1
2026 ATI RN Mental Health Proctored Exam –
Latest Version \ 90 Actual Questions with Correct
Answers and Rationales
1. A client with major depressive disorder states, "My family would be
better off without me." What is the nurse's priority action?
A. Document the statement and continue the daily assessment.
B. Reassure the client that things will improve.
C. Ask directly, "Are you thinking about harming yourself?"
D. Redirect the client to a positive activity.
Answer: C
Rationale: Any statement implying hopelessness or being a burden
requires immediate assessment for suicidal ideation. Asking directly
does not plant the idea. Reassurance (B) and redirection (D) may
dismiss the client's distress. Documentation (A) is important but
secondary to assessment.
2. A client with schizophrenia has been taking risperidone for 6 weeks
and develops lip smacking and tongue rolling. The nurse identifies these
findings as:
A. Acute dystonia
B. Tardive dyskinesia
C. Akathisia
D. Pseudoparkinsonism
Answer: B
Rationale: Tardive dyskinesia (TD) is a late-onset, potentially
irreversible movement disorder with involuntary facial movements.
pg. 1
,2
Acute dystonia (A) is early muscle spasms. Akathisia (C) is motor
restlessness. Pseudoparkinsonism (D) includes bradykinesia and rigidity.
3. A client with bipolar I disorder is in the manic phase, pacing and
shouting. The nurse's initial intervention should be:
A. Engage the client in a competitive game.
B. Provide a quiet, low-stimulation environment and set calm, firm
limits.
C. Confront the client's grandiose statements.
D. Encourage group therapy.
Answer: B
Rationale: Reducing environmental stimuli and using consistent, non-
confrontational limits help prevent escalation. Competitive activities (A)
increase agitation. Confrontation (C) is not therapeutic. Group therapy
(D) is too stimulating in acute mania.
4. A client on lithium has a level of 1.8 mEq/L and reports diarrhea,
coarse tremor, and confusion. The nurse should:
A. Administer the next dose with food.
B. Hold the lithium and notify the prescriber.
C. Give an antidiarrheal.
D. Reassure the client these are expected effects.
Answer: B
Rationale: Lithium level >1.5 mEq/L indicates toxicity. The nurse must
hold the dose and notify the provider. Giving more (A) or an
antidiarrheal (C) delays treatment. These are not normal side effects
(D).
pg. 2
,3
5. A client with generalized anxiety disorder is prescribed buspirone.
Which statement indicates understanding of the teaching?
A. "I will feel immediate relief after taking this medication."
B. "I should take it on an as-needed basis when I feel anxious."
C. "It may take 2 to 4 weeks to feel the full effect."
D. "I must avoid aged cheese while taking this medication."
Answer: C
Rationale: Buspirone requires weeks for full therapeutic effect and is
not for acute (A) or PRN use (B). Tyramine restriction (D) is for MAOIs.
6. A client in alcohol withdrawal has a heart rate of 130 bpm, tremors,
and is diaphoretic. The nurse anticipates administering:
A. Naltrexone
B. Disulfiram
C. Lorazepam
D. Haloperidol
Answer: C
Rationale: Benzodiazepines are first-line for alcohol withdrawal to
stabilize vital signs and prevent delirium tremens. Naltrexone (A) and
disulfiram (B) are for maintenance. Haloperidol (D) does not prevent
DTs and lowers seizure threshold.
7. A client with borderline personality disorder states, "You are the only
nurse who cares. The others hate me." The nurse recognizes this as:
A. Transference
B. Splitting
C. Projection
D. Denial
pg. 3
, 4
Answer: B
Rationale: Splitting is the inability to integrate positive and negative
aspects, viewing people as all good or all bad. Transference (A) is
projecting past feelings onto the nurse. Projection (C) attributes one's
own feelings to others.
8. A client on phenelzine (MAOI) asks about dietary restrictions. Which
food must be avoided?
A. Fresh apple
B. Grilled chicken
C. Aged cheddar cheese
D. Steamed rice
Answer: C
Rationale: Aged cheeses are high in tyramine and can cause
hypertensive crisis when combined with MAOIs. Fresh fruits, meats,
and rice are safe.
9. A client with auditory hallucinations tells the nurse, "The voices are
telling me to hurt myself." Which is the best therapeutic response?
A. "The voices aren't real; just ignore them."
B. "I don't hear voices, but I understand that you are frightened."
C. "Why would you listen to them?"
D. "You should go to your room until the voices stop."
Answer: B
Rationale: This response validates the client's experience without
reinforcing the hallucination. Dismissing (A) or asking "why" (C) is non-
therapeutic. Isolation (D) may increase risk.
pg. 4
2026 ATI RN Mental Health Proctored Exam –
Latest Version \ 90 Actual Questions with Correct
Answers and Rationales
1. A client with major depressive disorder states, "My family would be
better off without me." What is the nurse's priority action?
