ATI Mental Health — Anxiety, Trauma & Stress Disorders
2026/2027 | ATI RN Mental Health Nursing Study Guide &
Practice Questions | Anxiety Disorders, Trauma- and
Stressor-Related Disorders, PTSD, Panic Disorder, Phobias,
OCD, Acute Stress Disorder, Crisis Intervention, Stress
Responses, Coping Mechanisms, Therapeutic
Communication, Mental Health Assessment, Safety &
Suicide Risk, Pharmacology, Nursing Interventions,
Prioritization, Clinical Judgment, NGN-Style Case Studies
& Detailed Rationales
Question 1: A nurse is assessing a client who has been experiencing
excessive worry about multiple life events for the past eight
months. The client reports muscle tension, irritability, and
difficulty concentrating. Which disorder is the nurse most likely
evaluating?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Obsessive-compulsive disorder
CORRECT ANSWER: B. Generalized anxiety disorder
Rationale: Generalized anxiety disorder (GAD) is characterized by
excessive, uncontrollable worry about multiple areas of life for at least six
months, accompanied by symptoms such as muscle tension, irritability, and
concentration difficulties. Panic disorder involves recurrent unexpected
panic attacks, social anxiety disorder centers on fear of social scrutiny, and
OCD involves obsessions and compulsions.
Question 2: A client suddenly experiences palpitations, sweating,
trembling, and a feeling of impending doom that peaks within 10
minutes. The nurse recognizes this as which type of attack?
A. Panic attack
B. Anxiety attack
C. Conversion reaction
D. Dissociative episode
CORRECT ANSWER: A. Panic attack
Rationale: A panic attack is an abrupt surge of intense fear or discomfort
that reaches a peak within minutes and includes symptoms such as
,palpitations, sweating, trembling, and fear of dying or losing control.
Anxiety attacks are not a recognized DSM-5 diagnosis, and conversion and
dissociative episodes involve neurological or identity disturbances rather
than acute fear peaks.
Question 3: A nurse is caring for a client diagnosed with panic
disorder. Which initial intervention should the nurse implement
during an acute panic attack?
A. Encourage the client to discuss childhood conflicts
B. Remain with the client and use a calm, reassuring approach
C. Administer a PRN antidepressant immediately
D. Leave the client alone to regain self-control
CORRECT ANSWER: B. Remain with the client and use a calm,
reassuring approach
Rationale: During an acute panic attack, the nurse should stay with the
client and provide calm, short, simple directions to promote safety and
reduce fear. Exploring childhood conflicts is inappropriate during acute
distress, antidepressants are not used PRN for acute panic, and leaving the
client alone increases feelings of abandonment and fear.
Question 4: A client with agoraphobia is most likely to exhibit
which behavior?
A. Fear of being in situations where escape might be difficult
B. Fear of gaining weight
C. Fear of contamination
D. Fear of public speaking only
CORRECT ANSWER: A. Fear of being in situations where escape
might be difficult
Rationale: Agoraphobia is marked by intense fear or anxiety about being in
places or situations where escape might be difficult or help unavailable,
such as crowds, bridges, or public transportation. Fear of weight gain
suggests anorexia nervosa, fear of contamination suggests OCD, and fear of
public speaking alone suggests social anxiety disorder.
Question 5: Which neurotransmitter is most commonly associated
with the pathophysiology of anxiety disorders?
,A. Dopamine
B. GABA
C. Acetylcholine
D. Histamine
CORRECT ANSWER: B. GABA
Rationale: Gamma-aminobutyric acid (GABA) is the primary inhibitory
neurotransmitter in the central nervous system and is strongly implicated in
anxiety disorders. Reduced GABA activity contributes to excessive
neuronal excitation and anxiety. Dopamine is linked to psychosis,
acetylcholine to memory and muscle function, and histamine to allergic and
arousal responses.
Question 6: A nurse is teaching a client about buspirone for
generalized anxiety disorder. Which statement by the client
indicates understanding?
A. “I should feel the full effect within 24 hours.”
B. “I can take this medication PRN during panic attacks.”
C. “It may take several weeks before I notice improvement.”
D. “This medication is a benzodiazepine.”
CORRECT ANSWER: C. “It may take several weeks before I notice
improvement.”
