PN Mental Health Online Practice
2023 B Exam Questions & Answers
This comprehensive study guide contains verified questions and answers for the PN (Practical Nursing) Mental Health Online Practice 2023 B exam. The content covers essential mental health nursing topics including psychiatric disorders, therapeutic communication, medications, safety considerations, and patient care management. Use this guide to prepare for your ATI Mental Health assessment.
Eating Disorders – Anorexia Nervosa
Q1. A nurse on a mental health unit is assisting with the plan of care for a newly admitted client who has anorexia nervosa. Which of the following actions should the nurse include in the plan of care?
ANSWER: Offer liquid supplements to the client (the client might be unable to eat solid foods when first admitted)
Q2. A nurse in an outpatient clinic is reviewing the medical record of a client who has anorexia nervosa. Which of the following findings indicate the client’s condition is deteriorating?
ANSWER: QT prolongation, Exercise regimen, Hematemesis, Temperature (hypothermia), Laxative use, Low BMI
Q3. What should the nurse monitor for a client who has anorexia nervosa?
ANSWER: Monitor the client’s vital signs three times per day (clients can experience bradycardia, hypotension, and electrolyte imbalances leading to dysrhythmias)
Schizophrenia & Psychotic Disorders
Q4. A nurse in a mental health facility is caring for a client who has schizophrenia. The client becomes violent in the dayroom and begins throwing objects. After calling for assistance, which of the following actions should the nurse take next?
ANSWER: Tell the client calmly to sit down (least restrictive intervention first)
Q5. A nurse is assisting with a mental status examination for a client who has schizophrenia. Which of the following statements should the nurse make to gather information about the client’s ability to think abstractly?
ANSWER: How is an orange similar to an apple?
Q6. A nurse on a mental health unit is caring for a group of four clients. Which of the following clients should the nurse see first?
ANSWER: A client who has schizophrenia and is experiencing command hallucinations (greatest risk for harm to self or others)
Q7. A nurse is reviewing the medical record of a female client who has schizophrenia. What findings are important?
ANSWER: Monitor for medication side effects, thought patterns, and safety concerns
Bipolar Disorder
Q8. A nurse is preparing to administer lithium 450 mg PO to a client who has bipolar disorder. Available is lithium 150 mg capsules. How many capsules should the nurse administer?
ANSWER: 3 capsules (450 mg divided by 150 mg = 3)
Q9. A nurse is caring for a client who has a new prescription for lithium. Which of the following laboratory tests should the nurse monitor?
ANSWER: Sodium, Potassium, BUN (lithium toxicity monitoring)
Q10. A nurse is collecting data from a client who has bipolar disorder and a history of mania. Which of the following findings should the nurse identify as an indication that the client is relapsing?
ANSWER: Pressured speech (rapid or pressured speech, provocative behavior, and insomnia indicate potential relapse)
Q11. A nurse on a mental health unit is admitting a client who has bipolar disorder. When prioritizing hypotheses, what is the greatest risk?
ANSWER: Cardiovascular injury due to constant psychomotor activity (pacing, dramatic movements can increase BP and HR)
Depression & Major Depressive Disorder
Q12. A nurse is assisting with screening a group of clients for major depressive disorder (MDD). Which of the following clients is at an increased risk for the development of MDD?
ANSWER: A client who just gave birth (postpartum period increases risk for MDD or postpartum depression)
Q13. A client who has a diagnosis of depression is attending group therapy.
When it is the client’s turn, they do not respond. Which of the following actions should the nurse take before repeating the request?
ANSWER: Allow the client time to formulate an answer (slowed response time is common in clients with depression)
Anxiety Disorders
Q14. A nurse is reinforcing teaching with a client who has generalized anxiety disorder and a new prescription for buspirone. Which of the following statements indicates the client understands?
ANSWER: I should expect my symptoms to improve in about 2 to 4 weeks
Q15. A nurse is contributing to the plan of care for a client who has panic disorder. What should be included?
