ATI Mental Health A EXAM
LATEST UPDATE 2023
1. A nurse is caring for a client who says, "I don't know why I'm even here. Nothing helps."
Which response demonstrates the therapeutic technique of reflection?
A. "You feel that nothing has helped you."
B. "You're feeling hopeless about your treatment."
C. "Things will get better if you just keep trying."
D. "Why do you think you feel that way?"
Rationale: Reflection restates the client's feeling to encourage further expression. Option B
reflects the underlying emotion (hopelessness). Option A is closer to restating content. Option C
is false reassurance. Option D is probing "why" and can feel confrontational.
2. A nurse is establishing a therapeutic relationship. Which action should occur during the
orientation phase?
A. Reviewing coping strategies the client has used
B. Evaluating whether goals were met
C. Establishing trust and clarifying the contract
D. Terminating the relationship
Rationale: The orientation phase involves establishing trust, defining roles, and setting
goals. Working phase = interventions; termination phase = evaluation and closure.
3. A client with anxiety is pacing and wringing their hands. Which statement by the nurse is
most appropriate?
A. "Calm down. You're safe here."
B. "You seem anxious. Let's practice slow breathing together."
C. "Why are you so nervous?"
D. "I'll leave you alone until you feel better."
, Rationale: Recognizing the feeling and offering a concrete coping intervention is
therapeutic. "Calm down" minimizes feelings. "Why" questions increase anxiety. Leaving a
highly anxious client alone is unsafe.
4. Which of the following are barriers to therapeutic communication? (SATA)
A. Giving advice
B. False reassurance
C. Using silence
D. Changing the subject
E. Restating the client's message
Rationale: Advice, false reassurance, and changing the subject are non-therapeutic. Silence
and restating are therapeutic techniques.
5. A nurse is assessing a client who reports insomnia, irritability, and difficulty concentrating.
Which question should the nurse ask first?
A. "Do you drink caffeine?"
B. "What medications do you take?"
C. "Have you had thoughts of harming yourself?"
D. "How many hours do you sleep?"
Rationale: Safety first. Symptoms may indicate depression or anxiety; assessing suicidal
ideation takes priority.
6. A nurse uses the technique of "offering self" when stating:
A. "I'll get your medication now."
B. "I'll sit with you for a while."
C. "Tell me what you did yesterday."
D. "You should attend group therapy."
Rationale: Offering self means making oneself available without expectations—"I'll sit with
you" demonstrates presence.
,7. A client states, "My family would be better off without me." What is the nurse's priority
action?
A. Reassure the client the family loves them
B. Document the statement and continue the assessment
C. Ask directly about suicidal thoughts and intent
D. Notify the family immediately
Rationale: This is a warning sign for suicide. Direct, nonjudgmental questioning about intent
is the priority and does not increase risk.
8. Which nursing action demonstrates the ethical principle of veracity?
A. Keeping a client's information private
B. Providing care regardless of the client's ability to pay
C. Telling the client the truth about their diagnosis
D. Allowing the client to make their own decisions
Rationale: Veracity = truthfulness. A = confidentiality; B = justice; D = autonomy.
9. A nurse is teaching a client about a new prescription. Which action best demonstrates the
principle of autonomy?
A. The nurse decides when the client takes the medication
B. The client chooses to refuse the medication after education
C. The nurse withholds information to reduce anxiety
D. The provider makes the decision for the client
Rationale: Autonomy respects the client's right to make informed choices, including refusal.
10. A client tells the nurse, "I feel like a failure." Which is the most therapeutic response?
A. "You're not a failure."
B. "Tell me more about what makes you feel that way."
C. "Everyone feels that way sometimes."
D. "You should focus on your successes."
, Rationale: Exploring the feeling encourages expression. The other options minimize or
dismiss the client's experience.
11. A nurse is documenting in the client's chart. Which statement is appropriate?
A. "Client is manipulative and annoying."
B. "Client refused lunch and stated, 'I'm not hungry.'"
C. "Client seems like a difficult patient."
D. "Client is crazy today."
Rationale: Documentation should be objective, specific, and nonjudgmental.
12. Which of the following are components of a therapeutic milieu? (SATA)
A. Safety
B. Structured routines
C. Client involvement in care
D. Punitive consequences for rule-breaking
E. Respect for dignity
Rationale: A therapeutic milieu promotes safety, structure, respect, and client participation.
Punishment is not therapeutic.
13. A nurse is caring for a client who is grieving. Which statement is most appropriate?
A. "At least they lived a long life."
B. "You should be grateful for the time you had."
C. "I'm here if you'd like to talk."
D. "It's been a month; you should be feeling better."
Rationale: Offering presence and availability is therapeutic. The others minimize grief or
impose timelines.
