ATI MENTAL HEALTH CMS/MENTAL HEALTH CMS NEWEST 2026 ACTUAL
EXAM/NEWEST UPDATE!!!
Question 1
A nurse is caring for a client who states, "I have been having trouble sleeping for the last several
months." Which of the following responses should the nurse make?
A) "You should try to take a nap in the late afternoon to catch up on rest."
B) "You should avoid stressful activities prior to going to sleep."
C) "You should drink a cup of hot cocoa or caffeinated tea before bed."
D) "You should exercise vigorously right before you plan to sleep."
E) "You should stay in bed and watch television until you feel tired."
Correct Answer: B) You should avoid stressful activities prior to going to sleep.
Rationale: Stressful activities increase cortisol levels and stimulate the sympathetic nervous
system, making it difficult for the body to transition into a restful state. Proper sleep
hygiene includes creating a calm environment and engaging in relaxing activities before
bed. Napping late in the day (A), caffeine (C), and vigorous exercise right before bed (D)
interfere with the circadian rhythm, while watching TV in bed (E) associates the bed with
wakefulness rather than sleep.
Question 2
A nurse is recommending community resources for a client who has a chronic mental illness and
agrees to outpatient treatment. Which of the following outpatient care settings should the nurse
identify as a community resource for the client?
A) Acute care inpatient unit
B) Intensive care unit
C) Assertive Community Treatment (ACT)
D) Skilled nursing facility
E) Holistic massage center
Correct Answer: C) Assertive Community Treatment (ACT)
Rationale: ACT is an intensive, team-based approach to provide comprehensive,
community-based psychiatric treatment, rehabilitation, and support to persons with
serious and persistent mental illness. It is specifically designed to help clients who have
difficulty meeting their basic needs or staying out of the hospital. Acute care (A) and ICU
(B) are inpatient settings, not outpatient community resources.
Question 3
A nurse is caring for a client who is under observation for suicidal ideation and has verbalized a
suicide plan. The client demands privacy and to be left alone. Which of the following statements
should the nurse make?
A) "I will give you 15 minutes of alone time to process your feelings."
B) "I understand you want to be alone, so I will check on you every hour."
C) "We are concerned about you and need to keep you safe."
D) "Privacy is a right that we cannot take away, even in the hospital."
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E) "If you stop talking about suicide, we can allow you to have more privacy."
Correct Answer: C) "We are concerned about you and need to keep you safe."
Rationale: When a client is at high risk for suicide and has verbalized a plan, safety takes
priority over the right to privacy. The nurse must maintain continuous observation (one-to-
one) or close monitoring depending on the facility protocol. Using a "we" approach and
focusing on safety validates the client's worth while maintaining necessary clinical
boundaries.
Question 4
A nurse in a mental health clinic is assessing a client who has borderline personality disorder.
Which of the following findings should the nurse expect?
A) Perfectionism and preoccupation with order
B) Excessive social anxiety and fear of criticism
C) Intense efforts to avoid abandonment
D) Lack of remorse for harming others
E) Grandiose sense of self-importance
Correct Answer: C) Intense efforts to avoid abandonment
Rationale: Borderline personality disorder is characterized by instability in relationships,
self-image, and affect. A hallmark sign is a frantic effort to avoid real or imagined
abandonment, along with "splitting" (viewing people as all good or all bad). Perfectionism
(A) is seen in OCPD, social anxiety (B) in Avoidant PD, lack of remorse (D) in Antisocial
PD, and grandiosity (E) in Narcissistic PD.
Question 5
A nurse is caring for a client who is involuntarily admitted for major depressive disorder and
refuses to take a prescribed oral antianxiety medication. Which of the following actions should
the nurse take?
A) Force the client to take the medication because they are involuntarily admitted.
B) Place the client in seclusion until they agree to take the medication.
C) Offer the client the medication at the next scheduled dose time.
D) Inform the client that they will be discharged if they continue to refuse.
E) Disguise the medication in the client's food.
Correct Answer: C) Offer the client the medication at the next scheduled dose time.
