NGN ATI Mental Health Proctored & Retake
Exam 2023 | Verified Q&A with Detailed
Rationales | Latest Updated Test Bank
1. A client with major depressive disorder is started on phenelzine, an MAOI. Which food
item should the nurse instruct the client to avoid?
A) Broiled chicken
B) Aged cheddar cheese
C) Green beans
D) White rice
Rationale: MAOIs require a low-tyramine diet. Aged cheeses, cured meats, and
fermented products can trigger hypertensive crisis. Chicken, green beans, and rice are
safe.
2. A client with bipolar disorder is prescribed lithium. Which serum level indicates toxicity?
A) 0.8 mEq/L
B) 1.2 mEq/L
C) 1.8 mEq/L
D) 0.4 mEq/L
Rationale: Therapeutic lithium range is 0.6–1.2 mEq/L. Levels >1.5 mEq/L are potentially
toxic; 1.8 mEq/L is toxic with symptoms like coarse tremor, ataxia, and confusion.
3. A client with schizophrenia tells the nurse, “The FBI is poisoning my food.” Which
response is most therapeutic?
A) “That is not true; you are safe here.”
B) “I understand you believe that, but I don’t see any FBI agents.”
C) “It must be frightening to feel that someone wants to harm you.”
D) “Let’s talk about something else.”
Rationale: Validating the feeling without reinforcing the delusion builds trust. Arguing
or dismissing increases anxiety.
4. A client with generalized anxiety disorder is prescribed buspirone. Which statement
indicates a need for further teaching?
A) “I can take this medication with food.”
B) “It may take several weeks to feel the full effect.”
C) “I will not drink alcohol while taking this.”
D) “I should feel relief within 30 minutes of taking it.”
, Rationale: Buspirone is not a PRN anxiolytic; it requires 2–4 weeks for therapeutic effect,
unlike benzodiazepines.
5. A client with posttraumatic stress disorder (PTSD) reports recurrent nightmares and
avoiding driving after a car accident. Which intervention should the nurse implement
first?
A) Encourage the client to drive short distances
B) Teach relaxation techniques for anxiety
C) Establish a trusting therapeutic relationship
D) Refer for cognitive processing therapy
Rationale: Trust is foundational before exposure or cognitive therapy. Without rapport,
the client will likely refuse further interventions.
6. A client with borderline personality disorder has a history of self-cutting. Which
short-term goal is most appropriate?
A) The client will refrain from self-harm for 48 hours.
B) The client will understand the underlying cause of self-harm.
C) The client will agree to no-harm contracts weekly.
D) The client will develop one alternative coping strategy within 1 week.
Rationale: A short-term, measurable, behaviorally focused goal is realistic. Insight or
contracts without skill building are less effective for BPD.
7. A client with panic disorder is hyperventilating. What is the priority nursing action?
A) Administer oxygen at 2 L/min
B) Have the client breathe into a paper bag
C) Stay with the client and speak calmly
D) Encourage deep, slow breathing
Rationale: Staying with the client provides safety. Encouraging slow, diaphragmatic
breathing helps correct hyperventilation; paper bag use is outdated.
8. A client with obsessive-compulsive disorder (OCD) spends 3 hours daily washing hands.
Which nursing intervention is most therapeutic?
A) Set a limit that handwashing is allowed only once per hour.
B) Distract the client whenever handwashing begins.
C) Allow time for handwashing initially, then gradually reduce the time.
D) Tell the client that the behavior is irrational.
Rationale: Gradual reduction (response prevention with shaping) is part of exposure
therapy; abrupt stopping increases anxiety.
9. A client with alcohol use disorder is admitted for detoxification. Which medication is the
nurse most likely to administer to prevent seizures and delirium tremens?
A) Naltrexone
B) Disulfiram
C) Chlordiazepoxide
D) Acamprosate
, Rationale: Benzodiazepines (e.g., chlordiazepoxide, lorazepam) are standard to prevent
alcohol withdrawal seizures and DT.
10. A client with anorexia nervosa is admitted with a BMI of 15. Which finding requires
immediate intervention?
A) Blood pressure 90/60 mm Hg
B) Serum potassium 2.9 mEq/L
C) Fine lanugo hair on face
D) Body temperature 96.8°F (36°C)
Rationale: Hypokalemia (2.9) in anorexia nervosa can cause cardiac arrhythmias and
sudden death; it is a priority.
11. A client with bipolar disorder in the manic phase is pacing, talking rapidly, and not
eating. Which intervention should the nurse implement first?
A) Offer high-calorie finger foods
B) Lead the client to a quiet area
C) Restrict visitors to family only
D) Administer PRN haloperidol
Rationale: Reducing environmental stimulation helps decrease manic energy. Food is
important but not first; medication may be used later.
12. A client with schizophrenia is taking clozapine. The nurse should monitor for which
life-threatening adverse effect?
A) Tardive dyskinesia
B) Neuroleptic malignant syndrome
C) Agranulocytosis
D) Akathisia
Rationale: Clozapine carries a black box warning for agranulocytosis, requiring regular
absolute neutrophil count monitoring.
