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Details of ATI RN Mental Health Exam 2025 NGN Questions &
Verified Answers | 100% Pass Solution | Guaranteed A
ATI RN Mental Health Exam 2025 NGN Test Bank
Batch 1 of 4 (50 Questions)
Questions 1–50
Case Study 1 (Questions 1–6) — 6 NGN-style items
Scenario:
You are the RN in an adult inpatient psychiatric unit. Mr. J., a 28-
year-old man with schizoaffective disorder, is admitted
following increased agitation and auditory hallucinations after
discontinuing risperidone 2 weeks ago because he reported
neck stiffness. He has been using nicotine and drinks alcohol
socially. Current meds: none in the electronic record. Vital signs
on admission: BP 138/86, HR 96, T 36.8°C, RR 16, SpO₂ 98% on
,room air. He is pacing, muttering to himself, and reports voices
commanding him to "hurt clinic staff." He clenches his jaw
occasionally and has a mild tremor in his hands. He says he
stopped risperidone due to "stiff neck." Staff report decreased
sleep over 4 days. He denies suicidal intent but looks suspicious.
Question 1 (NGN — Prioritization / Hypothesis and Action)
Stem / Cues: Based on Mr. J.'s presentation (auditory command
hallucinations, prior risperidone discontinuation, jaw clenching,
tremor, decreased sleep), which nursing hypothesis is highest
priority?
Options:
A. Mr. J. is experiencing antipsychotic withdrawal with
emergent psychosis — immediate de-escalation and med
reconciliation are required.
B. Mr. J. is developing neuroleptic malignant syndrome (NMS)
— obtain STAT CK and cooling measures.
C. Mr. J. has acute intoxication from nicotine causing agitation
— provide nicotine replacement.
D. Mr. J. has extrapyramidal symptoms (EPS) from risperidone
causing discomfort — treat with anticholinergic PRN.
Correct Answer: A
Rationale:
• A is highest priority: abrupt cessation of an antipsychotic
commonly precipitates relapse of psychotic symptoms.
, Command hallucinations to "hurt staff" indicate imminent
safety risk; nursing action should prioritize safety, de-
escalation, med reconciliation, and urgent coordination
with prescriber to restart or adjust antipsychotic therapy.
• B (NMS): hallmark features include high fever, severe
rigidity, autonomic instability — Mr. J. has mild tremor and
jaw clenching but normal temperature and stable vitals,
making NMS less likely.
• C (nicotine intoxication): nicotine withdrawal/intoxication
doesn't explain command hallucinations or psychosis.
• D (EPS): jaw clenching (akathisia or tardive dyskinesia)
could reflect EPS, but EPS alone does not explain command
hallucinations and acute decompensation; anticholinergic
treatment may help EPS symptoms but addressing
psychosis and safety is higher priority.
Teaching Tip: Always prioritize safety (client/others) and
medication reconciliation when psychosis follows abrupt
psychotropic discontinuation.
Question 2 (NGN — Action/Order & Rationale)
Stem / Cues: Which immediate nursing actions should you
take? (Select the single best set.)
Options:
A. Place Mr. J. in seclusion, give IM lorazepam PRN, and call
security.
, B. Implement one-to-one observation, begin de-escalation
(calm voice, offer water), obtain med reconciliation, and notify
the psychiatric provider.
C. Allow him to pace alone to reduce agitation, document
behavior, and reassess in 2 hours.
D. Administer oral benztropine for jaw clenching and schedule
daytime naps.
Correct Answer: B
Rationale:
• B is correct: one-to-one observation and noncoercive de-
escalation preserve safety and therapeutic relationship;
med reconciliation addresses the apparent withdrawal;
provider notification allows timely medication restart.
• A is overly restrictive initially; seclusion and chemical
restraint are last-resort interventions after less restrictive
measures fail and require policy/physician orders. Calling
security immediately escalates risk. IM lorazepam may
sedate but doesn't treat psychosis.
• C delays necessary interventions; pacing alone does not
mitigate command hallucination risk.
• D benztropine treats EPS but not acute psychosis or safety;
scheduling naps is not an immediate priority.
Question 3 (NGN — Medication Safety / Prioritization)