ATI RN Mental Health Exam 2025 NGN
Questions & Verified Answers | 100% Pass
Solution | Guaranteed A
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
Scenario (Case Study 1):
A 32-year-old female, Maria R., admitted to the acute
psychiatric unit after family brought her in for 5 days of
decreased need for sleep, pressured speech, grandiose plans to
start multiple businesses, and severe agitation. She is currently
diagnosed with Bipolar I disorder, manic episode. Past
psychiatric history: multiple previous manic hospitalizations.
Current meds at admission from outpatient clinic: Lithium 900
mg PO BID, Valproate 1000 mg PO/day, and Olanzapine 10 mg
PO HS (recently added). Family reports decreased oral intake,
,vomiting once yesterday, and ongoing diarrhea for 2 days.
Admission labs: Lithium level 1.6 mEq/L (drawn on admission),
Na+ 132 mEq/L, BUN 28 mg/dL, Creatinine 1.4 mg/dL, AST 45
U/L, ALT 60 U/L. Vital signs: T 37.6°C, HR 110, BP 140/86, RR 18,
O2 98% RA. Nurse notes coarse tremor, ataxic gait, and
confusion intermittently. Maria is pacing, attempts to unplug IV
infusion pump in hallway; she refuses meds.
Question 1 (NGN — Bow-Tie / Identify critical cues)
Prompt / Task: Drag the TWO most critical cues (left side) that
indicate immediate medication toxicity risk and the TWO best
nursing actions (right side) that should be taken first. (Bow-Tie:
choose two cues and two actions.)
Left — Select 2 cues:
A. Lithium level 1.6 mEq/L
B. HR 110 and BP 140/86
C. Diarrhea for 2 days and decreased oral intake
D. Olanzapine started recently
Right — Select 2 actions:
1. Hold lithium and notify the prescriber immediately
2. Offer PRN benzodiazepine for agitation and continue
lithium
3. Start IV normal saline bolus and assess kidney function
, 4. Encourage oral fluids and give antiemetic, continue current
plan
Correct Answer: Left: A and C. Right: 1 and 3.
Rationale:
• Why A & C are critical cues: A lithium level 1.6 mEq/L
exceeds the usual therapeutic range (commonly 0.6–1.2
mEq/L for maintenance; levels >1.5 can indicate toxicity)
and coexisting diarrhea and decreased oral intake suggest
volume depletion and increased lithium reabsorption →
higher toxicity risk. (Labs: Lithium level is a load-bearing
safety cue.)
• Why actions 1 & 3 are correct: The nurse must hold
lithium (safety/medication stop) and notify the prescriber
to prevent worsening toxicity. Starting IV normal saline
(volume resuscitation) and reassessing renal function helps
reduce lithium reabsorption and improves excretion.
• Why others are incorrect: Elevated HR/BP (B) may reflect
agitation but are not the immediate medication-toxicity
drivers. Olanzapine (D) may contribute to sedation or
metabolic effects but is not the immediate cause of lithium
toxicity. Offering benzodiazepine while continuing lithium
(2) risks worsening toxicity; encouraging oral fluids (4) is
insufficient given vomiting/diarrhea and possible need for
IV fluids.
, Teaching Tip: Monitor lithium levels, renal function, and fluid
status closely; with levels ≥1.5 and neurologic signs (coarse
tremor, ataxia, confusion), hold lithium and contact prescriber.
Bold: Lithium level.
Question 2 (NGN — Priority drag-and-drop: Immediate
Nursing Actions)
Prompt / Task: Rank these nursing actions in order of priority (1
= highest) for Maria right now.
Options:
A. Place Maria on seizure and fall precautions, pad bedrails.
B. Reassess mental status and neuro checks q15 min.
C. Administer scheduled olanzapine to control agitation.
D. Secure IV access and begin normal saline bolus.
Correct Answer (priority order): D (1), B (2), A (3), C (4).
Rationale:
• D (Start IV fluids) addresses volume depletion and aids
lithium excretion (highest priority for suspected toxicity
and elevated lithium).
• B (Frequent neuro checks) monitors for progression
(confusion present) and guides emergent care.
• A (Seizure/fall precautions) protects patient safety given
ataxia and neuro signs.