Rationale: Buspirone is a non-benzodiazepine anxiolytic that requires two
to four weeks or longer to achieve therapeutic effect. It is not used PRN for
acute panic, is not a benzodiazepine, and does not provide immediate relief.
Client teaching should emphasize delayed onset and consistent daily
dosing.
Question 7: A client is prescribed lorazepam for anxiety. Which
adverse effect should the nurse monitor for most closely?
A. Hypertension
B. Sedation and respiratory depression
C. Hyperglycemia
D. Tachycardia
CORRECT ANSWER: B. Sedation and respiratory depression
Rationale: Lorazepam is a benzodiazepine that enhances GABA activity,
producing sedation, dizziness, and potentially respiratory depression,
, especially when combined with other CNS depressants. Hypertension,
hyperglycemia, and tachycardia are not typical adverse effects of
benzodiazepines.
Question 8: A nurse is assessing a client with social anxiety
disorder. Which finding is most characteristic?
A. Fear of gaining weight
B. Fear of negative evaluation by others
C. Fear of contamination
D. Fear of leaving the house alone
CORRECT ANSWER: B. Fear of negative evaluation by others
Rationale: Social anxiety disorder is characterized by marked fear or
anxiety about social situations in which the individual may be scrutinized or
negatively evaluated. Fear of weight gain relates to eating disorders,
contamination fear to OCD, and fear of leaving home alone to agoraphobia.
Question 9: A client reports repetitive handwashing to relieve
intrusive thoughts about germs. The nurse identifies this behavior
as which type of OCD symptom?
A. Obsession
B. Compulsion
C. Delusion
D. Hallucination
CORRECT ANSWER: B. Compulsion
Rationale: A compulsion is a repetitive behavior or mental act performed in
response to an obsession to reduce anxiety. The intrusive thought about
germs is the obsession, while handwashing is the compulsion. Delusions
and hallucinations are psychotic symptoms, not OCD symptoms.
Question 10: A nurse is evaluating a client’s understanding of
exposure and response prevention (ERP) therapy for OCD. Which
statement indicates correct understanding?
A. “I will avoid all situations that trigger my obsessions.”
B. “I will perform my rituals faster to reduce anxiety.”
C. “I will gradually face my fears without performing my rituals.”
D. “I will take medication only when I feel anxious.”
2026/2027 | ATI RN Mental Health Nursing Study Guide &
Practice Questions | Anxiety Disorders, Trauma- and
Stressor-Related Disorders, PTSD, Panic Disorder, Phobias,
OCD, Acute Stress Disorder, Crisis Intervention, Stress
Responses, Coping Mechanisms, Therapeutic
Communication, Mental Health Assessment, Safety &
Suicide Risk, Pharmacology, Nursing Interventions,
Prioritization, Clinical Judgment, NGN-Style Case Studies
& Detailed Rationales
Question 1: A nurse is assessing a client who has been experiencing
excessive worry about multiple life events for the past eight
months. The client reports muscle tension, irritability, and
difficulty concentrating. Which disorder is the nurse most likely
evaluating?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Obsessive-compulsive disorder
CORRECT ANSWER: B. Generalized anxiety disorder
Rationale: Generalized anxiety disorder (GAD) is characterized by
excessive, uncontrollable worry about multiple areas of life for at least six
months, accompanied by symptoms such as muscle tension, irritability, and
concentration difficulties. Panic disorder involves recurrent unexpected
panic attacks, social anxiety disorder centers on fear of social scrutiny, and
OCD involves obsessions and compulsions.
Question 2: A client suddenly experiences palpitations, sweating,
trembling, and a feeling of impending doom that peaks within 10
minutes. The nurse recognizes this as which type of attack?
A. Panic attack
B. Anxiety attack
C. Conversion reaction
D. Dissociative episode
CORRECT ANSWER: A. Panic attack
Rationale: A panic attack is an abrupt surge of intense fear or discomfort
that reaches a peak within minutes and includes symptoms such as
,palpitations, sweating, trembling, and fear of dying or losing control.
Anxiety attacks are not a recognized DSM-5 diagnosis, and conversion and
dissociative episodes involve neurological or identity disturbances rather
than acute fear peaks.
Question 3: A nurse is caring for a client diagnosed with panic
disorder. Which initial intervention should the nurse implement
during an acute panic attack?