A. Document the statement and continue the daily assessment.
B. Reassure the client that things will improve.
C. Ask directly, "Are you thinking about harming yourself?"
D. Redirect the client to a positive activity.
Answer: C
Rationale: Any statement implying hopelessness or being a burden
requires immediate assessment for suicidal ideation. Asking directly
does not plant the idea. Reassurance (B) and redirection (D) may
dismiss the client's distress. Documentation (A) is important but
secondary to assessment.
2. A client with schizophrenia has been taking risperidone for 6 weeks
and develops lip smacking and tongue rolling. The nurse identifies these
findings as:
A. Acute dystonia
B. Tardive dyskinesia
C. Akathisia
D. Pseudoparkinsonism
Answer: B
Rationale: Tardive dyskinesia (TD) is a late-onset, potentially
irreversible movement disorder with involuntary facial movements.
pg. 1
,2
Acute dystonia (A) is early muscle spasms. Akathisia (C) is motor
restlessness. Pseudoparkinsonism (D) includes bradykinesia and rigidity.
3. A client with bipolar I disorder is in the manic phase, pacing and
shouting. The nurse's initial intervention should be:
A. Engage the client in a competitive game.
B. Provide a quiet, low-stimulation environment and set calm, firm
limits.
C. Confront the client's grandiose statements.
D. Encourage group therapy.
Answer: B
Rationale: Reducing environmental stimuli and using consistent, non-
confrontational limits help prevent escalation. Competitive activities (A)
increase agitation. Confrontation (C) is not therapeutic. Group therapy
(D) is too stimulating in acute mania.
4. A client on lithium has a level of 1.8 mEq/L and reports diarrhea,
coarse tremor, and confusion. The nurse should:
A. Administer the next dose with food.
B. Hold the lithium and notify the prescriber.
C. Give an antidiarrheal.
D. Reassure the client these are expected effects.
Answer: B
Rationale: Lithium level >1.5 mEq/L indicates toxicity. The nurse must
hold the dose and notify the provider. Giving more (A) or an
antidiarrheal (C) delays treatment. These are not normal side effects
(D).
pg. 2
,3
5. A client with generalized anxiety disorder is prescribed buspirone.
Which statement indicates understanding of the teaching?
A. "I will feel immediate relief after taking this medication."
B. "I should take it on an as-needed basis when I feel anxious."
C. "It may take 2 to 4 weeks to feel the full effect."
D. "I must avoid aged cheese while taking this medication."
Answer: C
Rationale: Buspirone requires weeks for full therapeutic effect and is
not for acute (A) or PRN use (B). Tyramine restriction (D) is for MAOIs.
6. A client in alcohol withdrawal has a heart rate of 130 bpm, tremors,
and is diaphoretic. The nurse anticipates administering:
A. Naltrexone
B. Disulfiram
C. Lorazepam
D. Haloperidol
Answer: C
Rationale: Benzodiazepines are first-line for alcohol withdrawal to
stabilize vital signs and prevent delirium tremens. Naltrexone (A) and
disulfiram (B) are for maintenance. Haloperidol (D) does not prevent
DTs and lowers seizure threshold.
7. A client with borderline personality disorder states, "You are the only
nurse who cares. The others hate me." The nurse recognizes this as:
A. Transference
B. Splitting
C. Projection
D. Denial
pg. 3
, 4
Answer: B
Rationale: Splitting is the inability to integrate positive and negative
aspects, viewing people as all good or all bad. Transference (A) is
projecting past feelings onto the nurse. Projection (C) attributes one's
own feelings to others.
8. A client on phenelzine (MAOI) asks about dietary restrictions. Which
food must be avoided?
A. Fresh apple
B. Grilled chicken
C. Aged cheddar cheese
D. Steamed rice
Answer: C
Rationale: Aged cheeses are high in tyramine and can cause
hypertensive crisis when combined with MAOIs. Fresh fruits, meats,
and rice are safe.
9. A client with auditory hallucinations tells the nurse, "The voices are
telling me to hurt myself." Which is the best therapeutic response?
A. "The voices aren't real; just ignore them."
B. "I don't hear voices, but I understand that you are frightened."
C. "Why would you listen to them?"
D. "You should go to your room until the voices stop."
Answer: B
Rationale: This response validates the client's experience without
reinforcing the hallucination. Dismissing (A) or asking "why" (C) is non-
therapeutic. Isolation (D) may increase risk.
pg. 4
