ATI RN Mental Health Proctored Exam
Practice 2026 | 75 NGN Questions, Answers
& Rationales | Comprehensive Review &
Retake Prep Guide
• Features: Proctored-style ATI RN Mental Health practice items with A–E
stacked options, highlighted correct choice, and correct answer +
EXPERT RATIONALE placed below the options.
• Study use: Read EXPERT RATIONALE immediately, then retake targeting
weak topics (safety, psychopharm, therapeutic communication, therapies,
NGN-style prioritization).
Question 1. A client with schizophrenia is experiencing command
hallucinations to harm themselves. Which action should the nurse take first?
A. Ask the client why they are hearing voices
B. Assess immediate safety and initiate suicide/self-harm precautions
C. Encourage the client to focus on positive thoughts
D. Provide scheduled antipsychotic medication at the next due time
E. Wait to notify the provider until the next shift report
Correct Answer: B
EXPERT RATIONALE: Command hallucinations with self-harm intent create an
immediate safety risk. The priority is to protect the client by initiating suicide/self-
harm precautions, assessing risk, and escalating urgency to the appropriate
staff/provider.
Question 2. A client with bipolar disorder has decreased need for sleep,
increased energy, pressured speech, and risky behaviors. The nurse
documents which diagnosis?
A. Major depressive disorder
B. Generalized anxiety disorder
C. Acute mania
,D. Obsessive-compulsive disorder
E. Borderline personality disorder
Correct Answer: C
EXPERT RATIONALE: Decreased need for sleep, pressured speech, increased
energy, and risky behavior are classic symptoms of a manic episode (acute mania).
Question 3. A client becomes increasingly agitated on the unit. Which nursing
intervention is best initially?
A. Confront the client’s delusions
B. Use a calm tone and reduce stimuli while assessing risk for violence
C. Leave the client alone to cool down
D. Increase group activities to redirect energy
E. Require the client to explain irrational thoughts immediately
Correct Answer: B
EXPERT RATIONALE: Agitation increases risk of harm and may escalate if
challenged. Initial priorities include maintaining safety, using therapeutic
communication, and reducing environmental stimuli while assessing potential for
violence.
Question 4. The nurse is teaching a client about lithium therapy. Which
statement by the client indicates understanding?
A. “I should increase salt intake to help prevent dehydration.”
B. “It’s safe to stop lithium once symptoms improve.”
C. “I will report nausea, tremor, or diarrhea right away.”
D. “I don’t need periodic blood tests.”
E. “I can take ibuprofen daily without checking levels.”
,Correct Answer: C
EXPERT RATIONALE: Gastrointestinal upset, tremor, and diarrhea may signal
lithium toxicity. Lithium requires monitoring, and clients must report early signs
promptly.
Question 5. A client with severe depression says, “The world would be better
without me.” What is the nurse’s priority response?
A. Tell the client they are being negative
B. Assess for suicidal intent and ensure safety measures are initiated
C. Reassure the client that suicide is never an option
D. Ask about medication side effects first
E. Contact the provider only after the next scheduled assessment
Correct Answer: B
EXPERT RATIONALE: Statements about self-worthlessness or being better off dead
require immediate suicide risk assessment and safety intervention. Medication
review can occur after safety is addressed.
Question 6. Which finding would most concern the nurse in a client taking
antipsychotic medication?
A. Mild dry mouth
B. Increased appetite
C. Muscle rigidity, fever, and autonomic instability
D. Sedation at bedtime
E. Weight gain over several months
Correct Answer: C
EXPERT RATIONALE: Muscle rigidity plus fever and autonomic instability suggests
, neuroleptic malignant syndrome (NMS), a medical emergency requiring urgent
intervention and discontinuation per protocol.
Question 7. A client in alcohol withdrawal has tremors, diaphoresis, and
hallucinations. What nursing action is most important?
A. Encourage the client to drink fluids without monitoring
B. Monitor vital signs closely and prepare for benzodiazepine therapy
C. Provide a stimulating environment to reduce sleepiness
D. Encourage the client to walk around to reduce anxiety
E. Stop all monitoring once hallucinations decrease
Correct Answer: B
EXPERT RATIONALE: Alcohol withdrawal can progress to seizures and delirium
tremens. Frequent monitoring and timely benzodiazepine administration are key to
preventing life-threatening complications.
Question 8. Which therapeutic communication response best demonstrates
empathy to a client who says, “No one understands me”?
A. “You shouldn’t feel that way.”
B. “It sounds like you feel alone and unheard—tell me more about what
you’re experiencing.”
C. “I’m sure your family understands.”
D. “Everyone feels that way sometimes.”
E. “If you take your meds, you’ll feel better.”
Correct Answer: B
EXPERT RATIONALE: Reflection of emotion and invitation to share encourages
therapeutic communication and builds rapport without dismissing or arguing.
