ATI MENTAL HEALTH PROCTORED EXAM
(3 VERSIONS= A, B, C) (ANSWERS, A))
(NEW-2021)
Section 1: Foundations & Therapeutic Communication (Q1–Q15)
1. A nurse is caring for a client who was admitted with acute mania. Which of the following is
the priority nursing action?
A. Encourage the client to attend group therapy
B. Provide a safe, low-stimulation environment
C. Teach the client about lithium toxicity
D. Offer the client a menu to select meals
Safety is the priority. A low-stimulation environment reduces manic escalation and protects
the client from injury. Teaching and group therapy are not appropriate during acute mania.
Menu selection is not a priority over safety.
2. A client with a history of violence tells the nurse, "I'm going to hurt you if you don't let me
leave." Which of the following responses by the nurse is most appropriate?
A. "You're just upset right now; let's talk about it."
B. "If you threaten me again, I will have you restrained."
C. "I can see you're angry. I will not let you hurt me or anyone else."
D. "You know you don't mean that."
This response is honest, sets a clear limit, and acknowledges feelings without threatening or
dismissing the client. Restraint threats escalate; minimizing statements invalidate the client.
3. Which of the following statements by the nurse demonstrates the therapeutic
communication technique of reflection?
A. "Tell me more about that."
B. "You feel angry because your family didn't visit."
,C. "I noticed you're pacing and clenching your fists."
D. "Let's talk about something more pleasant."
Reflection restates the client's feelings/thoughts back to them. "Tell me more" is an open-
ended question; noticing behavior is making an observation; changing topics is nontherapeutic.
4. A nurse is conducting an admission interview. Which of the following is the most important
action to establish trust?
A. Complete the physical assessment first
B. Introduce yourself and explain your role and the purpose of the interview
C. Ask the client to sign the admission paperwork immediately
D. Tell the client you have read their entire chart
Orientation—name, role, and purpose—establishes trust and reduces anxiety. Paperwork
and assessments can follow.
5. A client says, "I don't want to take my medication. Everyone here is trying to poison me."
Which response uses the therapeutic technique of presenting reality?
A. "Nobody here wants to poison you."
B. "I am a nurse, and I do not poison people. I am here to give you medication prescribed by
your doctor."
C. "Why would you think that?"
D. "You'll feel better if you just take it."
Presenting reality gently clarifies the nurse's role and corrects the misperception without
arguing. "Why" questions are nontherapeutic, and reassurance dismisses the delusion.
6. Which of the following are appropriate nursing interventions for a client experiencing a
panic attack? (Select all that apply.)
A. Stay with the client and remain calm
B. Encourage deep, slow breathing
C. Take the client to a quiet, low-stimulation area
D. Ask the client to describe the panic in detail
E. Teach the client about panic disorder during the attack
, During a panic attack, the nurse stays calm, stays with the client, reduces stimuli, and guides
breathing. Detailed discussion and teaching are delayed until the client is calm.
7. A nurse is assessing a client's mental status. Which of the following should the nurse assess
first?
A. Judgment
B. Level of consciousness and orientation
C. Abstract reasoning
D. Memory
LOC and orientation are the most basic and are assessed first; they frame the rest of the
exam.
8. A client tells the nurse, "I feel like a failure. I can't do anything right." Which response is
most therapeutic?
A. "You shouldn't feel that way."
B. "You're a success in many ways."
C. "You feel like a failure right now."
D. "Let's focus on your strengths."
Reflection acknowledges the client's feeling without judgment or false reassurance,
encouraging further expression.
9. A nurse is teaching a client about the use of a token economy on an inpatient unit. Which
statement indicates understanding?
A. "I get tokens for attending groups, and I can trade them for privileges."
B. "Tokens are given to me when I behave badly."
C. "I get tokens only when I'm discharged."
D. "Tokens are a form of punishment."
A token economy reinforces desired behaviors with tokens exchangeable for privileges—a
behavioral therapy technique.
, 10. Which of the following behaviors indicates that a client is ready for discharge from an
inpatient psychiatric unit?
A. The client denies all problems
B. The client identifies triggers and coping strategies
C. The client refuses to attend groups
D. The client blames family for all problems
Recognizing triggers and using coping strategies demonstrates insight and readiness for
discharge. Denial and blame indicate limited insight.
11. A nurse is caring for a client who is nonverbal and withdrawn. Which of the following is
the most appropriate intervention?
A. Ask the client to join a group
B. Sit quietly with the client and offer brief, supportive statements
C. Tell the client to talk when ready
D. Leave the client alone to process feelings
Sitting quietly conveys acceptance and reduces isolation without pressure. Group therapy
may be too stimulating initially.
12. Which of the following are components of a mental status examination? (Select all that
apply.)
A. Appearance and behavior
B. Mood and affect
C. Thought content and process
D. Cognitive function
E. Serum electrolyte levels
MSE includes appearance, behavior, mood/affect, thought content/process, cognition,
insight, and judgment. Labs are not part of the MSE.
13. A nurse is documenting a client's affect. Which term best describes a client who is
laughing while discussing the death of a parent?
