ATI Mental Health Proctored Exam (31 Latest Versions, 2022) /
Mental Health ATI Proctored Exam / ATI Proctored Mental
Health Exam |Real + Practice Exam, Q and A
Section 1: Foundations of Psychiatric-Mental Health Nursing (Q1–12)
1. A nurse is assessing a client who states, "I hear voices telling me I'm worthless." Which
symptom is the nurse documenting?
A. Delusion
B. Hallucination
C. Illusion
D. Flight of ideas
Correct answer: B
Rationale: A hallucination is a false sensory perception without an external stimulus (most
commonly auditory). A delusion (A) is a fixed false belief. An illusion (C) is a misperception of a
real external stimulus. Flight of ideas (D) is rapid, fragmented speech seen in mania.
2. Which nursing action best demonstrates the ethical principle of autonomy?
A. Administering a PRN antipsychotic to an agitated client
B. Respecting a competent client's refusal of group therapy
C. Reporting suspected child abuse to authorities
D. Providing the least restrictive environment for a client
Correct answer: B
Rationale: Autonomy is the client's right to make their own decisions. A competent client
may refuse treatment. (A) relates to beneficence/emergency treatment; (C) is mandated duty
(beneficence/legal duty); (D) reflects the ethical/legal concept of least restrictive alternative.
3. SATA — A nurse is preparing to admit a client to an inpatient psychiatric unit. Which client
rights must the nurse protect? Select all that apply.
A. Right to refuse medication
B. Right to wear personal clothing
C. Right to unlimited phone use at any time
D. Right to habeas corpus
,E. Right to informed consent
F. Right to send and receive mail unopened
Correct answers: A, B, D, E, F
Rationale: Clients retain the right to refuse treatment, wear personal items, seek release
(habeas corpus), give informed consent, and have unopened mail. Phone/visitation privileges
(C) may be restricted for safety or milieu reasons and are not absolute rights.
4. A client diagnosed with major depressive disorder says, "I'm a burden to everyone." Which is
the priority nursing concern?
A. Impaired social interaction
B. Risk for suicide
C. Chronic low self-esteem
D. Ineffective coping
Correct answer: B
Rationale: Statements of worthlessness and being a burden are red flags for suicidal
ideation. Safety is always the priority. The other diagnoses are relevant but not immediately life-
threatening.
5. The nurse is teaching a client about the therapeutic milieu. Which statement by the client
indicates understanding?
A. "The milieu is where I go for my individual therapy sessions."
B. "The milieu is the structured, safe environment that promotes healing."
C. "The milieu is the medication protocol I must follow."
D. "The milieu is the team that decides my discharge plan."
Correct answer: B
Rationale: Milieu therapy is a structured, safe, supportive environment that uses the total
environment and peer interactions as therapeutic tools.
6. Which action by a nurse demonstrates beneficence?
A. Telling the truth about a medication's side effects
B. Acting in the client's best interest to promote good
C. Allowing the client to make an informed choice
D. Treating all clients fairly regardless of diagnosis
, Correct answer: B
Rationale: Beneficence is the duty to promote good and act in the client's best interest. (A)
is veracity; (C) is autonomy; (D) is justice.
7. SATA — Which findings indicate a client is experiencing neuroleptic malignant syndrome
(NMS)? Select all that apply.
A. Temperature 103.2°F (39.6°C)
B. Muscle rigidity
C. Bradycardia
D. Diaphoresis
E. Blood pressure 168/94 mm Hg
F. Decreased level of consciousness
Correct answers: A, B, D, E, F
Rationale: NMS is a life-threatening reaction to antipsychotics: high fever, severe muscle
rigidity ("lead-pipe"), autonomic instability (tachycardia—not bradycardia—and hypertension,
diaphoresis), and altered mental status. Bradycardia (C) is incorrect; tachycardia is expected.
8. A nurse is caring for a client on haloperidol who reports a stiff neck and difficulty swallowing.
Which is the priority action?
