NGN ATI MENTAL HEALTH PROCTORED EXAM 2026/2027
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Section 1: Therapeutic Communication & Nurse-Client
Relationship (Q1-12)
Q1. A client newly diagnosed with bipolar disorder states, "I don't think I need
medication. I feel great when I'm manic." Which response demonstrates therapeutic
communication?
A. "You should take your medication because the doctor ordered it."
B. "Everyone with bipolar disorder needs medication to stay stable."
C. "You're feeling good now, but mania can lead to risky decisions. Tell me more
about your concerns." [CORRECT]
D. "If you don't take your medication, you'll end up back in the hospital."
Rationale: This response uses the therapeutic technique of exploring/seeking
clarification while providing factual information. It validates the client's current
feelings without false reassurance or giving advice. Options A, B, and D use non-
therapeutic techniques (advising, stereotyping, and threatening). [ATI Mental Health:
Therapeutic Communication]
Correct Answer: C
Q2. During the orientation phase of the nurse-client relationship, the nurse's primary
goal is to:
A. Establish mutual goals for therapy
B. Develop trust and establish boundaries [CORRECT]
,C. Implement the plan of care
D. Evaluate progress toward outcomes
Rationale: The orientation phase focuses on establishing trust, defining roles, and
clarifying boundaries. Goal-setting (A) occurs during the working phase.
Implementation (C) and evaluation (D) are ongoing but not primary to orientation.
[ATI Mental Health: Phases of Therapeutic Relationship]
Correct Answer: B
Q3. A client with schizophrenia tells the nurse, "The voices are telling me to hurt
myself." Which is the nurse's most appropriate initial response?
A. "I don't hear any voices. You're just imagining things."
B. "Don't listen to the voices. They're not real."
C. "What are the voices telling you to do? Are you having thoughts of harming
yourself?" [CORRECT]
D. "I'll increase your medication so the voices will stop."
Rationale: The nurse must first assess the content of the hallucinations and
determine suicide risk. This response demonstrates active listening and risk
assessment without validating or invalidating the hallucination. Options A and B
dismiss the client's experience; Option D makes a medical decision outside nursing
scope. [ATI Mental Health: Psychotic Disorders; NCSBN CJMM: Recognize Cues]
Correct Answer: C
Q4. A nurse is caring for a client who states, "My wife left me because I'm worthless."
Which response uses the therapeutic technique of reflection?
A. "You're feeling worthless because your wife left?" [CORRECT]
B. "I'm sure your wife didn't think you were worthless."
C. "Many people feel that way after a divorce."
D. "You should focus on your positive qualities."
,Rationale: Reflection mirrors the client's emotional content to encourage
exploration. Option B offers false reassurance; C minimizes with stereotyping; D gives
advice. [ATI Mental Health: Therapeutic Communication Techniques]
Correct Answer: A
Q5. A client with borderline personality disorder becomes angry and shouts, "You
don't care about me!" Which nurse response maintains therapeutic boundaries?
A. "I do care about you. Let me give you a hug."
B. "You're feeling angry. Let's discuss what's bothering you within our professional
relationship." [CORRECT]
C. "If you continue yelling, I will leave the room."
D. "Why would you say that? I've been very nice to you."
Rationale: This response validates emotions while maintaining professional
boundaries. Option A blurs boundaries with physical contact; C is punitive; D is
defensive and non-therapeutic. [ATI Mental Health: Personality Disorders;
Professional Boundaries]
Correct Answer: B
Q6. During a group therapy session, a client with social anxiety disorder remains
silent. Which intervention is most appropriate?
A. Force the client to speak by calling on them directly
B. Ignore the client and focus on more participative members
C. Ask an open-ended question that requires only a brief response and provide
positive reinforcement [CORRECT]
D. Tell the client they must participate to benefit from group
Rationale: Graduated exposure with positive reinforcement reduces anxiety. Forcing
participation (A, D) increases anxiety; ignoring the client (B) is abandonment. [ATI
Mental Health: Anxiety Disorders; Group Therapy]
, Correct Answer: C
Q7. A nurse is using the Socratic questioning technique with a client who has
depression. The purpose of this technique is to:
A. Challenge the client's irrational beliefs through guided discovery [CORRECT]
B. Provide immediate solutions to the client's problems
C. Analyze the client's dreams for hidden meanings
D. Reinforce positive behavior through reward systems
Rationale: Socratic questioning is a cognitive-behavioral technique used to help
clients examine and reframe distorted thinking. It is not solution-focused (B),
psychoanalytic (C), or behavioral reinforcement (D). [ATI Mental Health: Cognitive
Behavioral Therapy]
Correct Answer: A
Q8. A client tells the nurse, "I'm going to stop taking my lithium because I miss the
energy of my manic episodes." Which response demonstrates the principle of
collaboration in the nurse-client relationship?
A. "You can't stop your medication without talking to your provider first."
B. "Let's explore what you miss about those episodes and discuss strategies to help
you feel more energetic safely." [CORRECT]
C. "Mania is dangerous. You need to stay on your medication."
D. "I'll document your refusal in the medical record."
Rationale: Collaboration involves shared decision-making and mutual problem-
solving. This response partners with the client while maintaining safety. Options A
and C are authoritarian; D is punitive documentation. [ATI Mental Health: Nurse-
Client Relationship; NCSBN CJMM: Generate Solutions]
Correct Answer: B
| Verified Correct Answers | A+ Grade | NGN NCLEX & ATI
CMS | Pass Guaranteed - A+ Graded
Section 1: Therapeutic Communication & Nurse-Client
Relationship (Q1-12)
Q1. A client newly diagnosed with bipolar disorder states, "I don't think I need
medication. I feel great when I'm manic." Which response demonstrates therapeutic
communication?
