about something more pleasant."
D. "That's just the medication talking."
, Correct: B
Rationale: Directly assessing suicidal ideation is the priority when a client expresses
hopelessness. It does not "plant" the idea. The other options minimize or avoid the concern.
4. Which of the following are components of a therapeutic nurse-client relationship? SATA
A. Genuineness
B. Empathy
C. Sympathy
D. Positive regard
E. Self-disclosure of intimate details
Correct: A, B, D
Rationale: Genuineness, empathy, and positive regard are core therapeutic conditions.
Sympathy (C) implies pity and blurs boundaries; intimate self-disclosure (E) is nontherapeutic.
5. During the orientation phase of the nurse-client relationship, the nurse should primarily:
A. Evaluate goal attainment
B. Establish trust and formulate a contract
C. Terminate the relationship
D. Explore the client's childhood in depth
Correct: B
Rationale: The orientation phase establishes trust, rapport, and the therapeutic contract.
Evaluation (A) occurs in the working/termination phases; termination (C) is the final phase;
deep childhood exploration (D) occurs only as appropriate in the working phase.
6. A client diagnosed with borderline personality disorder tells the nurse, "You're the only one
who understands me." This is an example of:
A. Transference
B. Countertransference
C. Splitting
D. Projection
Correct: C
Rationale: Splitting is viewing people as all good or all bad, often idealizing one staff
member while devaluing others. Transference (A) is the client's projection of feelings onto the
,nurse; countertransference (B) is the nurse's reaction to the client; projection (D) is attributing
one's own feelings to others.
7. Which nursing action demonstrates the ethical principle of beneficence?
A. Reporting suspected abuse
B. Administering pain medication as ordered to relieve suffering
C. Keeping a client's information confidential
D. Respecting a client's refusal of treatment
Correct: B
Rationale: Beneficence is doing good and promoting the client's well-being. Reporting
abuse (A) reflects nonmaleficence/legal duty; confidentiality (C) reflects fidelity; respecting
refusal (D) reflects autonomy.
8. A nurse is teaching a client about the Health Insurance Portability and Accountability Act
(HIPAA). Which statement indicates understanding?
A. "My family can access my records anytime."
B. "My information can be shared with anyone who asks."
C. "My protected health information will be kept confidential."
D. "I cannot see my own medical record."
Correct: C
Rationale: HIPAA protects the privacy and confidentiality of health information. Clients
generally have the right to access their own records (D is false); disclosure requires
authorization (A, B are false).
9. Which is an example of a nontherapeutic communication technique?
A. Offering self
B. Giving false reassurance
C. Using silence
D. Restating
Correct: B
Rationale: False reassurance ("It'll be okay") minimizes feelings and blocks further
expression. Offering self, silence, and restating are therapeutic.
, 10. A client is admitted involuntarily. The nurse understands that involuntary commitment
requires:
A. The client's written consent
B. A court order or legal hold based on danger to self or others
C. Family permission only
D. The client's ability to pay
Correct: B
Rationale: Involuntary commitment requires legal justification—typically danger to
self/others or grave disability—and is authorized by a court or statutorily defined hold. Consent
(A), family permission (C), and finances (D) are not the basis.
11. The nurse is assessing a client's mental status. Which finding suggests impaired reality
testing?
A. Client states, "I feel sad today."
B. Client states, "The voices tell me to hurt myself."
C. Client states, "I'm worried about my job."
D. Client states, "I have trouble sleeping."
Correct: B
Rationale: Command hallucinations indicate impaired reality testing and are a safety
priority. Sadness, worry, and insomnia are mood/sleep findings, not reality-testing deficits.
12. Which defense mechanism is the client using when they blame the nurse for their own
angry feelings?
A. Denial
B. Projection
C. Regression
D. Sublimation
Correct: B
Rationale: Projection is attributing one's own unacceptable feelings to another. Denial (A)
refuses reality; regression (C) reverts to earlier behavior; sublimation (D) channels impulses
constructively.
