ATI RN Mental Health Exam with NGN Format – Updated
Practice and Rationales
A charge nurse is discussing mental status examinations with a newly licensed nurse.
Which of the following statements by the newly licensed nurse indicates a need for
further teaching?
A. "To assess cognitive ability, I should ask the client to count backward by 7."
B. "To assess affect, I should observe the client's facial expression."
C. "To assess language ability, I should instruct the client to write a sentence."
D. "To assess remote memory, I should have the client repeat a list of objec -
AnswerD. "To assess remote memory, I should have the client repeat a list of
objects."
Asking the client to repeat a list of objects is appropriate to assess immediate, rather
than remote, memory.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
A nurse is planning care for a client who has a mental health disorder. Which of the
following is appropriate to include as a psychobiological intervention?
A. Assist the client with systematic desensitization therapy.
B. Teach the client appropriate coping mechanisms.
C. Assess the client for comorbid health conditions.
D. Monitor the client for adverse effects of medications.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises - AnswerD.
Monitor the client for adverse effects of medications.
Assisting with systematic desensitization therapy is a cognitive and behavioral.
Teaching appropriate coping mechanisms is a counseling or health teaching.
Assessing for comorbid health conditions is health promotion and maintenance.
D. Monitoring for adverse effects of medications is an example of a psychobiological
intervention.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
A nurse in an outpatient mental health clinic is preparing to conduct an initial client
interview. When conducting the interview, which of the following is the highest priority
action?
A. Respect the client's need for personal space.
B. Identify the client's perception of her mental health status.
C. Include the client's family in the interview.
,D. Teach the client about her current mental health disorder.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises - Answer*B.
Identify the client's perception of her mental health status.*
A. Appropriate, but not highest priority.
B. Assessment is the priority action when taking the nursing process approach.
Identifying the client's perception of her mental health status provides important
information about the client's psychosocial history.
C. Appropriate, but not highest priority.
D. Appropriate, but not highest priority.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
A nurse is told during change-of-shift report that a client is stuporous. When assessing
the client, which of the following is an expected finding?
A. The client arouses briefly in response to a sternal rib.
B. The client has a Glasgow Coma Scale score less than 7.
C. The client exhibits decorticate rigidity.
D. The client is alert but disoriented to time and place.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises - Answer*A. The
client arouses briefly in response to a sternal rib.*
A. A client who is stuporous requires vigorous or painful stimuli to elicit a response.
B. <7 on GCS indicates comatose, not stuporous, level of consciousness.
C. Abnormal posturing = comatose.
D. Stuporous /= alert.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
A nurse is planning a peer group discussion about the Diagnostic and Statistical Manual
of Mental Disorders, 5th Edition (DSM-5). Which of the following is appropriate to
include in the discussion? (SATA)
A. The DSM-5 is used to identify mental health disorders.
B. The DSM-5 establishes diagnostic criteria.
C. The DSM-5 indicates recommended pharmacological treatment.
D. The DSM-5 assists nurses in planning care.
E. The DSM-5 indicates expected assessment findings.
ATI RN Mental Health Nursing - AnswerA, B, D, E.
,The DSM-5 is used as a diagnostic tool, establishes diagnostic criteria, used by nurses
to plan, implement, and evaluate care, and identifies expected findings for mental health
disorders.
It does not indicate pharmacological treatment.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
Which of the following is an example of a client who requires emergency admission to a
mental health facility?
A. A client with schizophrenia who has frequent hallucinations.
B. A client with symptoms of depression who attempted suicide a year ago.
C. A client with borderline personality disorder who assaulted a homeless man with a
metal rod.
D. A client with bipolar disorder who paces quickly down the sidewalk while talking to
himself.
ATI RN Mental Health Nursing Modules Ch. 2 Application Ex - AnswerC. A client with
borderline personality disorder who assaulted a homeless man with a metal rod.
Hallucinations, depression, and/or pacing does not constitute clear reason for
emergency commitment.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
A client tells a student nurse, "Don't tell anyone, but I hid a sharp knife under my
mattress in order to protect myself from my roommate, who is always yelling at me and
threatening me." Which of the following actions should the nurse take?
