Page 1 of 88
ATI RN MENTAL HEALTH PROCTORED EXAM TEST
BANK WITH NGN ACTUAL EXAM PREP 2026 ALL
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES ALREADY A GRADED WITH
EXPERT FEEDBACK|NEW AND REVISED
1. A nurse is establishing a therapeutic relationship with a patient who
has major depressive disorder. Which action by the nurse demonstrates
the principle of genuineness?
A) Using a standardized greeting for all patients
B) Responding authentically and congruently while maintaining
professional boundaries
C) Agreeing with the patient’s negative self-statements to build rapport
D) Avoiding self-disclosure of any kind to maintain objectivity
Rationale: Genuineness involves being real, honest, and authentic.
The nurse’s responses should match their feelings. Superficial or
formulaic responses are not genuine. Agreeing with negative
statements reinforces distortions; complete self-avoidance is not
necessary.
2. A patient with borderline personality disorder tells the nurse, “You’re
the only one who understands me; the other nurses don’t care.” Which is
the nurse’s most therapeutic response?
A) “Thank you. I’m glad we have a connection.”
B) “It must feel lonely when you think others don’t care. The
treatment team works together to support you.”
C) “You’re right, the night nurse is often busy.”
D) “I’ll make sure you only work with me.”
Rationale: This response avoids reinforcing splitting (idealizing one
staff, devaluing others). It validates the patient’s feeling while
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redirecting to the team approach. Taking sides or promising exclusive
attention would worsen splitting.
3. A nurse is caring for a patient experiencing a panic attack. Which
intervention is most appropriate initially?
A) Teach deep breathing and relaxation techniques
B) Remain with the patient, speak calmly, and reduce
environmental stimuli
C) Administer a PRN benzodiazepine without waiting
D) Ask the patient to describe the cause of the anxiety
Rationale: During a panic attack, the patient cannot process complex
instructions. The priority is to provide safety, presence, and a calm
environment. Teaching comes after the acute phase. PRN medication
may be needed, but not as first action without assessment.
4. A patient on an inpatient unit tells the nurse, “I want to leave right
now. You can’t keep me here.” The patient was voluntarily admitted two
hours ago. Which response is correct?
A) “You have the right to leave at any time.”
B) “Because you are here voluntarily, you can request discharge,
but the provider must evaluate you first to ensure you are not a
danger to yourself or others.”
C) “You are here involuntarily, so you cannot leave.”
D) “I will call security to restrain you.”
Rationale: Voluntarily admitted patients have the right to request
discharge; however, the facility may require an evaluation (usually by
a provider) and may initiate involuntary commitment if the patient
poses a risk. The nurse should explain the process without coercion.
5. A nurse is assessing a patient with schizophrenia who reports hearing
voices telling him to “stay away from windows.” The nurse should first:
A) Ask the patient if he intends to follow the command
B) Assess the content of the command and the patient’s intent to
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harm himself or others
C) Distract the patient by changing the subject
D) Administer an antipsychotic medication immediately
Rationale: Command hallucinations require immediate safety
assessment. The nurse must determine if the command is dangerous
(e.g., self-harm, violence) and if the patient feels compelled to obey.
Distraction or medication without assessment is premature.
6. A patient with alcohol use disorder is prescribed disulfiram. The
nurse’s teaching should include the consequence of drinking alcohol
while taking this medication:
A) Euphoria and disinhibition
B) Nausea, vomiting, flushing, and hypotension (disulfiram-ethanol
reaction)
C) Enhanced alertness and decreased craving
D) Immediate sedation and respiratory depression
Rationale: Disulfiram blocks aldehyde dehydrogenase, causing
acetaldehyde accumulation when alcohol is consumed. This produces
a severe unpleasant reaction (flushing, N/V, hypotension). It is a
deterrent, not a treatment for withdrawal.
7. According to the American Nurses Association (ANA) Code of
Ethics, a nurse’s primary commitment is to:
A) The healthcare institution
B) The patient, whether an individual, family, group, community, or
population
C) The physician’s orders
D) Cost-containment measures
Rationale: The Code of Ethics clearly states that the nurse’s primary
commitment is to the patient. This supersedes loyalty to institutions,
providers, or financial constraints.
, Page 4 of 88
8. A patient with posttraumatic stress disorder (PTSD) reports recurrent
nightmares about a military combat event. The nurse knows this
symptom is related to which cluster of PTSD symptoms?
A) Hyperarousal
B) Negative alterations in cognition and mood
C) Intrusion (re-experiencing)
D) Dissociative symptoms
Rationale: Intrusion symptoms include recurrent, involuntary, and
distressing memories, dreams, or flashbacks related to the traumatic
event. Hyperarousal includes sleep disturbance (not specific to trauma
content).
9. A patient with schizophrenia is experiencing alogia. Which clinical
manifestation would the nurse observe?
A) Echolalia (repeating others’ words)
B) Poverty of speech; reduced fluency and output
C) Inability to experience pleasure (anhedonia)
D) Purposeless, repetitive movements
Rationale: Alogia refers to poverty of speech, reduced content, and
prolonged latency in responding. It is a negative symptom of
schizophrenia. Echolalia is a disorganized speech symptom.
Anhedonia is also a negative symptom but distinct.
10. A nurse is preparing to discharge a patient who has been treated for
suicidal ideation. Which component is essential in the safety plan?
