ATI Mental Health Proctored Exam V3 |
2026 Q&A with Rationale (ATI Mental
Health Proctored Exam 2026)
1. A nurse is caring for a client who is experiencing a manic episode. Which of the following
interventions should the nurse prioritize?
A. Dim the lights and reduce environmental stimuli.
B. Provide high-calorie finger foods for the client to eat while walking.
C. Encourage the client to participate in a group volleyball game.
D. Allow the client to lead the community meeting.
Correct Answer: A
Rationale: Safety and stabilization are the primary goals for a client in an acute manic
state. Reducing environmental stimuli helps to decrease the client’s agitation and prevents
escalation of behavior. While nutrition is important, the immediate nursing priority is to
manage the environment for safety and containment.
2. A nurse is assessing a client for potential lithium toxicity. Which of the following findings
should the nurse identify as an early sign of toxicity?
A. Fine hand tremors
B. Slurred speech and ataxia
C. Seizures
,D. Polyuria and mild thirst
Correct Answer: B
Rationale: Slurred speech and muscle weakness or ataxia are early signs of lithium
toxicity, typically occurring at levels between 1.5 to 2.0 mEq/L. Fine hand tremors and
polyuria are common expected side effects at therapeutic levels, not indicators of toxicity.
Severe toxicity (above 2.5 mEq/L) can lead to seizures, coma, and death.
3. A nurse is conducting a health history for a client who has anorexia nervosa. Which of the
following clinical findings should the nurse expect?
A. Tachycardia
B. Hyperkalemia
C. Hypertension
D. Amenorrhea
Correct Answer: D
Rationale: Amenorrhea, or the absence of menstruation, is a classic physiological symptom
of anorexia nervosa due to low body weight and hormonal imbalances. Clients typically
exhibit bradycardia and hypotension rather than tachycardia or hypertension.
Hypokalemia is more common than hyperkalemia due to purging behaviors or
malnutrition.
,4. A nurse is caring for a client who was voluntarily admitted to the psychiatric unit. The client
states, ‘I want to leave right now.’ Which of the following responses should the nurse
provide?
A. I will notify the provider of your request to leave against medical advice.
B. You cannot leave until the doctor signs your discharge papers.
C. You signed yourself in, so you can leave whenever you want.
D. We will need to put you on an involuntary hold if you try to leave.
Correct Answer: A
Rationale: Voluntary clients have the right to request discharge, but they must follow the
facility’s legal protocol, which often involves a formal written request and evaluation. If the
client is not a danger to self or others, they can leave against medical advice (AMA). The
nurse must involve the provider to determine if the client meets criteria for involuntary
commitment before allowing them to leave.
5. A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse
notes the client has a high fever, muscle rigidity, and tachycardia. Which of the following
conditions should the nurse suspect?
A. Agranulocytosis
B. Tardive dyskinesia
C. Neuroleptic malignant syndrome (NMS)
D. Acute dystonia
, Correct Answer: C
Rationale: Neuroleptic malignant syndrome (NMS) is a life-threatening complication of
antipsychotic medications characterized by high fever, lead-pipe muscle rigidity, and
autonomic instability like tachycardia. Agranulocytosis involves low white blood cell
counts, while tardive dyskinesia involves involuntary movements of the tongue and face.
Acute dystonia involves sudden muscle spasms and is not typically associated with high
fever.
6. A nurse is teaching a client who has a new prescription for clozapine. Which of the
following laboratory tests should the nurse emphasize the need for regular monitoring?
A. Liver function tests
B. Serum creatinine
C. Thyroid stimulating hormone (TSH)
D. White blood cell (WBC) count
Correct Answer: D
Rationale: Clozapine carries a high risk for agranulocytosis, a severe reduction in white
blood cell count. Therefore, the client must undergo weekly WBC monitoring for the first
six months of treatment. Failure to monitor WBC count can lead to life-threatening
infections and is a strict requirement for prescribing the drug.