Practice 2026 | 75 NGN Questions, Answers
& Rationales | Comprehensive Review &
Retake Prep Guide
• Features: Proctored-style ATI RN Mental Health practice items with A–E
stacked options, highlighted correct choice, and correct answer +
EXPERT RATIONALE placed below the options.
• Study use: Read EXPERT RATIONALE immediately, then retake targeting
weak topics (safety, psychopharm, therapeutic communication, therapies,
NGN-style prioritization).
Question 1. A client with schizophrenia is experiencing command
hallucinations to harm themselves. Which action should the nurse take first?
A. Ask the client why they are hearing voices
B. Assess immediate safety and initiate suicide/self-harm precautions
C. Encourage the client to focus on positive thoughts
D. Provide scheduled antipsychotic medication at the next due time
E. Wait to notify the provider until the next shift report
Correct Answer: B
EXPERT RATIONALE: Command hallucinations with self-harm intent create an
immediate safety risk. The priority is to protect the client by initiating suicide/self-
harm precautions, assessing risk, and escalating urgency to the appropriate
staff/provider.
Question 2. A client with bipolar disorder has decreased need for sleep,
increased energy, pressured speech, and risky behaviors. The nurse
documents which diagnosis?
A. Major depressive disorder
B. Generalized anxiety disorder
C. Acute mania
,D. Obsessive-compulsive disorder
E. Borderline personality disorder
Correct Answer: C
EXPERT RATIONALE: Decreased need for sleep, pressured speech, increased
energy, and risky behavior are classic symptoms of a manic episode (acute mania).
Question 3. A client becomes increasingly agitated on the unit. Which nursing
intervention is best initially?
A. Confront the client’s delusions
B. Use a calm tone and reduce stimuli while assessing risk for violence
C. Leave the client alone to cool down
D. Increase group activities to redirect energy
E. Require the client to explain irrational thoughts immediately
Correct Answer: B
EXPERT RATIONALE: Agitation increases risk of harm and may escalate if
challenged. Initial priorities include maintaining safety, using therapeutic
communication, and reducing environmental stimuli while assessing potential for
violence.
Question 4. The nurse is teaching a client about lithium therapy. Which
statement by the client indicates understanding?
A. “I should increase salt intake to help prevent dehydration.”
B. “It’s safe to stop lithium once symptoms improve.”
C. “I will report nausea, tremor, or diarrhea right away.”
D. “I don’t need periodic blood tests.”
E. “I can take ibuprofen daily without checking levels.”
,Correct Answer: C
EXPERT RATIONALE: Gastrointestinal upset, tremor, and diarrhea may signal
lithium toxicity. Lithium requires monitoring, and clients must report early signs
promptly.
Question 5. A client with severe depression says, “The world would be better
without me.” What is the nurse’s priority response?
A. Tell the client they are being negative
B. Assess for suicidal intent and ensure safety measures are initiated
C. Reassure the client that suicide is never an option
D. Ask about medication side effects first
E. Contact the provider only after the next scheduled assessment
Correct Answer: B
EXPERT RATIONALE: Statements about self-worthlessness or being better off dead
require immediate suicide risk assessment and safety intervention. Medication
review can occur after safety is addressed.
Question 6. Which finding would most concern the nurse in a client taking
antipsychotic medication?
A. Mild dry mouth
B. Increased appetite
C. Muscle rigidity, fever, and autonomic instability
D. Sedation at bedtime
E. Weight gain over several months
Correct Answer: C
EXPERT RATIONALE: Muscle rigidity plus fever and autonomic instability suggests
, neuroleptic malignant syndrome (NMS), a medical emergency requiring urgent
intervention and discontinuation per protocol.
Question 7. A client in alcohol withdrawal has tremors, diaphoresis, and
hallucinations. What nursing action is most important?
A. Encourage the client to drink fluids without monitoring
B. Monitor vital signs closely and prepare for benzodiazepine therapy
C. Provide a stimulating environment to reduce sleepiness
D. Encourage the client to walk around to reduce anxiety
E. Stop all monitoring once hallucinations decrease
Correct Answer: B
EXPERT RATIONALE: Alcohol withdrawal can progress to seizures and delirium
tremens. Frequent monitoring and timely benzodiazepine administration are key to
preventing life-threatening complications.
Question 8. Which therapeutic communication response best demonstrates
empathy to a client who says, “No one understands me”?
A. “You shouldn’t feel that way.”
B. “It sounds like you feel alone and unheard—tell me more about what
you’re experiencing.”
C. “I’m sure your family understands.”
D. “Everyone feels that way sometimes.”
E. “If you take your meds, you’ll feel better.”
Correct Answer: B
EXPERT RATIONALE: Reflection of emotion and invitation to share encourages
therapeutic communication and builds rapport without dismissing or arguing.
