ATI -- ASSESSMENT TECHNOLOGIES INSTITUTE
Mental Health B 2019
Proctored Exam
Official Practice Exam . 2026/2027 Edition
70 Questions | 90 Minutes | 80% Passing Score | 6 Sections
TABLE OF CONTENTS
Section 1: Anxiety and Mood Disorders (14 Questions)
Section 2: Psychotic Disorders (12 Questions)
Section 3: Substance Use Disorders (12 Questions)
Section 4: Personality and Eating Disorders (10 Questions)
Section 5: Crisis, Trauma, and Special Populations (12 Questions)
Section 6: Therapeutic Communication and Psychopharmacology (10 Questions)
EXAM INSTRUCTIONS
Read each question carefully. Select the single best answer from the four options provided. Each question includes a
rationale explaining the correct answer and why a key distractor is incorrect. A score of 80% or higher (56 of 70) is
required to pass. Manage your time to allow approximately 1.3 minutes per question. Review all answers before
submission.
ATI Mental Health B -- 2026/2027 | Passing Score: 80% | Page 0 of 0
ATI Mental Health B Proctored Exam | 2026/2027 Edition
,Section 1: Anxiety and Mood Disorders
Q1. Question 1 of 70
Q1. A 32-year-old woman presents to the mental health clinic reporting persistent worry, muscle tension, and
difficulty sleeping for the past 8 months. She states she worries about her job performance, her children's safety,
and financial stability almost every day. The nurse practitioner recognizes these findings are most consistent with
which diagnosis?
A. Generalized anxiety disorder characterized by excessive and persistent worry about multiple life
domains for at least 6 months
B. Panic disorder characterized by recurrent unexpected panic attacks with anticipatory anxiety
C. Social anxiety disorder characterized by intense fear of social scrutiny and embarrassment
D. Adjustment disorder with anxiety characterized by emotional response to an identifiable stressor
Correct Answer: A
Rationale:
The patient's symptoms of persistent, excessive worry about multiple domains lasting more than 6 months with
accompanying muscle tension and sleep disturbance meet DSM-5 criteria for generalized anxiety disorder. Panic
disorder (choice B) requires recurrent unexpected panic attacks, not chronic worry. Social anxiety disorder (choice
C) is specific to social situations, not generalized worry. Adjustment disorder (choice D) occurs within 3 months of
a specific stressor and does not persist for 8 months.
Q2. Question 2 of 70
Q2. A 45-year-old man with a history of major depressive disorder has been taking sertraline 200 mg daily for 6
weeks with minimal improvement. The nurse practitioner considers augmenting with which agent that has FDA
approval for treatment-resistant depression?
A. Lithium carbonate used off-label as an augmenting agent for depression
B. Aripiprazole which has FDA approval as an adjunct to antidepressants for major depressive
disorder
C. Buspirone which is approved as an adjunct for generalized anxiety disorder
D. Hydroxyzine which is approved for symptomatic relief of anxiety and tension
Correct Answer: B
Rationale:
Aripiprazole has FDA approval as adjunctive therapy for major depressive disorder in patients with inadequate
response to antidepressant monotherapy. Lithium (choice A) is used as an augmenting agent but is not
FDA-approved for this indication in depression. Buspirone (choice C) is used for anxiety, not depression
augmentation. Hydroxyzine (choice D) is an antihistamine for anxiety symptoms, not depression augmentation.
ATI Mental Health B -- 2026/2027 | Passing Score: 80% | Page 1 of 0
,Q3. Question 3 of 70
Q3. A 28-year-old woman is brought to the emergency department after her roommate found her with a bottle of
acetaminophen and a suicide note. The patient reports she broke up with her partner 2 days ago and feels
hopeless. She has a prior history of cutting her wrists at age 19. Which factor most strongly increases this
patient's risk of completed suicide?