A. Keep the client's communication confidential, but talk to the client daily, using
therapeutic communication to convince him to admit to holding the knife.
B. Keep the client's communication confidential, but watch the client and his roommate
closely.
C. - AnswerC. Tell the client that this must be reported to health care staff because it
concerns the health and safety of the client and others.
The information cannot be kept confidential and the client must be informed that this will
be reported to the health care staff.
• This is a serious safety issue that must be reported to the staff. Using the principle of
veracity, the student tells this client truthfully what must be done regarding the issue.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
, A nurse decides to put a client who has psychosis in seclusion overnight because the
unit is very short-staffed, and the client frequently fights with other clients. This is an
example of:
A. beneficence.
B. a tort.
C. a facility policy.
D. justice.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises - AnswerB. a tort.
Beneficence: doing good for a client.
Tort: a civil wrong that violates a client's civil rights.
If a policy, the facility would be in violation of federal and state statute, and the nurse
could be held responsible.
Justice: action involving the fair and equal treatment of clients.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
A nurse is caring for a client in restraints. Which of the following statements are
appropriate documentation? (SATA)
A. " Client ate most of his breakfast."
B. "Client was offered 8oz of water every hr."
C. "Client shouted at assistive personnel."
D. "Client received chlorpromazine (Thorazine) 15mg by mouth at 1000."
E. "Client acted out after lunch." - AnswerB, C, D: Objective data is correct, not
subjective.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
A nurse hears a newly licensed nurse discussing a client's hallucinations in the hallway
with another nurse. Which of the following actions should the nurse take first?
A. Notify the nurse manager.
B. Tell the nurse to stop discussing the behavior.
C. Provide an in-service program about confidentiality.
D. Complete an incident report.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises - Answer*B. Tell
the nurse to stop discussing the behavior.*
The nurse should notify the nurse manager, provide in-service, and complete an
incident report, but these actions are not the first to take.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
Practice and Rationales
A charge nurse is discussing mental status examinations with a newly licensed nurse.
Which of the following statements by the newly licensed nurse indicates a need for
further teaching?
A. "To assess cognitive ability, I should ask the client to count backward by 7."
B. "To assess affect, I should observe the client's facial expression."
C. "To assess language ability, I should instruct the client to write a sentence."
D. "To assess remote memory, I should have the client repeat a list of objec -
AnswerD. "To assess remote memory, I should have the client repeat a list of
objects."
Asking the client to repeat a list of objects is appropriate to assess immediate, rather
than remote, memory.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
A nurse is planning care for a client who has a mental health disorder. Which of the
following is appropriate to include as a psychobiological intervention?
A. Assist the client with systematic desensitization therapy.
B. Teach the client appropriate coping mechanisms.
C. Assess the client for comorbid health conditions.
D. Monitor the client for adverse effects of medications.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises - AnswerD.
Monitor the client for adverse effects of medications.
Assisting with systematic desensitization therapy is a cognitive and behavioral.
Teaching appropriate coping mechanisms is a counseling or health teaching.
Assessing for comorbid health conditions is health promotion and maintenance.
D. Monitoring for adverse effects of medications is an example of a psychobiological
intervention.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
A nurse in an outpatient mental health clinic is preparing to conduct an initial client
interview. When conducting the interview, which of the following is the highest priority
action?
A. Respect the client's need for personal space.
B. Identify the client's perception of her mental health status.
C. Include the client's family in the interview.
,D. Teach the client about her current mental health disorder.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises - Answer*B.
Identify the client's perception of her mental health status.*
A. Appropriate, but not highest priority.
B. Assessment is the priority action when taking the nursing process approach.
Identifying the client's perception of her mental health status provides important
information about the client's psychosocial history.
C. Appropriate, but not highest priority.
D. Appropriate, but not highest priority.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
A nurse is told during change-of-shift report that a client is stuporous. When assessing
the client, which of the following is an expected finding?
