ATI MENTAL HEALTH A 2019
PROCTORED EXAM 70 QUESTIONS
WITH ANSWERS HIGHLITED
REVISED FOR 2023/2024
EXAM
1. A nurse is caring for a client with major depressive
disorder. Which of the following findings should the nurse
expect?
A. Grandiose delusions
B. Pressured speech
C. Anhedonia
D. Hyperactivity
Answer: C. Anhedonia
Rationale: Anhedonia (loss of interest or pleasure in activities) is a
core symptom of major depressive disorder. Grandiose delusions
and pressured speech are more typical of bipolar mania;
hyperactivity may be seen in mania or anxiety.
2. A nurse is planning care for a client with anorexia nervosa.
Which intervention should be included?
A. Allow the client to eat alone to reduce anxiety
B. Monitor the client for 1 hour after meals
,C. Weigh the client weekly with clothing on
D. Encourage high-calorie supplements only if weight loss
continues
Answer: B. Monitor the client for 1 hour after meals
Rationale: Clients with anorexia nervosa may hide or purge food.
Monitoring for 1 hour after meals prevents purging behaviors.
Eating alone increases risk of food manipulation. Weighing should
be daily (not weekly) and without clothing for accuracy.
3. A client with schizophrenia tells the nurse, “The FBI is
poisoning my food.” The nurse’s best response is:
A. “Why do you think the FBI would do that?”
B. “I know you believe that, but I don’t hear the voices you
hear.”
C. “That sounds frightening. Let’s eat together in the dining
room.”
D. “You are safe here. No one is poisoning your food.”
Answer: C. “That sounds frightening. Let’s eat together in the
dining room.”
Rationale: Acknowledge the client’s feelings without reinforcing
the delusion. Redirecting to a safe activity (eating together) is
therapeutic. Asking “why” encourages delusional elaboration;
arguing is ineffective.
,4. A nurse is administering haloperidol to a client. Which
adverse effect requires immediate discontinuation?
A. Dry mouth
B. Akathisia
C. Neuroleptic malignant syndrome (NMS)
D. Drowsiness
Answer: C. Neuroleptic malignant syndrome (NMS)
Rationale: NMS is a life-threatening reaction (fever, rigidity,
autonomic instability, elevated CK). Haloperidol must be stopped
immediately. Akathisia and dry mouth are uncomfortable but not
immediately life-threatening.
5. A nurse is caring for a client with bipolar disorder who is
taking lithium. Which lithium level indicates toxicity?
A. 0.6 mEq/L
B. 0.8 mEq/L
C. 1.2 mEq/L
D. 1.8 mEq/L
Answer: D. 1.8 mEq/L
Rationale: Therapeutic lithium level: 0.6–1.2 mEq/L. Levels above
1.5 mEq/L are potentially toxic; 1.8 mEq/L is in the toxic range
(nausea, tremor, confusion, seizures).
, 6. A client with borderline personality disorder says, “You’re
the only nurse who understands me. The others are mean.”
Which response is most therapeutic?
A. “I’ll speak to the other nurses about how you feel.”
B. “I am glad we have a good relationship. Let’s focus on your
treatment goals.”
C. “You are splitting, and that’s not allowed here.”
D. “Why do you think the other nurses are mean?”
Answer: B. “I am glad we have a good relationship. Let’s focus on
your treatment goals.”
Rationale: Avoids reinforcing splitting (idealization vs.
devaluation). Redirects to neutral, goal-oriented conversation.
Challenging or asking “why” can escalate.
7. A nurse is assessing a client with panic disorder. Which
symptom is characteristic of a panic attack?
A. Gradual onset of worry
B. Fear of open spaces
C. Depersonalization
D. Flashbacks
Answer: C. Depersonalization
Rationale: Panic attacks can include depersonalization (feeling
detached from self). Onset is abrupt, not gradual. Fear of open
spaces is agoraphobia; flashbacks are PTSD.