Rationale: Even clients who are involuntarily admitted retain the right to refuse medication,
unless they are a danger to themselves or others and meet specific court-ordered criteria
for forced medication. The nurse should respect the client's autonomy, document the
refusal, and offer it again at the next scheduled time to provide another opportunity for
compliance.
Question 6
A nurse is caring for a client who is prescribed massage therapy to treat panic disorder. The client
, 3
states, "I can't stand to be touched by another person." Which of the following responses should
the nurse make?
A) "Massage therapy is the best way to relax, so you should try to endure it."
B) "I will tell your provider that you would like a treatment other than massages."
C) "Why does being touched make you feel uncomfortable?"
D) "Maybe we can have a family member perform the massage instead."
E) "I will stay in the room with you during the massage so you feel safe."
Correct Answer: B) "I will tell your provider that you would like a treatment other than
massages."
Rationale: Patient-centered care requires the nurse to respect the client's preferences and
boundaries. If a treatment modality (massage) causes distress or violates personal
boundaries, the nurse should advocate for an alternative. Asking "Why" (C) is often non-
therapeutic as it can make the client defensive.
Question 7
A nurse is reviewing new prescriptions for a client who is experiencing acute manifestations of
alcohol withdrawal. Which of the following medications should the nurse expect the provider to
prescribe for this client?
A) Disulfiram
B) Varenicline
C) Chlordiazepoxide
D) Methadone
E) Bupropion
Correct Answer: C) Chlordiazepoxide
Rationale: Chlordiazepoxide is a benzodiazepine used to prevent seizures and stabilize vital
signs during acute alcohol withdrawal. Disulfiram (A) is used for maintenance/aversion
therapy after withdrawal. Varenicline (B) and Bupropion (E) are for smoking cessation.
Methadone (D) is for opioid use disorder.
Question 8
A nurse is caring for a client following a physical assault. The client states, "I don't remember
what happened to me." The nurse should recognize that the client is using which of the following
defense mechanisms?
A) Displacement
B) Denial
C) Repression
D) Projection
E) Sublimation
Correct Answer: C) Repression
Rationale: Repression is an unconscious defense mechanism where the mind pushes
, 4
traumatic or unacceptable ideas, impulses, or memories out of conscious awareness. This
explains why the client cannot remember the details of the assault. Displacement (A)
involves shifting feelings to a neutral object, while Projection (D) involves blaming others
for one's own thoughts.
Question 9
A charge nurse is discussing the care of a client who has a substance use disorder with a staff
nurse. Which of the following statements by the staff nurse should the charge nurse identify as
countertransference?
A) "I am feeling frustrated because the client won't follow the rules."
B) "The client is just like my brother who finally overcame his habit."
C) "I need to set firm boundaries with this client regarding their behavior."
D) "I am concerned that the client might relapse after discharge."
E) "The client's family seems very supportive of their recovery."
Correct Answer: B) "The client is just like my brother who finally overcame his habit."
Rationale: Countertransference occurs when a healthcare professional develops personal
feelings toward a client based on the professional's past relationships or experiences.
Identifying a client with a family member (the staff nurse's brother) can cloud professional
judgment and affect the therapeutic relationship.
Question 10
A nurse in a rehabilitation center is caring for a client who has bipolar disorder. Which of the
following actions by the client indicates mania?
A) The client sleeps for 10 hours at night.
B) The client is constantly talking.
C) The client refuses to leave their room.
D) The client maintains eye contact during conversation.
E) The client eats all of their meals quietly.
Correct Answer: B) The client is constantly talking.
Rationale: Mania is characterized by "pressure of speech," where the client talks
incessantly, often jumping from one topic to another (flight of ideas). Other signs include
decreased need for sleep, distractibility, and psychomotor agitation. Sleeping 10 hours (A),
refusing to leave the room (C), and eating quietly (E) are more indicative of depression or a
stable state.
Question 11
A nurse is providing teaching to a client who is newly diagnosed with Alzheimer's disease.
Which of the following treatment options should the nurse include in the teaching?
A) Cure the disease with high-dose vitamin therapy
B) Reverse memory loss with intensive brain exercises
C) Delaying cognitive impairment with NMDA receptor agonist medications
EXAM/NEWEST UPDATE!!!