A. Document and reassess in 1 hour
B. Administer the prescribed benztropine
C. Encourage the client to relax
D. Hold the next dose of haloperidol only
Correct answer: B
Rationale: Stiff neck and difficulty swallowing suggest acute dystonia, an extrapyramidal
symptom treated with an anticholinergic such as benztropine or diphenhydramine. It is a
medical urgency (airway risk). Documentation alone (A) delays treatment.
9. Which statement about tardive dyskinesia (TD) is accurate?
A. It appears within hours of the first antipsychotic dose.
B. It is reversible with immediate discontinuation of the antipsychotic.
C. It involves involuntary movements of the tongue, face, and extremities.
D. It is treated with benztropine.
, Correct answer: C
Rationale: TD is a late-onset (months to years) EPS with involuntary choreoathetoid
movements (tongue, lips, face, extremities). It may be irreversible. Anticholinergics do not treat
TD and may worsen it.
10. SATA — A nurse is performing a mental status examination. Which components are
included? Select all that apply.
A. Appearance and behavior
B. Mood and affect
C. Serum lithium level
D. Thought content and process
E. Cognition and orientation
F. Insight and judgment
Correct answers: A, B, D, E, F
Rationale: The MSE assesses appearance, behavior, mood/affect, thought content/process,
cognition, orientation, insight, and judgment. Lithium level (C) is a laboratory value, not part of
the MSE.
11. A client is admitted with a diagnosis of "rule out" psychiatric disorder. What is the nurse's
initial priority?
A. Begin psychoeducation
B. Establish trust and safety
C. Start the discharge plan
D. Administer PRN medications
Correct answer: B
Rationale: During the orientation/assessment phase of the nurse-client relationship, the
priority is establishing trust, rapport, and safety before education or discharge planning.
12. A nurse observes a client pacing, wringing hands, and reporting feeling "on edge." Which
nursing diagnosis is most appropriate?
A. Anxiety
B. Powerlessness
Mental Health ATI Proctored Exam / ATI Proctored Mental
Health Exam |Real + Practice Exam, Q and A
Section 1: Foundations of Psychiatric-Mental Health Nursing (Q1–12)
1. A nurse is assessing a client who states, "I hear voices telling me I'm worthless." Which
symptom is the nurse documenting?
A. Delusion
B. Hallucination
C. Illusion
D. Flight of ideas
Correct answer: B
Rationale: A hallucination is a false sensory perception without an external stimulus (most
commonly auditory). A delusion (A) is a fixed false belief. An illusion (C) is a misperception of a
real external stimulus. Flight of ideas (D) is rapid, fragmented speech seen in mania.
2. Which nursing action best demonstrates the ethical principle of autonomy?
A. Administering a PRN antipsychotic to an agitated client
B. Respecting a competent client's refusal of group therapy
C. Reporting suspected child abuse to authorities
D. Providing the least restrictive environment for a client
Correct answer: B
Rationale: Autonomy is the client's right to make their own decisions. A competent client
may refuse treatment. (A) relates to beneficence/emergency treatment; (C) is mandated duty
(beneficence/legal duty); (D) reflects the ethical/legal concept of least restrictive alternative.
3. SATA — A nurse is preparing to admit a client to an inpatient psychiatric unit. Which client
rights must the nurse protect? Select all that apply.
A. Right to refuse medication
B. Right to wear personal clothing
C. Right to unlimited phone use at any time
D. Right to habeas corpus
,E. Right to informed consent
F. Right to send and receive mail unopened
Correct answers: A, B, D, E, F
Rationale: Clients retain the right to refuse treatment, wear personal items, seek release
(habeas corpus), give informed consent, and have unopened mail. Phone/visitation privileges
(C) may be restricted for safety or milieu reasons and are not absolute rights.
4. A client diagnosed with major depressive disorder says, "I'm a burden to everyone." Which is
the priority nursing concern?
