ATI RN Mental Health Proctored Exam
2023/2026 with NGN: 100 Real Exam
Questions and 100% Correct Verified
Answers
Question 1
A client with major depressive disorder has been withdrawn and
anhedonic for weeks. During morning rounds, the nurse finds the
client suddenly calm, cheerful, and energetic. What is the nurse's
priority action?
A. Encourage the client to attend group therapy
B. Document the client's improved mood
C. Increase the client's level of observation
D. Ask the client if they have a plan for suicide
Correct Answer: D
Rationale: A sudden, unexpected improvement in mood in a
severely depressed client often indicates that the client has made
a decision to commit suicide and now feels peaceful and
energized. The nurse must directly assess for suicidal ideation and
a plan. Safety is the priority.
Question 2
A client taking haloperidol (Haldol) for schizophrenia develops a
,temperature of 104°F (40°C), muscle rigidity, and altered mental
status. Which action should the nurse take first?
A. Administer acetaminophen for fever
B. Hold the next dose of haloperidol and notify the provider
C. Apply cooling blankets
D. Obtain a stat creatine kinase (CK) level
Correct Answer: B
Rationale: This presentation is classic for Neuroleptic Malignant
Syndrome (NMS), a life-threatening emergency. The priority is to
stop the offending antipsychotic medication immediately. While
cooling and CK levels are important, holding the medication is the
first and most critical action.
Question 3
A client started sertraline (Zoloft) 10 days ago for panic disorder.
The client now reports agitation, confusion, diarrhea, and tremors.
Vital signs: HR 120, BP 150/90, temp 101.2°F (38.4°C). What does
the nurse suspect?
A. Neuroleptic Malignant Syndrome
B. Serotonin Syndrome
C. Extrapyramidal Symptoms
D. Anticholinergic toxicity
Correct Answer: B
Rationale: Serotonin syndrome is caused by excessive
serotonergic activity, often when starting an SSRI like sertraline.
The triad includes mental status changes (agitation, confusion),
autonomic instability (tachycardia, hyperthermia), and
,neuromuscular abnormalities (tremors). NMS is associated with
antipsychotics, not SSRIs.
Question 4
A client with bipolar disorder has a lithium level of 1.8 mEq/L.
Which finding would the nurse expect to assess?
A. Polyuria and polydipsia
B. Fine hand tremor and nausea
C. Coarse tremor, confusion, and vomiting
D. Muscle weakness and ataxia
Correct Answer: C
Rationale: Therapeutic lithium level is 0.6-1.2 mEq/L. Levels above
1.5 mEq/L indicate toxicity. Early toxicity (1.5-2.0) includes coarse
tremor, nausea, vomiting, and confusion. Polyuria is a common
side effect but not a sign of acute toxicity. Fine tremor can occur
at therapeutic levels.
Question 5
A client taking clozapine (Clozaril) reports sore throat, fever, and
fatigue. Which lab result is most concerning?
A. Serum sodium 135 mEq/L
B. WBC count 2,500/mm³
C. Hemoglobin 12 g/dL
D. Platelet count 150,000/mm³
, Correct Answer: B
Rationale: Clozapine has a black box warning for agranulocytosis
(WBC < 3000/mm³). The client's symptoms plus a low WBC
suggest this life-threatening complication. The nurse must hold
clozapine and notify the provider immediately.
Question 6
A client with anorexia nervosa is admitted with a BMI of 15. Which
laboratory finding requires immediate intervention?
A. Potassium 3.2 mEq/L
B. Blood pH 7.60
C. Magnesium 1.8 mg/dL
D. Hemoglobin 11 g/dL
Correct Answer: B
Rationale: A blood pH of 7.60 indicates severe metabolic
alkalosis, typically from self-induced vomiting. This can lead to
life-threatening cardiac arrhythmias. While hypokalemia (3.2) is
also serious, a pH of 7.60 is a critical emergency requiring
immediate intervention.
Question 7
A client admitted involuntarily for suicidal ideation refuses their
prescribed antidepressant. What is the nurse's best response?
A. "You are not allowed to refuse medication since you are here
involuntarily."