Question 1
A nurse is caring for a client who states, "I have been having trouble sleeping for the last several
months." Which of the following responses should the nurse make?
A) "You should try to take a nap in the late afternoon to catch up on rest."
B) "You should avoid stressful activities prior to going to sleep."
C) "You should drink a cup of hot cocoa or caffeinated tea before bed."
D) "You should exercise vigorously right before you plan to sleep."
E) "You should stay in bed and watch television until you feel tired."
Correct Answer: B) You should avoid stressful activities prior to going to sleep.
Rationale: Stressful activities increase cortisol levels and stimulate the sympathetic nervous
system, making it difficult for the body to transition into a restful state. Proper sleep
hygiene includes creating a calm environment and engaging in relaxing activities before
bed. Napping late in the day (A), caffeine (C), and vigorous exercise right before bed (D)
interfere with the circadian rhythm, while watching TV in bed (E) associates the bed with
wakefulness rather than sleep.
Question 2
A nurse is recommending community resources for a client who has a chronic mental illness and
agrees to outpatient treatment. Which of the following outpatient care settings should the nurse
identify as a community resource for the client?
A) Acute care inpatient unit
B) Intensive care unit
C) Assertive Community Treatment (ACT)
D) Skilled nursing facility
E) Holistic massage center
Correct Answer: C) Assertive Community Treatment (ACT)
Rationale: ACT is an intensive, team-based approach to provide comprehensive,
community-based psychiatric treatment, rehabilitation, and support to persons with
serious and persistent mental illness. It is specifically designed to help clients who have
difficulty meeting their basic needs or staying out of the hospital. Acute care (A) and ICU
(B) are inpatient settings, not outpatient community resources.
Question 3
A nurse is caring for a client who is under observation for suicidal ideation and has verbalized a
suicide plan. The client demands privacy and to be left alone. Which of the following statements
should the nurse make?
A) "I will give you 15 minutes of alone time to process your feelings."
B) "I understand you want to be alone, so I will check on you every hour."
C) "We are concerned about you and need to keep you safe."
D) "Privacy is a right that we cannot take away, even in the hospital."
, 2
E) "If you stop talking about suicide, we can allow you to have more privacy."
Correct Answer: C) "We are concerned about you and need to keep you safe."
Rationale: When a client is at high risk for suicide and has verbalized a plan, safety takes
priority over the right to privacy. The nurse must maintain continuous observation (one-to-
one) or close monitoring depending on the facility protocol. Using a "we" approach and
focusing on safety validates the client's worth while maintaining necessary clinical
boundaries.
Question 4
A nurse in a mental health clinic is assessing a client who has borderline personality disorder.
Which of the following findings should the nurse expect?
A) Perfectionism and preoccupation with order
B) Excessive social anxiety and fear of criticism
C) Intense efforts to avoid abandonment
D) Lack of remorse for harming others
E) Grandiose sense of self-importance
Correct Answer: C) Intense efforts to avoid abandonment
Rationale: Borderline personality disorder is characterized by instability in relationships,
self-image, and affect. A hallmark sign is a frantic effort to avoid real or imagined
abandonment, along with "splitting" (viewing people as all good or all bad). Perfectionism
(A) is seen in OCPD, social anxiety (B) in Avoidant PD, lack of remorse (D) in Antisocial
PD, and grandiosity (E) in Narcissistic PD.
Question 5
A nurse is caring for a client who is involuntarily admitted for major depressive disorder and
refuses to take a prescribed oral antianxiety medication. Which of the following actions should
the nurse take?
A) Force the client to take the medication because they are involuntarily admitted.
B) Place the client in seclusion until they agree to take the medication.
C) Offer the client the medication at the next scheduled dose time.
D) Inform the client that they will be discharged if they continue to refuse.
E) Disguise the medication in the client's food.
Correct Answer: C) Offer the client the medication at the next scheduled dose time.