14. A nurse is assessing a client's judgment. Which question is best?
A. "What day is it today?"
B. "Can you repeat these three words?"
LATEST UPDATE 2023
1. A nurse is caring for a client who says, "I don't know why I'm even here. Nothing helps."
Which response demonstrates the therapeutic technique of reflection?
A. "You feel that nothing has helped you."
B. "You're feeling hopeless about your treatment."
C. "Things will get better if you just keep trying."
D. "Why do you think you feel that way?"
Rationale: Reflection restates the client's feeling to encourage further expression. Option B
reflects the underlying emotion (hopelessness). Option A is closer to restating content. Option C
is false reassurance. Option D is probing "why" and can feel confrontational.
2. A nurse is establishing a therapeutic relationship. Which action should occur during the
orientation phase?
A. Reviewing coping strategies the client has used
B. Evaluating whether goals were met
C. Establishing trust and clarifying the contract
D. Terminating the relationship
Rationale: The orientation phase involves establishing trust, defining roles, and setting
goals. Working phase = interventions; termination phase = evaluation and closure.
3. A client with anxiety is pacing and wringing their hands. Which statement by the nurse is
most appropriate?
A. "Calm down. You're safe here."
B. "You seem anxious. Let's practice slow breathing together."
C. "Why are you so nervous?"
D. "I'll leave you alone until you feel better."
, Rationale: Recognizing the feeling and offering a concrete coping intervention is
therapeutic. "Calm down" minimizes feelings. "Why" questions increase anxiety. Leaving a
highly anxious client alone is unsafe.
4. Which of the following are barriers to therapeutic communication? (SATA)
A. Giving advice
B. False reassurance
C. Using silence
D. Changing the subject
E. Restating the client's message
Rationale: Advice, false reassurance, and changing the subject are non-therapeutic. Silence
and restating are therapeutic techniques.
5. A nurse is assessing a client who reports insomnia, irritability, and difficulty concentrating.
Which question should the nurse ask first?
A. "Do you drink caffeine?"
B. "What medications do you take?"
C. "Have you had thoughts of harming yourself?"
D. "How many hours do you sleep?"
Rationale: Safety first. Symptoms may indicate depression or anxiety; assessing suicidal
ideation takes priority.
6. A nurse uses the technique of "offering self" when stating:
A. "I'll get your medication now."
B. "I'll sit with you for a while."
C. "Tell me what you did yesterday."
D. "You should attend group therapy."
Rationale: Offering self means making oneself available without expectations—"I'll sit with
you" demonstrates presence.
,7. A client states, "My family would be better off without me." What is the nurse's priority
action?
A. Reassure the client the family loves them
B. Document the statement and continue the assessment
C. Ask directly about suicidal thoughts and intent
D. Notify the family immediately
Rationale: This is a warning sign for suicide. Direct, nonjudgmental questioning about intent
is the priority and does not increase risk.
8. Which nursing action demonstrates the ethical principle of veracity?
A. Keeping a client's information private
B. Providing care regardless of the client's ability to pay
C. Telling the client the truth about their diagnosis
D. Allowing the client to make their own decisions
Rationale: Veracity = truthfulness. A = confidentiality; B = justice; D = autonomy.
9. A nurse is teaching a client about a new prescription. Which action best demonstrates the
principle of autonomy?
A. The nurse decides when the client takes the medication
B. The client chooses to refuse the medication after education
C. The nurse withholds information to reduce anxiety
D. The provider makes the decision for the client
Rationale: Autonomy respects the client's right to make informed choices, including refusal.
10. A client tells the nurse, "I feel like a failure." Which is the most therapeutic response?
A. "You're not a failure."
B. "Tell me more about what makes you feel that way."
C. "Everyone feels that way sometimes."
D. "You should focus on your successes."
, Rationale: Exploring the feeling encourages expression. The other options minimize or
dismiss the client's experience.
11. A nurse is documenting in the client's chart. Which statement is appropriate?
A. "Client is manipulative and annoying."
B. "Client refused lunch and stated, 'I'm not hungry.'"
C. "Client seems like a difficult patient."
D. "Client is crazy today."
Rationale: Documentation should be objective, specific, and nonjudgmental.
12. Which of the following are components of a therapeutic milieu? (SATA)
A. Safety
B. Structured routines
C. Client involvement in care
D. Punitive consequences for rule-breaking
E. Respect for dignity
Rationale: A therapeutic milieu promotes safety, structure, respect, and client participation.
Punishment is not therapeutic.
13. A nurse is caring for a client who is grieving. Which statement is most appropriate?
A. "At least they lived a long life."
B. "You should be grateful for the time you had."
C. "I'm here if you'd like to talk."
D. "It's been a month; you should be feeling better."
Rationale: Offering presence and availability is therapeutic. The others minimize grief or
impose timelines.
14. A nurse is assessing a client's judgment. Which question is best?
A. "What day is it today?"
B. "Can you repeat these three words?"