A. Recent interpersonal loss and acute emotional distress as precipitating events
B. Female sex which is associated with a higher rate of completed suicide
C. Prior self-harm history and current suicidal intent with a lethal means attempt
D. Young age which is the strongest demographic predictor of completed suicide
Correct Answer: C
Rationale:
The strongest risk factors for completed suicide include prior suicide attempts, current suicidal intent, and access
to lethal means. This patient has a history of prior self-harm and has already attempted suicide with a lethal
method (acetaminophen overdose). While recent loss (choice A) is a precipitant, it is not as strong a predictor as
prior attempts. Male sex (choice B), not female, is associated with higher completed suicide rates. Older age
(choice D), not younger, carries higher risk of completion.
Q4. Question 4 of 70
Q4. A 52-year-old woman with bipolar I disorder has been stable on lithium 900 mg daily for 3 years. She
presents with coarse tremor, confusion, ataxia, and vomiting after starting ibuprofen for back pain. Her lithium
level is 2.1 mEq/L. The nurse practitioner's immediate priority intervention is which action?
A. Reduce the lithium dose to 450 mg daily and recheck the level in 1 week
B. Administer oral polyethylene glycol solution for gastrointestinal decontamination
C. Discontinue ibuprofen and continue the lithium at the current dose with close monitoring
D. Hold lithium and initiate emergency treatment for lithium toxicity with hydration and possible
dialysis
Correct Answer: D
Rationale:
The patient presents with severe lithium toxicity (level above 2.0 mEq/L with neurologic symptoms including
confusion and ataxia), which requires immediate discontinuation of lithium and emergency treatment including IV
hydration and potential hemodialysis. Simply reducing the dose (choice A) is inappropriate at this toxic level. GI
decontamination (choice B) is not effective for lithium because it is rapidly absorbed. Continuing lithium at the
current dose (choice C) is dangerous with a level of 2.1 mEq/L and neurologic symptoms.
ATI Mental Health B -- 2026/2027 | Passing Score: 80% | Page 2 of 0
, Q5. Question 5 of 70
Q5. A 60-year-old man with a 30-year history of recurrent major depressive disorder has failed trials of three
different antidepressant classes. The psychiatric-mental health nurse practitioner is considering electroconvulsive
therapy. Which statement about ECT is most accurate?
A. ECT is the most effective treatment for severe, treatment-resistant depression with response
rates of 50 to 70 percent
B. ECT is contraindicated in elderly patients due to excessive cardiovascular risk from general anesthesia
C. ECT works primarily by increasing serotonin receptor sensitivity in the cerebral cortex
D. ECT produces permanent memory loss as an unavoidable side effect in all patients
Correct Answer: A
Rationale:
ECT is the most effective treatment for severe, treatment-resistant depression with response rates of 50-70%, and
is particularly effective in elderly patients. ECT is not contraindicated in the elderly (choice B); it is actually a
preferred treatment in this population. The mechanism of ECT is not primarily serotonergic (choice C); it likely
involves neuroplasticity and neurotransmitter modulation. Memory loss (choice D) is typically temporary and not
permanent in all patients.
Q6. Question 6 of 70
Q6. A 22-year-old college student presents with a 3-month history of binge eating episodes followed by
self-induced vomiting twice weekly. She is of normal weight but expresses intense fear of gaining weight. Which
laboratory finding is most concerning in this patient?
A. Elevated hemoglobin and hematocrit suggesting hemoconcentration from dehydration
B. Hypokalemia from recurrent vomiting leading to potential cardiac arrhythmias
C. Elevated amylase from salivary gland stimulation during vomiting episodes
D. Mild hyponatremia from excessive water intake before binge episodes
Correct Answer: B
Rationale:
In bulimia nervosa, recurrent vomiting causes loss of hydrochloric acid and potassium, leading to hypokalemic
metabolic alkalosis. Hypokalemia is the most dangerous electrolyte abnormality because it can cause
life-threatening cardiac arrhythmias. Hemoconcentration (choice A) may occur but is not the most dangerous
finding. Elevated amylase (choice C) is a marker of vomiting but is not life-threatening. Hyponatremia (choice D)
can occur but is typically less immediately dangerous than severe hypokalemia.