Rationale: Even clients who are involuntarily admitted retain the right to refuse medication,
unless they are a danger to themselves or others and meet specific court-ordered criteria
for forced medication. The nurse should respect the client's autonomy, document the
refusal, and offer it again at the next scheduled time to provide another opportunity for
compliance.
Question 6
A nurse is caring for a client who is prescribed massage therapy to treat panic disorder. The client
, 3
states, "I can't stand to be touched by another person." Which of the following responses should
the nurse make?
A) "Massage therapy is the best way to relax, so you should try to endure it."
B) "I will tell your provider that you would like a treatment other than massages."
C) "Why does being touched make you feel uncomfortable?"
D) "Maybe we can have a family member perform the massage instead."
E) "I will stay in the room with you during the massage so you feel safe."
Correct Answer: B) "I will tell your provider that you would like a treatment other than
massages."
Rationale: Patient-centered care requires the nurse to respect the client's preferences and
boundaries. If a treatment modality (massage) causes distress or violates personal
boundaries, the nurse should advocate for an alternative. Asking "Why" (C) is often non-
therapeutic as it can make the client defensive.
Question 7
A nurse is reviewing new prescriptions for a client who is experiencing acute manifestations of
alcohol withdrawal. Which of the following medications should the nurse expect the provider to
prescribe for this client?
A) Disulfiram
B) Varenicline
C) Chlordiazepoxide
D) Methadone
E) Bupropion
Correct Answer: C) Chlordiazepoxide
Rationale: Chlordiazepoxide is a benzodiazepine used to prevent seizures and stabilize vital
signs during acute alcohol withdrawal. Disulfiram (A) is used for maintenance/aversion
therapy after withdrawal. Varenicline (B) and Bupropion (E) are for smoking cessation.
Methadone (D) is for opioid use disorder.
Question 8
A nurse is caring for a client following a physical assault. The client states, "I don't remember
what happened to me." The nurse should recognize that the client is using which of the following
defense mechanisms?
A) Displacement
B) Denial
C) Repression
D) Projection
E) Sublimation
Correct Answer: C) Repression
Rationale: Repression is an unconscious defense mechanism where the mind pushes
, 4
traumatic or unacceptable ideas, impulses, or memories out of conscious awareness. This
explains why the client cannot remember the details of the assault. Displacement (A)
involves shifting feelings to a neutral object, while Projection (D) involves blaming others
for one's own thoughts.
Question 9
A charge nurse is discussing the care of a client who has a substance use disorder with a staff
nurse. Which of the following statements by the staff nurse should the charge nurse identify as
countertransference?
A) "I am feeling frustrated because the client won't follow the rules."
B) "The client is just like my brother who finally overcame his habit."
C) "I need to set firm boundaries with this client regarding their behavior."
D) "I am concerned that the client might relapse after discharge."
E) "The client's family seems very supportive of their recovery."
Correct Answer: B) "The client is just like my brother who finally overcame his habit."
Rationale: Countertransference occurs when a healthcare professional develops personal
feelings toward a client based on the professional's past relationships or experiences.
Identifying a client with a family member (the staff nurse's brother) can cloud professional
judgment and affect the therapeutic relationship.
Question 10
A nurse in a rehabilitation center is caring for a client who has bipolar disorder. Which of the
following actions by the client indicates mania?
A) The client sleeps for 10 hours at night.
B) The client is constantly talking.
C) The client refuses to leave their room.
D) The client maintains eye contact during conversation.
E) The client eats all of their meals quietly.
Correct Answer: B) The client is constantly talking.
Rationale: Mania is characterized by "pressure of speech," where the client talks
incessantly, often jumping from one topic to another (flight of ideas). Other signs include
decreased need for sleep, distractibility, and psychomotor agitation. Sleeping 10 hours (A),
refusing to leave the room (C), and eating quietly (E) are more indicative of depression or a
stable state.
Question 11
A nurse is providing teaching to a client who is newly diagnosed with Alzheimer's disease.
Which of the following treatment options should the nurse include in the teaching?
A) Cure the disease with high-dose vitamin therapy
B) Reverse memory loss with intensive brain exercises
C) Delaying cognitive impairment with NMDA receptor agonist medications