13. A client with PTSD is prescribed sertraline. Which statement indicates understanding?
A) “I will feel better within 24 hours.”
B) “I should avoid aged cheese and red wine.”
C) “It may take 4–6 weeks to see improvement.”
D) “I can stop taking it once my nightmares stop.”
Rationale: SSRIs like sertraline require several weeks for full effect. Abrupt
discontinuation causes withdrawal.
14. A client with major depressive disorder has not eaten for 3 days. Which nursing
intervention is most appropriate?
A) Offer the client a choice between two small, high-protein snacks
B) Sit with the client during meals to encourage eating
C) Insert a nasogastric tube for enteral feeding
D) Tell the client that eating is necessary for strength
, Rationale: Offering limited, simple choices respects autonomy and reduces anxiety. NG
tube is last resort.
15. A client with antisocial personality disorder is manipulative and demanding. Which
approach by the nurse is most effective?
A) Enforce unit rules consistently with clear consequences
B) Allow the client to make choices about their treatment plan
C) Confront the client about their manipulative behavior
D) Ignore the behavior to avoid reinforcement
Rationale: Consistent limit-setting with consequences is essential for antisocial PD.
Confrontation leads to power struggles.
16. A client with social anxiety disorder is about to give a speech. Which short-acting
medication is most likely prescribed for acute anxiety in this situation?
A) Paroxetine
B) Propranolol
C) Venlafaxine
D) Fluoxetine
Rationale: Propranolol, a beta-blocker, reduces autonomic symptoms (tachycardia,
tremor) of performance anxiety.
17. A client with bulimia nervosa has dental erosion and Russell’s sign. Which intervention is
priority?
A) Monitor electrolyte levels daily
B) Supervise the client for 1 hour after meals
C) Refer to a dentist for repair of teeth
D) Teach about the effects of purging
Rationale: Hypokalemia from purging can cause cardiac arrest. Electrolyte monitoring is
the priority.
18. A client with depression is started on electroconvulsive therapy (ECT). Which nursing
action is most important before the procedure?
A) Obtain informed consent from the client
B) Withhold all antihypertensive medications
C) Ensure the client has been NPO for at least 8 hours
D) Administer atropine to reduce secretions
Rationale: NPO status prevents aspiration during general anesthesia.
19. A client with paranoid schizophrenia believes the food is poisoned. Which intervention is
most appropriate?
A) Offer the client unopened, commercially packaged foods
B) Explain that the kitchen staff is trustworthy
C) Allow the client to select food from the buffet
D) Provide a liquid diet to avoid solid food fears
Exam 2023 | Verified Q&A with Detailed
Rationales | Latest Updated Test Bank
1. A client with major depressive disorder is started on phenelzine, an MAOI. Which food
item should the nurse instruct the client to avoid?
A) Broiled chicken
B) Aged cheddar cheese
C) Green beans
D) White rice
Rationale: MAOIs require a low-tyramine diet. Aged cheeses, cured meats, and
fermented products can trigger hypertensive crisis. Chicken, green beans, and rice are
safe.
2. A client with bipolar disorder is prescribed lithium. Which serum level indicates toxicity?
A) 0.8 mEq/L
B) 1.2 mEq/L
C) 1.8 mEq/L
D) 0.4 mEq/L
Rationale: Therapeutic lithium range is 0.6–1.2 mEq/L. Levels >1.5 mEq/L are potentially
toxic; 1.8 mEq/L is toxic with symptoms like coarse tremor, ataxia, and confusion.
3. A client with schizophrenia tells the nurse, “The FBI is poisoning my food.” Which
response is most therapeutic?
A) “That is not true; you are safe here.”
B) “I understand you believe that, but I don’t see any FBI agents.”
C) “It must be frightening to feel that someone wants to harm you.”
D) “Let’s talk about something else.”
Rationale: Validating the feeling without reinforcing the delusion builds trust. Arguing
or dismissing increases anxiety.
4. A client with generalized anxiety disorder is prescribed buspirone. Which statement
indicates a need for further teaching?
A) “I can take this medication with food.”
B) “It may take several weeks to feel the full effect.”
C) “I will not drink alcohol while taking this.”
D) “I should feel relief within 30 minutes of taking it.”
, Rationale: Buspirone is not a PRN anxiolytic; it requires 2–4 weeks for therapeutic effect,
unlike benzodiazepines.
5. A client with posttraumatic stress disorder (PTSD) reports recurrent nightmares and
avoiding driving after a car accident. Which intervention should the nurse implement
first?
A) Encourage the client to drive short distances
B) Teach relaxation techniques for anxiety
C) Establish a trusting therapeutic relationship
D) Refer for cognitive processing therapy
Rationale: Trust is foundational before exposure or cognitive therapy. Without rapport,
the client will likely refuse further interventions.
6. A client with borderline personality disorder has a history of self-cutting. Which
short-term goal is most appropriate?
A) The client will refrain from self-harm for 48 hours.
B) The client will understand the underlying cause of self-harm.
C) The client will agree to no-harm contracts weekly.