2023/2026 with NGN: 100 Real Exam
Questions and 100% Correct Verified
Answers
Question 1
A client with major depressive disorder has been withdrawn and
anhedonic for weeks. During morning rounds, the nurse finds the
client suddenly calm, cheerful, and energetic. What is the nurse's
priority action?
A. Encourage the client to attend group therapy
B. Document the client's improved mood
C. Increase the client's level of observation
D. Ask the client if they have a plan for suicide
Correct Answer: D
Rationale: A sudden, unexpected improvement in mood in a
severely depressed client often indicates that the client has made
a decision to commit suicide and now feels peaceful and
energized. The nurse must directly assess for suicidal ideation and
a plan. Safety is the priority.
Question 2
A client taking haloperidol (Haldol) for schizophrenia develops a
,temperature of 104°F (40°C), muscle rigidity, and altered mental
status. Which action should the nurse take first?
A. Administer acetaminophen for fever
B. Hold the next dose of haloperidol and notify the provider
C. Apply cooling blankets
D. Obtain a stat creatine kinase (CK) level
Correct Answer: B
Rationale: This presentation is classic for Neuroleptic Malignant
Syndrome (NMS), a life-threatening emergency. The priority is to
stop the offending antipsychotic medication immediately. While
cooling and CK levels are important, holding the medication is the
first and most critical action.
Question 3
A client started sertraline (Zoloft) 10 days ago for panic disorder.
The client now reports agitation, confusion, diarrhea, and tremors.
Vital signs: HR 120, BP 150/90, temp 101.2°F (38.4°C). What does
the nurse suspect?
A. Neuroleptic Malignant Syndrome
B. Serotonin Syndrome
C. Extrapyramidal Symptoms
D. Anticholinergic toxicity
Correct Answer: B
Rationale: Serotonin syndrome is caused by excessive
serotonergic activity, often when starting an SSRI like sertraline.
The triad includes mental status changes (agitation, confusion),
autonomic instability (tachycardia, hyperthermia), and
,neuromuscular abnormalities (tremors). NMS is associated with
antipsychotics, not SSRIs.
Question 4
A client with bipolar disorder has a lithium level of 1.8 mEq/L.
Which finding would the nurse expect to assess?
A. Polyuria and polydipsia
B. Fine hand tremor and nausea
C. Coarse tremor, confusion, and vomiting
D. Muscle weakness and ataxia
Correct Answer: C
Rationale: Therapeutic lithium level is 0.6-1.2 mEq/L. Levels above
1.5 mEq/L indicate toxicity. Early toxicity (1.5-2.0) includes coarse
tremor, nausea, vomiting, and confusion. Polyuria is a common
side effect but not a sign of acute toxicity. Fine tremor can occur
at therapeutic levels.
Question 5
A client taking clozapine (Clozaril) reports sore throat, fever, and
fatigue. Which lab result is most concerning?
A. Serum sodium 135 mEq/L
B. WBC count 2,500/mm³
C. Hemoglobin 12 g/dL
D. Platelet count 150,000/mm³
, Correct Answer: B
Rationale: Clozapine has a black box warning for agranulocytosis
(WBC < 3000/mm³). The client's symptoms plus a low WBC
suggest this life-threatening complication. The nurse must hold
clozapine and notify the provider immediately.
Question 6
A client with anorexia nervosa is admitted with a BMI of 15. Which
laboratory finding requires immediate intervention?
A. Potassium 3.2 mEq/L
B. Blood pH 7.60
C. Magnesium 1.8 mg/dL
D. Hemoglobin 11 g/dL
Correct Answer: B
Rationale: A blood pH of 7.60 indicates severe metabolic
alkalosis, typically from self-induced vomiting. This can lead to
life-threatening cardiac arrhythmias. While hypokalemia (3.2) is
also serious, a pH of 7.60 is a critical emergency requiring
immediate intervention.
Question 7
A client admitted involuntarily for suicidal ideation refuses their
prescribed antidepressant. What is the nurse's best response?
A. "You are not allowed to refuse medication since you are here
involuntarily."