A. Encourage the client to discuss childhood conflicts
B. Remain with the client and use a calm, reassuring approach
C. Administer a PRN antidepressant immediately
D. Leave the client alone to regain self-control
CORRECT ANSWER: B. Remain with the client and use a calm,
reassuring approach
Rationale: During an acute panic attack, the nurse should stay with the
client and provide calm, short, simple directions to promote safety and
reduce fear. Exploring childhood conflicts is inappropriate during acute
distress, antidepressants are not used PRN for acute panic, and leaving the
client alone increases feelings of abandonment and fear.
Question 4: A client with agoraphobia is most likely to exhibit
which behavior?
A. Fear of being in situations where escape might be difficult
B. Fear of gaining weight
C. Fear of contamination
D. Fear of public speaking only
CORRECT ANSWER: A. Fear of being in situations where escape
might be difficult
Rationale: Agoraphobia is marked by intense fear or anxiety about being in
places or situations where escape might be difficult or help unavailable,
such as crowds, bridges, or public transportation. Fear of weight gain
suggests anorexia nervosa, fear of contamination suggests OCD, and fear of
public speaking alone suggests social anxiety disorder.
Question 5: Which neurotransmitter is most commonly associated
with the pathophysiology of anxiety disorders?
,A. Dopamine
B. GABA
C. Acetylcholine
D. Histamine
CORRECT ANSWER: B. GABA
Rationale: Gamma-aminobutyric acid (GABA) is the primary inhibitory
neurotransmitter in the central nervous system and is strongly implicated in
anxiety disorders. Reduced GABA activity contributes to excessive
neuronal excitation and anxiety. Dopamine is linked to psychosis,
acetylcholine to memory and muscle function, and histamine to allergic and
arousal responses.
Question 6: A nurse is teaching a client about buspirone for
generalized anxiety disorder. Which statement by the client
indicates understanding?
A. “I should feel the full effect within 24 hours.”
B. “I can take this medication PRN during panic attacks.”
C. “It may take several weeks before I notice improvement.”
D. “This medication is a benzodiazepine.”
CORRECT ANSWER: C. “It may take several weeks before I notice
improvement.”
Rationale: Buspirone is a non-benzodiazepine anxiolytic that requires two
to four weeks or longer to achieve therapeutic effect. It is not used PRN for
acute panic, is not a benzodiazepine, and does not provide immediate relief.
Client teaching should emphasize delayed onset and consistent daily
dosing.
Question 7: A client is prescribed lorazepam for anxiety. Which
adverse effect should the nurse monitor for most closely?
A. Hypertension
B. Sedation and respiratory depression
C. Hyperglycemia
D. Tachycardia
CORRECT ANSWER: B. Sedation and respiratory depression
Rationale: Lorazepam is a benzodiazepine that enhances GABA activity,
producing sedation, dizziness, and potentially respiratory depression,
, especially when combined with other CNS depressants. Hypertension,
hyperglycemia, and tachycardia are not typical adverse effects of
benzodiazepines.
Question 8: A nurse is assessing a client with social anxiety
disorder. Which finding is most characteristic?
A. Fear of gaining weight
B. Fear of negative evaluation by others
C. Fear of contamination
D. Fear of leaving the house alone
CORRECT ANSWER: B. Fear of negative evaluation by others
Rationale: Social anxiety disorder is characterized by marked fear or
anxiety about social situations in which the individual may be scrutinized or
negatively evaluated. Fear of weight gain relates to eating disorders,
contamination fear to OCD, and fear of leaving home alone to agoraphobia.
Question 9: A client reports repetitive handwashing to relieve
intrusive thoughts about germs. The nurse identifies this behavior
as which type of OCD symptom?
A. Obsession
B. Compulsion
C. Delusion
D. Hallucination
CORRECT ANSWER: B. Compulsion
Rationale: A compulsion is a repetitive behavior or mental act performed in
response to an obsession to reduce anxiety. The intrusive thought about
germs is the obsession, while handwashing is the compulsion. Delusions
and hallucinations are psychotic symptoms, not OCD symptoms.
Question 10: A nurse is evaluating a client’s understanding of
exposure and response prevention (ERP) therapy for OCD. Which
statement indicates correct understanding?
A. “I will avoid all situations that trigger my obsessions.”
B. “I will perform my rituals faster to reduce anxiety.”
C. “I will gradually face my fears without performing my rituals.”
D. “I will take medication only when I feel anxious.”