ATI Mental Health B -- 2026/2027 | Passing Score: 80% | Page 3 of 0
Mental Health B 2019
Proctored Exam
Official Practice Exam . 2026/2027 Edition
70 Questions | 90 Minutes | 80% Passing Score | 6 Sections
TABLE OF CONTENTS
Section 1: Anxiety and Mood Disorders (14 Questions)
Section 2: Psychotic Disorders (12 Questions)
Section 3: Substance Use Disorders (12 Questions)
Section 4: Personality and Eating Disorders (10 Questions)
Section 5: Crisis, Trauma, and Special Populations (12 Questions)
Section 6: Therapeutic Communication and Psychopharmacology (10 Questions)
EXAM INSTRUCTIONS
Read each question carefully. Select the single best answer from the four options provided. Each question includes a
rationale explaining the correct answer and why a key distractor is incorrect. A score of 80% or higher (56 of 70) is
required to pass. Manage your time to allow approximately 1.3 minutes per question. Review all answers before
submission.
ATI Mental Health B -- 2026/2027 | Passing Score: 80% | Page 0 of 0
ATI Mental Health B Proctored Exam | 2026/2027 Edition
,Section 1: Anxiety and Mood Disorders
Q1. Question 1 of 70
Q1. A 32-year-old woman presents to the mental health clinic reporting persistent worry, muscle tension, and
difficulty sleeping for the past 8 months. She states she worries about her job performance, her children's safety,
and financial stability almost every day. The nurse practitioner recognizes these findings are most consistent with
which diagnosis?
A. Generalized anxiety disorder characterized by excessive and persistent worry about multiple life
domains for at least 6 months
B. Panic disorder characterized by recurrent unexpected panic attacks with anticipatory anxiety
C. Social anxiety disorder characterized by intense fear of social scrutiny and embarrassment
D. Adjustment disorder with anxiety characterized by emotional response to an identifiable stressor
Correct Answer: A
Rationale:
The patient's symptoms of persistent, excessive worry about multiple domains lasting more than 6 months with
accompanying muscle tension and sleep disturbance meet DSM-5 criteria for generalized anxiety disorder. Panic
disorder (choice B) requires recurrent unexpected panic attacks, not chronic worry. Social anxiety disorder (choice
C) is specific to social situations, not generalized worry. Adjustment disorder (choice D) occurs within 3 months of
a specific stressor and does not persist for 8 months.
Q2. Question 2 of 70
Q2. A 45-year-old man with a history of major depressive disorder has been taking sertraline 200 mg daily for 6
weeks with minimal improvement. The nurse practitioner considers augmenting with which agent that has FDA
approval for treatment-resistant depression?
A. Lithium carbonate used off-label as an augmenting agent for depression
B. Aripiprazole which has FDA approval as an adjunct to antidepressants for major depressive
disorder
C. Buspirone which is approved as an adjunct for generalized anxiety disorder
D. Hydroxyzine which is approved for symptomatic relief of anxiety and tension
Correct Answer: B
Rationale:
Aripiprazole has FDA approval as adjunctive therapy for major depressive disorder in patients with inadequate
response to antidepressant monotherapy. Lithium (choice A) is used as an augmenting agent but is not
FDA-approved for this indication in depression. Buspirone (choice C) is used for anxiety, not depression
augmentation. Hydroxyzine (choice D) is an antihistamine for anxiety symptoms, not depression augmentation.
ATI Mental Health B -- 2026/2027 | Passing Score: 80% | Page 1 of 0
,Q3. Question 3 of 70
Q3. A 28-year-old woman is brought to the emergency department after her roommate found her with a bottle of
acetaminophen and a suicide note. The patient reports she broke up with her partner 2 days ago and feels
hopeless. She has a prior history of cutting her wrists at age 19. Which factor most strongly increases this
patient's risk of completed suicide?