Questions & Verified Answers | 100% Pass
Solution | Guaranteed A
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
Scenario (Case Study 1):
A 32-year-old female, Maria R., admitted to the acute
psychiatric unit after family brought her in for 5 days of
decreased need for sleep, pressured speech, grandiose plans to
start multiple businesses, and severe agitation. She is currently
diagnosed with Bipolar I disorder, manic episode. Past
psychiatric history: multiple previous manic hospitalizations.
Current meds at admission from outpatient clinic: Lithium 900
mg PO BID, Valproate 1000 mg PO/day, and Olanzapine 10 mg
PO HS (recently added). Family reports decreased oral intake,
,vomiting once yesterday, and ongoing diarrhea for 2 days.
Admission labs: Lithium level 1.6 mEq/L (drawn on admission),
Na+ 132 mEq/L, BUN 28 mg/dL, Creatinine 1.4 mg/dL, AST 45
U/L, ALT 60 U/L. Vital signs: T 37.6°C, HR 110, BP 140/86, RR 18,
O2 98% RA. Nurse notes coarse tremor, ataxic gait, and
confusion intermittently. Maria is pacing, attempts to unplug IV
infusion pump in hallway; she refuses meds.
Question 1 (NGN — Bow-Tie / Identify critical cues)
Prompt / Task: Drag the TWO most critical cues (left side) that
indicate immediate medication toxicity risk and the TWO best
nursing actions (right side) that should be taken first. (Bow-Tie:
choose two cues and two actions.)
Left — Select 2 cues:
A. Lithium level 1.6 mEq/L
B. HR 110 and BP 140/86
C. Diarrhea for 2 days and decreased oral intake
D. Olanzapine started recently
Right — Select 2 actions:
1. Hold lithium and notify the prescriber immediately
2. Offer PRN benzodiazepine for agitation and continue
lithium
3. Start IV normal saline bolus and assess kidney function
, 4. Encourage oral fluids and give antiemetic, continue current
plan
Correct Answer: Left: A and C. Right: 1 and 3.
Rationale:
• Why A & C are critical cues: A lithium level 1.6 mEq/L
exceeds the usual therapeutic range (commonly 0.6–1.2
mEq/L for maintenance; levels >1.5 can indicate toxicity)
and coexisting diarrhea and decreased oral intake suggest
volume depletion and increased lithium reabsorption →
higher toxicity risk. (Labs: Lithium level is a load-bearing
safety cue.)
• Why actions 1 & 3 are correct: The nurse must hold
lithium (safety/medication stop) and notify the prescriber
to prevent worsening toxicity. Starting IV normal saline
(volume resuscitation) and reassessing renal function helps
reduce lithium reabsorption and improves excretion.
• Why others are incorrect: Elevated HR/BP (B) may reflect
agitation but are not the immediate medication-toxicity
drivers. Olanzapine (D) may contribute to sedation or
metabolic effects but is not the immediate cause of lithium
toxicity. Offering benzodiazepine while continuing lithium
(2) risks worsening toxicity; encouraging oral fluids (4) is
insufficient given vomiting/diarrhea and possible need for
IV fluids.
, Teaching Tip: Monitor lithium levels, renal function, and fluid
status closely; with levels ≥1.5 and neurologic signs (coarse
tremor, ataxia, confusion), hold lithium and contact prescriber.
Bold: Lithium level.
Question 2 (NGN — Priority drag-and-drop: Immediate
Nursing Actions)
Prompt / Task: Rank these nursing actions in order of priority (1
= highest) for Maria right now.
Options:
A. Place Maria on seizure and fall precautions, pad bedrails.
B. Reassess mental status and neuro checks q15 min.
C. Administer scheduled olanzapine to control agitation.
D. Secure IV access and begin normal saline bolus.
Correct Answer (priority order): D (1), B (2), A (3), C (4).
Rationale:
• D (Start IV fluids) addresses volume depletion and aids
lithium excretion (highest priority for suspected toxicity
and elevated lithium).
• B (Frequent neuro checks) monitors for progression
(confusion present) and guides emergent care.
• A (Seizure/fall precautions) protects patient safety given
ataxia and neuro signs.