PROCTORED EXAM 70 QUESTIONS
WITH ANSWERS HIGHLITED
REVISED FOR 2023/2024
EXAM
1. A nurse is caring for a client with major depressive
disorder. Which of the following findings should the nurse
expect?
A. Grandiose delusions
B. Pressured speech
C. Anhedonia
D. Hyperactivity
Answer: C. Anhedonia
Rationale: Anhedonia (loss of interest or pleasure in activities) is a
core symptom of major depressive disorder. Grandiose delusions
and pressured speech are more typical of bipolar mania;
hyperactivity may be seen in mania or anxiety.
2. A nurse is planning care for a client with anorexia nervosa.
Which intervention should be included?
A. Allow the client to eat alone to reduce anxiety
B. Monitor the client for 1 hour after meals
,C. Weigh the client weekly with clothing on
D. Encourage high-calorie supplements only if weight loss
continues
Answer: B. Monitor the client for 1 hour after meals
Rationale: Clients with anorexia nervosa may hide or purge food.
Monitoring for 1 hour after meals prevents purging behaviors.
Eating alone increases risk of food manipulation. Weighing should
be daily (not weekly) and without clothing for accuracy.
3. A client with schizophrenia tells the nurse, “The FBI is
poisoning my food.” The nurse’s best response is:
A. “Why do you think the FBI would do that?”
B. “I know you believe that, but I don’t hear the voices you
hear.”
C. “That sounds frightening. Let’s eat together in the dining
room.”
D. “You are safe here. No one is poisoning your food.”
Answer: C. “That sounds frightening. Let’s eat together in the
dining room.”
Rationale: Acknowledge the client’s feelings without reinforcing
the delusion. Redirecting to a safe activity (eating together) is
therapeutic. Asking “why” encourages delusional elaboration;
arguing is ineffective.
,4. A nurse is administering haloperidol to a client. Which
adverse effect requires immediate discontinuation?
A. Dry mouth
B. Akathisia
C. Neuroleptic malignant syndrome (NMS)
D. Drowsiness
Answer: C. Neuroleptic malignant syndrome (NMS)
Rationale: NMS is a life-threatening reaction (fever, rigidity,
autonomic instability, elevated CK). Haloperidol must be stopped
immediately. Akathisia and dry mouth are uncomfortable but not
immediately life-threatening.
5. A nurse is caring for a client with bipolar disorder who is
taking lithium. Which lithium level indicates toxicity?
A. 0.6 mEq/L
B. 0.8 mEq/L
C. 1.2 mEq/L
D. 1.8 mEq/L
Answer: D. 1.8 mEq/L
Rationale: Therapeutic lithium level: 0.6–1.2 mEq/L. Levels above
1.5 mEq/L are potentially toxic; 1.8 mEq/L is in the toxic range
(nausea, tremor, confusion, seizures).
, 6. A client with borderline personality disorder says, “You’re
the only nurse who understands me. The others are mean.”
Which response is most therapeutic?
A. “I’ll speak to the other nurses about how you feel.”
B. “I am glad we have a good relationship. Let’s focus on your
treatment goals.”
C. “You are splitting, and that’s not allowed here.”
D. “Why do you think the other nurses are mean?”
Answer: B. “I am glad we have a good relationship. Let’s focus on
your treatment goals.”
Rationale: Avoids reinforcing splitting (idealization vs.
devaluation). Redirects to neutral, goal-oriented conversation.
Challenging or asking “why” can escalate.
7. A nurse is assessing a client with panic disorder. Which
symptom is characteristic of a panic attack?
A. Gradual onset of worry
B. Fear of open spaces
C. Depersonalization
D. Flashbacks
Answer: C. Depersonalization
Rationale: Panic attacks can include depersonalization (feeling
detached from self). Onset is abrupt, not gradual. Fear of open
spaces is agoraphobia; flashbacks are PTSD.