A. Recent interpersonal loss and acute emotional distress as precipitating events
B. Female sex which is associated with a higher rate of completed suicide
C. Prior self-harm history and current suicidal intent with a lethal means attempt
D. Young age which is the strongest demographic predictor of completed suicide
Correct Answer: C
Rationale:
The strongest risk factors for completed suicide include prior suicide attempts, current suicidal intent, and access
to lethal means. This patient has a history of prior self-harm and has already attempted suicide with a lethal
method (acetaminophen overdose). While recent loss (choice A) is a precipitant, it is not as strong a predictor as
prior attempts. Male sex (choice B), not female, is associated with higher completed suicide rates. Older age
(choice D), not younger, carries higher risk of completion.
Q4. Question 4 of 70
Q4. A 52-year-old woman with bipolar I disorder has been stable on lithium 900 mg daily for 3 years. She
presents with coarse tremor, confusion, ataxia, and vomiting after starting ibuprofen for back pain. Her lithium
level is 2.1 mEq/L. The nurse practitioner's immediate priority intervention is which action?
A. Reduce the lithium dose to 450 mg daily and recheck the level in 1 week
B. Administer oral polyethylene glycol solution for gastrointestinal decontamination
C. Discontinue ibuprofen and continue the lithium at the current dose with close monitoring
D. Hold lithium and initiate emergency treatment for lithium toxicity with hydration and possible
dialysis
Correct Answer: D
Rationale:
The patient presents with severe lithium toxicity (level above 2.0 mEq/L with neurologic symptoms including
confusion and ataxia), which requires immediate discontinuation of lithium and emergency treatment including IV
hydration and potential hemodialysis. Simply reducing the dose (choice A) is inappropriate at this toxic level. GI
decontamination (choice B) is not effective for lithium because it is rapidly absorbed. Continuing lithium at the
current dose (choice C) is dangerous with a level of 2.1 mEq/L and neurologic symptoms.
ATI Mental Health B -- 2026/2027 | Passing Score: 80% | Page 2 of 0
, Q5. Question 5 of 70
Q5. A 60-year-old man with a 30-year history of recurrent major depressive disorder has failed trials of three
different antidepressant classes. The psychiatric-mental health nurse practitioner is considering electroconvulsive
therapy. Which statement about ECT is most accurate?
A. ECT is the most effective treatment for severe, treatment-resistant depression with response
rates of 50 to 70 percent
B. ECT is contraindicated in elderly patients due to excessive cardiovascular risk from general anesthesia
C. ECT works primarily by increasing serotonin receptor sensitivity in the cerebral cortex
D. ECT produces permanent memory loss as an unavoidable side effect in all patients
Correct Answer: A
Rationale:
ECT is the most effective treatment for severe, treatment-resistant depression with response rates of 50-70%, and
is particularly effective in elderly patients. ECT is not contraindicated in the elderly (choice B); it is actually a
preferred treatment in this population. The mechanism of ECT is not primarily serotonergic (choice C); it likely
involves neuroplasticity and neurotransmitter modulation. Memory loss (choice D) is typically temporary and not
permanent in all patients.
Q6. Question 6 of 70
Q6. A 22-year-old college student presents with a 3-month history of binge eating episodes followed by
self-induced vomiting twice weekly. She is of normal weight but expresses intense fear of gaining weight. Which
laboratory finding is most concerning in this patient?
A. Elevated hemoglobin and hematocrit suggesting hemoconcentration from dehydration
B. Hypokalemia from recurrent vomiting leading to potential cardiac arrhythmias
C. Elevated amylase from salivary gland stimulation during vomiting episodes
D. Mild hyponatremia from excessive water intake before binge episodes
Correct Answer: B
Rationale:
In bulimia nervosa, recurrent vomiting causes loss of hydrochloric acid and potassium, leading to hypokalemic
metabolic alkalosis. Hypokalemia is the most dangerous electrolyte abnormality because it can cause
life-threatening cardiac arrhythmias. Hemoconcentration (choice A) may occur but is not the most dangerous
finding. Elevated amylase (choice C) is a marker of vomiting but is not life-threatening. Hyponatremia (choice D)
can occur but is typically less immediately dangerous than severe hypokalemia.
ATI Mental Health B -- 2026/2027 | Passing Score: 80% | Page 3 of 0