A. "You should take your medication because the doctor ordered it."
B. "Everyone with bipolar disorder needs medication to stay stable."
C. "You're feeling good now, but mania can lead to risky decisions. Tell me more
about your concerns." [CORRECT]
D. "If you don't take your medication, you'll end up back in the hospital."
Rationale: This response uses the therapeutic technique of exploring/seeking
clarification while providing factual information. It validates the client's current
feelings without false reassurance or giving advice. Options A, B, and D use non-
therapeutic techniques (advising, stereotyping, and threatening). [ATI Mental Health:
Therapeutic Communication]
Correct Answer: C
Q2. During the orientation phase of the nurse-client relationship, the nurse's primary
goal is to:
A. Establish mutual goals for therapy
B. Develop trust and establish boundaries [CORRECT]
,C. Implement the plan of care
D. Evaluate progress toward outcomes
Rationale: The orientation phase focuses on establishing trust, defining roles, and
clarifying boundaries. Goal-setting (A) occurs during the working phase.
Implementation (C) and evaluation (D) are ongoing but not primary to orientation.
[ATI Mental Health: Phases of Therapeutic Relationship]
Correct Answer: B
Q3. A client with schizophrenia tells the nurse, "The voices are telling me to hurt
myself." Which is the nurse's most appropriate initial response?
A. "I don't hear any voices. You're just imagining things."
B. "Don't listen to the voices. They're not real."
C. "What are the voices telling you to do? Are you having thoughts of harming
yourself?" [CORRECT]
D. "I'll increase your medication so the voices will stop."
Rationale: The nurse must first assess the content of the hallucinations and
determine suicide risk. This response demonstrates active listening and risk
assessment without validating or invalidating the hallucination. Options A and B
dismiss the client's experience; Option D makes a medical decision outside nursing
scope. [ATI Mental Health: Psychotic Disorders; NCSBN CJMM: Recognize Cues]
Correct Answer: C
Q4. A nurse is caring for a client who states, "My wife left me because I'm worthless."
Which response uses the therapeutic technique of reflection?
A. "You're feeling worthless because your wife left?" [CORRECT]
B. "I'm sure your wife didn't think you were worthless."
C. "Many people feel that way after a divorce."
D. "You should focus on your positive qualities."
,Rationale: Reflection mirrors the client's emotional content to encourage
exploration. Option B offers false reassurance; C minimizes with stereotyping; D gives
advice. [ATI Mental Health: Therapeutic Communication Techniques]
Correct Answer: A
Q5. A client with borderline personality disorder becomes angry and shouts, "You
don't care about me!" Which nurse response maintains therapeutic boundaries?
A. "I do care about you. Let me give you a hug."
B. "You're feeling angry. Let's discuss what's bothering you within our professional
relationship." [CORRECT]
C. "If you continue yelling, I will leave the room."
D. "Why would you say that? I've been very nice to you."
Rationale: This response validates emotions while maintaining professional
boundaries. Option A blurs boundaries with physical contact; C is punitive; D is
defensive and non-therapeutic. [ATI Mental Health: Personality Disorders;
Professional Boundaries]
Correct Answer: B
Q6. During a group therapy session, a client with social anxiety disorder remains
silent. Which intervention is most appropriate?
A. Force the client to speak by calling on them directly
B. Ignore the client and focus on more participative members
C. Ask an open-ended question that requires only a brief response and provide
positive reinforcement [CORRECT]
D. Tell the client they must participate to benefit from group
Rationale: Graduated exposure with positive reinforcement reduces anxiety. Forcing
participation (A, D) increases anxiety; ignoring the client (B) is abandonment. [ATI
Mental Health: Anxiety Disorders; Group Therapy]
, Correct Answer: C
Q7. A nurse is using the Socratic questioning technique with a client who has
depression. The purpose of this technique is to:
A. Challenge the client's irrational beliefs through guided discovery [CORRECT]
B. Provide immediate solutions to the client's problems
C. Analyze the client's dreams for hidden meanings
D. Reinforce positive behavior through reward systems
Rationale: Socratic questioning is a cognitive-behavioral technique used to help
clients examine and reframe distorted thinking. It is not solution-focused (B),
psychoanalytic (C), or behavioral reinforcement (D). [ATI Mental Health: Cognitive
Behavioral Therapy]
Correct Answer: A
Q8. A client tells the nurse, "I'm going to stop taking my lithium because I miss the
energy of my manic episodes." Which response demonstrates the principle of
collaboration in the nurse-client relationship?
A. "You can't stop your medication without talking to your provider first."
B. "Let's explore what you miss about those episodes and discuss strategies to help
you feel more energetic safely." [CORRECT]
C. "Mania is dangerous. You need to stay on your medication."
D. "I'll document your refusal in the medical record."
Rationale: Collaboration involves shared decision-making and mutual problem-
solving. This response partners with the client while maintaining safety. Options A
and C are authoritarian; D is punitive documentation. [ATI Mental Health: Nurse-
Client Relationship; NCSBN CJMM: Generate Solutions]
Correct Answer: B