A. Impaired social interaction
B. Risk for suicide
C. Chronic low self-esteem
D. Ineffective coping
Correct answer: B
Rationale: Statements of worthlessness and being a burden are red flags for suicidal
ideation. Safety is always the priority. The other diagnoses are relevant but not immediately life-
threatening.
5. The nurse is teaching a client about the therapeutic milieu. Which statement by the client
indicates understanding?
A. "The milieu is where I go for my individual therapy sessions."
B. "The milieu is the structured, safe environment that promotes healing."
C. "The milieu is the medication protocol I must follow."
D. "The milieu is the team that decides my discharge plan."
Correct answer: B
Rationale: Milieu therapy is a structured, safe, supportive environment that uses the total
environment and peer interactions as therapeutic tools.
6. Which action by a nurse demonstrates beneficence?
A. Telling the truth about a medication's side effects
B. Acting in the client's best interest to promote good
C. Allowing the client to make an informed choice
D. Treating all clients fairly regardless of diagnosis
, Correct answer: B
Rationale: Beneficence is the duty to promote good and act in the client's best interest. (A)
is veracity; (C) is autonomy; (D) is justice.
7. SATA — Which findings indicate a client is experiencing neuroleptic malignant syndrome
(NMS)? Select all that apply.
A. Temperature 103.2°F (39.6°C)
B. Muscle rigidity
C. Bradycardia
D. Diaphoresis
E. Blood pressure 168/94 mm Hg
F. Decreased level of consciousness
Correct answers: A, B, D, E, F
Rationale: NMS is a life-threatening reaction to antipsychotics: high fever, severe muscle
rigidity ("lead-pipe"), autonomic instability (tachycardia—not bradycardia—and hypertension,
diaphoresis), and altered mental status. Bradycardia (C) is incorrect; tachycardia is expected.
8. A nurse is caring for a client on haloperidol who reports a stiff neck and difficulty swallowing.
Which is the priority action?
A. Document and reassess in 1 hour
B. Administer the prescribed benztropine
C. Encourage the client to relax
D. Hold the next dose of haloperidol only
Correct answer: B
Rationale: Stiff neck and difficulty swallowing suggest acute dystonia, an extrapyramidal
symptom treated with an anticholinergic such as benztropine or diphenhydramine. It is a
medical urgency (airway risk). Documentation alone (A) delays treatment.
9. Which statement about tardive dyskinesia (TD) is accurate?
A. It appears within hours of the first antipsychotic dose.
B. It is reversible with immediate discontinuation of the antipsychotic.
C. It involves involuntary movements of the tongue, face, and extremities.
D. It is treated with benztropine.
, Correct answer: C
Rationale: TD is a late-onset (months to years) EPS with involuntary choreoathetoid
movements (tongue, lips, face, extremities). It may be irreversible. Anticholinergics do not treat
TD and may worsen it.
10. SATA — A nurse is performing a mental status examination. Which components are
included? Select all that apply.
A. Appearance and behavior
B. Mood and affect
C. Serum lithium level
D. Thought content and process
E. Cognition and orientation
F. Insight and judgment
Correct answers: A, B, D, E, F
Rationale: The MSE assesses appearance, behavior, mood/affect, thought content/process,
cognition, orientation, insight, and judgment. Lithium level (C) is a laboratory value, not part of
the MSE.
11. A client is admitted with a diagnosis of "rule out" psychiatric disorder. What is the nurse's
initial priority?
A. Begin psychoeducation
B. Establish trust and safety
C. Start the discharge plan
D. Administer PRN medications
Correct answer: B
Rationale: During the orientation/assessment phase of the nurse-client relationship, the
priority is establishing trust, rapport, and safety before education or discharge planning.
12. A nurse observes a client pacing, wringing hands, and reporting feeling "on edge." Which
nursing diagnosis is most appropriate?
A. Anxiety
B. Powerlessness