2026 Q&A with Rationale (ATI Mental
Health Proctored Exam 2026)
1. A nurse is caring for a client who is experiencing a manic episode. Which of the following
interventions should the nurse prioritize?
A. Dim the lights and reduce environmental stimuli.
B. Provide high-calorie finger foods for the client to eat while walking.
C. Encourage the client to participate in a group volleyball game.
D. Allow the client to lead the community meeting.
Correct Answer: A
Rationale: Safety and stabilization are the primary goals for a client in an acute manic
state. Reducing environmental stimuli helps to decrease the client’s agitation and prevents
escalation of behavior. While nutrition is important, the immediate nursing priority is to
manage the environment for safety and containment.
2. A nurse is assessing a client for potential lithium toxicity. Which of the following findings
should the nurse identify as an early sign of toxicity?
A. Fine hand tremors
B. Slurred speech and ataxia
C. Seizures
,D. Polyuria and mild thirst
Correct Answer: B
Rationale: Slurred speech and muscle weakness or ataxia are early signs of lithium
toxicity, typically occurring at levels between 1.5 to 2.0 mEq/L. Fine hand tremors and
polyuria are common expected side effects at therapeutic levels, not indicators of toxicity.
Severe toxicity (above 2.5 mEq/L) can lead to seizures, coma, and death.
3. A nurse is conducting a health history for a client who has anorexia nervosa. Which of the
following clinical findings should the nurse expect?
A. Tachycardia
B. Hyperkalemia
C. Hypertension
D. Amenorrhea
Correct Answer: D
Rationale: Amenorrhea, or the absence of menstruation, is a classic physiological symptom
of anorexia nervosa due to low body weight and hormonal imbalances. Clients typically
exhibit bradycardia and hypotension rather than tachycardia or hypertension.
Hypokalemia is more common than hyperkalemia due to purging behaviors or
malnutrition.
,4. A nurse is caring for a client who was voluntarily admitted to the psychiatric unit. The client
states, ‘I want to leave right now.’ Which of the following responses should the nurse
provide?
A. I will notify the provider of your request to leave against medical advice.
B. You cannot leave until the doctor signs your discharge papers.
C. You signed yourself in, so you can leave whenever you want.
D. We will need to put you on an involuntary hold if you try to leave.
Correct Answer: A
Rationale: Voluntary clients have the right to request discharge, but they must follow the
facility’s legal protocol, which often involves a formal written request and evaluation. If the
client is not a danger to self or others, they can leave against medical advice (AMA). The
nurse must involve the provider to determine if the client meets criteria for involuntary
commitment before allowing them to leave.
5. A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse
notes the client has a high fever, muscle rigidity, and tachycardia. Which of the following
conditions should the nurse suspect?
A. Agranulocytosis
B. Tardive dyskinesia
C. Neuroleptic malignant syndrome (NMS)
D. Acute dystonia
, Correct Answer: C
Rationale: Neuroleptic malignant syndrome (NMS) is a life-threatening complication of
antipsychotic medications characterized by high fever, lead-pipe muscle rigidity, and
autonomic instability like tachycardia. Agranulocytosis involves low white blood cell
counts, while tardive dyskinesia involves involuntary movements of the tongue and face.
Acute dystonia involves sudden muscle spasms and is not typically associated with high
fever.
6. A nurse is teaching a client who has a new prescription for clozapine. Which of the
following laboratory tests should the nurse emphasize the need for regular monitoring?
A. Liver function tests
B. Serum creatinine
C. Thyroid stimulating hormone (TSH)
D. White blood cell (WBC) count
Correct Answer: D
Rationale: Clozapine carries a high risk for agranulocytosis, a severe reduction in white
blood cell count. Therefore, the client must undergo weekly WBC monitoring for the first
six months of treatment. Failure to monitor WBC count can lead to life-threatening
infections and is a strict requirement for prescribing the drug.