A) A signed no-suicide contract
B) A list of personal warning signs, internal coping strategies, and
emergency contacts
C) A promise to call the nurse every day
D) A prescription for unlimited benzodiazepines
Rationale: Evidence-based safety planning includes warning signs,
coping strategies, social contacts, professional contacts, and means
ATI RN MENTAL HEALTH PROCTORED EXAM TEST
BANK WITH NGN ACTUAL EXAM PREP 2026 ALL
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES ALREADY A GRADED WITH
EXPERT FEEDBACK|NEW AND REVISED
1. A nurse is establishing a therapeutic relationship with a patient who
has major depressive disorder. Which action by the nurse demonstrates
the principle of genuineness?
A) Using a standardized greeting for all patients
B) Responding authentically and congruently while maintaining
professional boundaries
C) Agreeing with the patient’s negative self-statements to build rapport
D) Avoiding self-disclosure of any kind to maintain objectivity
Rationale: Genuineness involves being real, honest, and authentic.
The nurse’s responses should match their feelings. Superficial or
formulaic responses are not genuine. Agreeing with negative
statements reinforces distortions; complete self-avoidance is not
necessary.
2. A patient with borderline personality disorder tells the nurse, “You’re
the only one who understands me; the other nurses don’t care.” Which is
the nurse’s most therapeutic response?
A) “Thank you. I’m glad we have a connection.”
B) “It must feel lonely when you think others don’t care. The
treatment team works together to support you.”
C) “You’re right, the night nurse is often busy.”
D) “I’ll make sure you only work with me.”
Rationale: This response avoids reinforcing splitting (idealizing one
staff, devaluing others). It validates the patient’s feeling while
,Page 2 of 88
redirecting to the team approach. Taking sides or promising exclusive
attention would worsen splitting.
3. A nurse is caring for a patient experiencing a panic attack. Which
intervention is most appropriate initially?
A) Teach deep breathing and relaxation techniques
B) Remain with the patient, speak calmly, and reduce
environmental stimuli
C) Administer a PRN benzodiazepine without waiting
D) Ask the patient to describe the cause of the anxiety
Rationale: During a panic attack, the patient cannot process complex
instructions. The priority is to provide safety, presence, and a calm
environment. Teaching comes after the acute phase. PRN medication
may be needed, but not as first action without assessment.
4. A patient on an inpatient unit tells the nurse, “I want to leave right
now. You can’t keep me here.” The patient was voluntarily admitted two
hours ago. Which response is correct?
A) “You have the right to leave at any time.”
B) “Because you are here voluntarily, you can request discharge,
but the provider must evaluate you first to ensure you are not a
danger to yourself or others.”
C) “You are here involuntarily, so you cannot leave.”
D) “I will call security to restrain you.”
Rationale: Voluntarily admitted patients have the right to request
discharge; however, the facility may require an evaluation (usually by
a provider) and may initiate involuntary commitment if the patient
poses a risk. The nurse should explain the process without coercion.
5. A nurse is assessing a patient with schizophrenia who reports hearing
voices telling him to “stay away from windows.” The nurse should first:
A) Ask the patient if he intends to follow the command
B) Assess the content of the command and the patient’s intent to
,Page 3 of 88
harm himself or others
C) Distract the patient by changing the subject
D) Administer an antipsychotic medication immediately
Rationale: Command hallucinations require immediate safety
assessment. The nurse must determine if the command is dangerous
(e.g., self-harm, violence) and if the patient feels compelled to obey.
Distraction or medication without assessment is premature.
6. A patient with alcohol use disorder is prescribed disulfiram. The
nurse’s teaching should include the consequence of drinking alcohol
while taking this medication:
A) Euphoria and disinhibition
B) Nausea, vomiting, flushing, and hypotension (disulfiram-ethanol
reaction)
C) Enhanced alertness and decreased craving
D) Immediate sedation and respiratory depression
Rationale: Disulfiram blocks aldehyde dehydrogenase, causing
acetaldehyde accumulation when alcohol is consumed. This produces
a severe unpleasant reaction (flushing, N/V, hypotension). It is a
deterrent, not a treatment for withdrawal.
7. According to the American Nurses Association (ANA) Code of
Ethics, a nurse’s primary commitment is to:
A) The healthcare institution
B) The patient, whether an individual, family, group, community, or
population
C) The physician’s orders
D) Cost-containment measures
Rationale: The Code of Ethics clearly states that the nurse’s primary
commitment is to the patient. This supersedes loyalty to institutions,
providers, or financial constraints.
, Page 4 of 88
8. A patient with posttraumatic stress disorder (PTSD) reports recurrent
nightmares about a military combat event. The nurse knows this
symptom is related to which cluster of PTSD symptoms?
A) Hyperarousal
B) Negative alterations in cognition and mood
C) Intrusion (re-experiencing)
D) Dissociative symptoms
Rationale: Intrusion symptoms include recurrent, involuntary, and
distressing memories, dreams, or flashbacks related to the traumatic
event. Hyperarousal includes sleep disturbance (not specific to trauma
content).
9. A patient with schizophrenia is experiencing alogia. Which clinical
manifestation would the nurse observe?
A) Echolalia (repeating others’ words)
B) Poverty of speech; reduced fluency and output
C) Inability to experience pleasure (anhedonia)
D) Purposeless, repetitive movements
Rationale: Alogia refers to poverty of speech, reduced content, and
prolonged latency in responding. It is a negative symptom of
schizophrenia. Echolalia is a disorganized speech symptom.
Anhedonia is also a negative symptom but distinct.
10. A nurse is preparing to discharge a patient who has been treated for
suicidal ideation. Which component is essential in the safety plan?
A) A signed no-suicide contract
B) A list of personal warning signs, internal coping strategies, and
emergency contacts
C) A promise to call the nurse every day
D) A prescription for unlimited benzodiazepines
Rationale: Evidence-based safety planning includes warning signs,
coping strategies, social contacts, professional contacts, and means