A. The client arouses briefly in response to a sternal rib.
B. The client has a Glasgow Coma Scale score less than 7.
C. The client exhibits decorticate rigidity.
D. The client is alert but disoriented to time and place.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises - Answer*A. The
client arouses briefly in response to a sternal rib.*
A. A client who is stuporous requires vigorous or painful stimuli to elicit a response.
B. <7 on GCS indicates comatose, not stuporous, level of consciousness.
C. Abnormal posturing = comatose.
D. Stuporous /= alert.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
A nurse is planning a peer group discussion about the Diagnostic and Statistical Manual
of Mental Disorders, 5th Edition (DSM-5). Which of the following is appropriate to
include in the discussion? (SATA)
A. The DSM-5 is used to identify mental health disorders.
B. The DSM-5 establishes diagnostic criteria.
C. The DSM-5 indicates recommended pharmacological treatment.
D. The DSM-5 assists nurses in planning care.
E. The DSM-5 indicates expected assessment findings.
ATI RN Mental Health Nursing - AnswerA, B, D, E.
,The DSM-5 is used as a diagnostic tool, establishes diagnostic criteria, used by nurses
to plan, implement, and evaluate care, and identifies expected findings for mental health
disorders.
It does not indicate pharmacological treatment.
ATI RN Mental Health Nursing Modules Ch. 1 Application Exercises
Which of the following is an example of a client who requires emergency admission to a
mental health facility?
A. A client with schizophrenia who has frequent hallucinations.
B. A client with symptoms of depression who attempted suicide a year ago.
C. A client with borderline personality disorder who assaulted a homeless man with a
metal rod.
D. A client with bipolar disorder who paces quickly down the sidewalk while talking to
himself.
ATI RN Mental Health Nursing Modules Ch. 2 Application Ex - AnswerC. A client with
borderline personality disorder who assaulted a homeless man with a metal rod.
Hallucinations, depression, and/or pacing does not constitute clear reason for
emergency commitment.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
A client tells a student nurse, "Don't tell anyone, but I hid a sharp knife under my
mattress in order to protect myself from my roommate, who is always yelling at me and
threatening me." Which of the following actions should the nurse take?
A. Keep the client's communication confidential, but talk to the client daily, using
therapeutic communication to convince him to admit to holding the knife.
B. Keep the client's communication confidential, but watch the client and his roommate
closely.
C. - AnswerC. Tell the client that this must be reported to health care staff because it
concerns the health and safety of the client and others.
The information cannot be kept confidential and the client must be informed that this will
be reported to the health care staff.
• This is a serious safety issue that must be reported to the staff. Using the principle of
veracity, the student tells this client truthfully what must be done regarding the issue.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
, A nurse decides to put a client who has psychosis in seclusion overnight because the
unit is very short-staffed, and the client frequently fights with other clients. This is an
example of:
A. beneficence.
B. a tort.
C. a facility policy.
D. justice.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises - AnswerB. a tort.
Beneficence: doing good for a client.
Tort: a civil wrong that violates a client's civil rights.
If a policy, the facility would be in violation of federal and state statute, and the nurse
could be held responsible.
Justice: action involving the fair and equal treatment of clients.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
A nurse is caring for a client in restraints. Which of the following statements are
appropriate documentation? (SATA)
A. " Client ate most of his breakfast."
B. "Client was offered 8oz of water every hr."
C. "Client shouted at assistive personnel."
D. "Client received chlorpromazine (Thorazine) 15mg by mouth at 1000."
E. "Client acted out after lunch." - AnswerB, C, D: Objective data is correct, not
subjective.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
A nurse hears a newly licensed nurse discussing a client's hallucinations in the hallway
with another nurse. Which of the following actions should the nurse take first?
A. Notify the nurse manager.
B. Tell the nurse to stop discussing the behavior.
C. Provide an in-service program about confidentiality.
D. Complete an incident report.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises - Answer*B. Tell
the nurse to stop discussing the behavior.*
The nurse should notify the nurse manager, provide in-service, and complete an
incident report, but these actions are not the first to take.
ATI RN Mental Health Nursing Modules Ch. 2 Application Exercises