(3 VERSIONS= A, B, C) (ANSWERS, A))
(NEW-2021)
Section 1: Foundations & Therapeutic Communication (Q1–Q15)
1. A nurse is caring for a client who was admitted with acute mania. Which of the following is
the priority nursing action?
A. Encourage the client to attend group therapy
B. Provide a safe, low-stimulation environment
C. Teach the client about lithium toxicity
D. Offer the client a menu to select meals
Safety is the priority. A low-stimulation environment reduces manic escalation and protects
the client from injury. Teaching and group therapy are not appropriate during acute mania.
Menu selection is not a priority over safety.
2. A client with a history of violence tells the nurse, "I'm going to hurt you if you don't let me
leave." Which of the following responses by the nurse is most appropriate?
A. "You're just upset right now; let's talk about it."
B. "If you threaten me again, I will have you restrained."
C. "I can see you're angry. I will not let you hurt me or anyone else."
D. "You know you don't mean that."
This response is honest, sets a clear limit, and acknowledges feelings without threatening or
dismissing the client. Restraint threats escalate; minimizing statements invalidate the client.
3. Which of the following statements by the nurse demonstrates the therapeutic
communication technique of reflection?
A. "Tell me more about that."
B. "You feel angry because your family didn't visit."
,C. "I noticed you're pacing and clenching your fists."
D. "Let's talk about something more pleasant."
Reflection restates the client's feelings/thoughts back to them. "Tell me more" is an open-
ended question; noticing behavior is making an observation; changing topics is nontherapeutic.
4. A nurse is conducting an admission interview. Which of the following is the most important
action to establish trust?
A. Complete the physical assessment first
B. Introduce yourself and explain your role and the purpose of the interview
C. Ask the client to sign the admission paperwork immediately
D. Tell the client you have read their entire chart
Orientation—name, role, and purpose—establishes trust and reduces anxiety. Paperwork
and assessments can follow.
5. A client says, "I don't want to take my medication. Everyone here is trying to poison me."
Which response uses the therapeutic technique of presenting reality?
A. "Nobody here wants to poison you."
B. "I am a nurse, and I do not poison people. I am here to give you medication prescribed by
your doctor."
C. "Why would you think that?"
D. "You'll feel better if you just take it."
Presenting reality gently clarifies the nurse's role and corrects the misperception without
arguing. "Why" questions are nontherapeutic, and reassurance dismisses the delusion.
6. Which of the following are appropriate nursing interventions for a client experiencing a
panic attack? (Select all that apply.)
A. Stay with the client and remain calm
B. Encourage deep, slow breathing
C. Take the client to a quiet, low-stimulation area
D. Ask the client to describe the panic in detail
E. Teach the client about panic disorder during the attack
, During a panic attack, the nurse stays calm, stays with the client, reduces stimuli, and guides
breathing. Detailed discussion and teaching are delayed until the client is calm.
7. A nurse is assessing a client's mental status. Which of the following should the nurse assess
first?
A. Judgment
B. Level of consciousness and orientation
C. Abstract reasoning
D. Memory
LOC and orientation are the most basic and are assessed first; they frame the rest of the
exam.
8. A client tells the nurse, "I feel like a failure. I can't do anything right." Which response is
most therapeutic?
A. "You shouldn't feel that way."
B. "You're a success in many ways."
C. "You feel like a failure right now."
D. "Let's focus on your strengths."
Reflection acknowledges the client's feeling without judgment or false reassurance,
encouraging further expression.
9. A nurse is teaching a client about the use of a token economy on an inpatient unit. Which
statement indicates understanding?
A. "I get tokens for attending groups, and I can trade them for privileges."
B. "Tokens are given to me when I behave badly."
C. "I get tokens only when I'm discharged."
D. "Tokens are a form of punishment."
A token economy reinforces desired behaviors with tokens exchangeable for privileges—a
behavioral therapy technique.
, 10. Which of the following behaviors indicates that a client is ready for discharge from an
inpatient psychiatric unit?
A. The client denies all problems
B. The client identifies triggers and coping strategies
C. The client refuses to attend groups
D. The client blames family for all problems
Recognizing triggers and using coping strategies demonstrates insight and readiness for
discharge. Denial and blame indicate limited insight.
11. A nurse is caring for a client who is nonverbal and withdrawn. Which of the following is
the most appropriate intervention?
A. Ask the client to join a group
B. Sit quietly with the client and offer brief, supportive statements
C. Tell the client to talk when ready
D. Leave the client alone to process feelings
Sitting quietly conveys acceptance and reduces isolation without pressure. Group therapy
may be too stimulating initially.
12. Which of the following are components of a mental status examination? (Select all that
apply.)
A. Appearance and behavior
B. Mood and affect
C. Thought content and process
D. Cognitive function
E. Serum electrolyte levels
MSE includes appearance, behavior, mood/affect, thought content/process, cognition,
insight, and judgment. Labs are not part of the MSE.
13. A nurse is documenting a client's affect. Which term best describes a client who is
laughing while discussing the death of a parent?