D) The client will develop one alternative coping strategy within 1 week.
Rationale: A short-term, measurable, behaviorally focused goal is realistic. Insight or
contracts without skill building are less effective for BPD.
7. A client with panic disorder is hyperventilating. What is the priority nursing action?
A) Administer oxygen at 2 L/min
B) Have the client breathe into a paper bag
C) Stay with the client and speak calmly
D) Encourage deep, slow breathing
Rationale: Staying with the client provides safety. Encouraging slow, diaphragmatic
breathing helps correct hyperventilation; paper bag use is outdated.
8. A client with obsessive-compulsive disorder (OCD) spends 3 hours daily washing hands.
Which nursing intervention is most therapeutic?
A) Set a limit that handwashing is allowed only once per hour.
B) Distract the client whenever handwashing begins.
C) Allow time for handwashing initially, then gradually reduce the time.
D) Tell the client that the behavior is irrational.
Rationale: Gradual reduction (response prevention with shaping) is part of exposure
therapy; abrupt stopping increases anxiety.
9. A client with alcohol use disorder is admitted for detoxification. Which medication is the
nurse most likely to administer to prevent seizures and delirium tremens?
A) Naltrexone
B) Disulfiram
C) Chlordiazepoxide
D) Acamprosate
, Rationale: Benzodiazepines (e.g., chlordiazepoxide, lorazepam) are standard to prevent
alcohol withdrawal seizures and DT.
10. A client with anorexia nervosa is admitted with a BMI of 15. Which finding requires
immediate intervention?
A) Blood pressure 90/60 mm Hg
B) Serum potassium 2.9 mEq/L
C) Fine lanugo hair on face
D) Body temperature 96.8°F (36°C)
Rationale: Hypokalemia (2.9) in anorexia nervosa can cause cardiac arrhythmias and
sudden death; it is a priority.
11. A client with bipolar disorder in the manic phase is pacing, talking rapidly, and not
eating. Which intervention should the nurse implement first?
A) Offer high-calorie finger foods
B) Lead the client to a quiet area
C) Restrict visitors to family only
D) Administer PRN haloperidol
Rationale: Reducing environmental stimulation helps decrease manic energy. Food is
important but not first; medication may be used later.
12. A client with schizophrenia is taking clozapine. The nurse should monitor for which
life-threatening adverse effect?
A) Tardive dyskinesia
B) Neuroleptic malignant syndrome
C) Agranulocytosis
D) Akathisia
Rationale: Clozapine carries a black box warning for agranulocytosis, requiring regular
absolute neutrophil count monitoring.
13. A client with PTSD is prescribed sertraline. Which statement indicates understanding?
A) “I will feel better within 24 hours.”
B) “I should avoid aged cheese and red wine.”
C) “It may take 4–6 weeks to see improvement.”
D) “I can stop taking it once my nightmares stop.”
Rationale: SSRIs like sertraline require several weeks for full effect. Abrupt
discontinuation causes withdrawal.
14. A client with major depressive disorder has not eaten for 3 days. Which nursing
intervention is most appropriate?
A) Offer the client a choice between two small, high-protein snacks
B) Sit with the client during meals to encourage eating
C) Insert a nasogastric tube for enteral feeding
D) Tell the client that eating is necessary for strength
, Rationale: Offering limited, simple choices respects autonomy and reduces anxiety. NG
tube is last resort.
15. A client with antisocial personality disorder is manipulative and demanding. Which
approach by the nurse is most effective?
A) Enforce unit rules consistently with clear consequences
B) Allow the client to make choices about their treatment plan
C) Confront the client about their manipulative behavior
D) Ignore the behavior to avoid reinforcement
Rationale: Consistent limit-setting with consequences is essential for antisocial PD.
Confrontation leads to power struggles.
16. A client with social anxiety disorder is about to give a speech. Which short-acting
medication is most likely prescribed for acute anxiety in this situation?
A) Paroxetine
B) Propranolol
C) Venlafaxine
D) Fluoxetine
Rationale: Propranolol, a beta-blocker, reduces autonomic symptoms (tachycardia,
tremor) of performance anxiety.
17. A client with bulimia nervosa has dental erosion and Russell’s sign. Which intervention is
priority?
A) Monitor electrolyte levels daily
B) Supervise the client for 1 hour after meals
C) Refer to a dentist for repair of teeth
D) Teach about the effects of purging
Rationale: Hypokalemia from purging can cause cardiac arrest. Electrolyte monitoring is
the priority.
18. A client with depression is started on electroconvulsive therapy (ECT). Which nursing
action is most important before the procedure?
A) Obtain informed consent from the client
B) Withhold all antihypertensive medications
C) Ensure the client has been NPO for at least 8 hours
D) Administer atropine to reduce secretions
Rationale: NPO status prevents aspiration during general anesthesia.
19. A client with paranoid schizophrenia believes the food is poisoned. Which intervention is
most appropriate?
A) Offer the client unopened, commercially packaged foods
B) Explain that the kitchen staff is trustworthy
C) Allow the client to select food from the buffet
D) Provide a liquid diet to avoid solid food fears