ANSWER: Teach relaxation techniques and demonstrate coping strategies
Q16. A nurse is collecting data from a client who has agoraphobia. Which of the following situations will increase the client’s anxiety?
ANSWER: Being in crowded or open spaces where escape might be difficult
Q17. A nurse is reinforcing teaching with a newly admitted client who has generalized anxiety disorder. Which statement should the nurse make?
ANSWER: We will demonstrate for you how to use relaxation techniques
Obsessive-Compulsive Disorder (OCD)
Q18. A nurse is reinforcing teaching with a client who has obsessive-compulsive disorder and performs hand hygiene to decrease anxiety. What should the nurse include?
ANSWER: Teach alternative coping mechanisms and cognitive-behavioral techniques
PTSD & Trauma
Q19. A nurse is caring for a client who is undergoing behavioral therapy for posttraumatic stress disorder (PTSD). Which finding indicates improvement?
ANSWER: Client demonstrates use of learned coping strategies and reports decreased anxiety symptoms
Dementia & Cognitive Disorders
Q20. A nurse is caring for a client who has dementia. Which of the following actions should the nurse take?
ANSWER: Use simple, clear communication; maintain a calm environment; ensure safety
Q21. A nurse is collecting data from a client who has dementia and whose family expresses concern about their increasing memory problems. Which finding should the nurse identify as the priority?
ANSWER: The client sometimes wanders from the house (safety is priority)
Q22. A nurse in a long-term care center is caring for an adult client who has Alzheimer’s disease and whose partner died several years ago. The client appears upset and asks when their partner will visit. Which communication strategy is appropriate?
ANSWER: It seems like you are feeling lonely. Let’s go outside and talk (validation and redirection)
Q23. A nurse is reinforcing teaching with the caregiver of a client who has dementia about home safety. Which instruction should the nurse include?
ANSWER: Maintain a consistent, structured daily routine for the client
Substance Use Disorders – Alcohol
Q24. A nurse is collecting data from a client who uses alcohol to cope with stress. Which of the following questions should the nurse ask?
ANSWER: What daily activities are disrupted because of your alcohol consumption? (open-ended therapeutic question)
Q25. A nurse is caring for a client who has alcohol use disorder. After reviewing the medical record, what findings should be reported to the provider?
ANSWER: Blood pressure (hypertension), heart rate (tachycardia), temperature (fever), speech pattern (rapid/rambling), hallucinations (possible delirium tremens)
Q26. A nurse is assisting with the plan of care for a client who is malnourished due to alcohol use disorder. What should be included?
ANSWER: Nutritional support, vitamin supplementation (especially thiamine), monitoring for withdrawal
Substance Use Disorders – Opioids
Q27. A nurse in an emergency department is assisting in the care of a client who is experiencing opioid withdrawal. Which medication should the nurse plan to administer?
ANSWER: Buprenorphine (opioid partial agonist administered at least 12 hours after last opioid use)
Q28. A nurse is collecting data from a client who reports using heroin recently.
What should the nurse monitor?
ANSWER: Vital signs, withdrawal symptoms, and risk for overdose
Smoking Cessation
Q29. A nurse is reinforcing teaching about expected withdrawal manifestations with a client who has enrolled in a smoking cessation course. What should be included?
ANSWER: Irritability, anxiety, difficulty concentrating, increased appetite, sleep disturbances
Medications – MAOIs
Q30. A nurse is reinforcing teaching about foods that contain tyramine with a client who has a prescription for phenelzine (MAOI). Which food should the client avoid?
ANSWER: Smoked sausage (aged/fermented foods containing tyramine can cause hypertensive crisis)
Medications – Antipsychotics
Q31. A nurse is preparing to administer haloperidol 3 mg IM to a client.
Available is haloperidol solution 5 mg/mL. How many mL should the nurse plan to administer?
ANSWER: 0.6 mL (3 mg divided by 5 mg/mL = 0.6 mL)
Medications – Alcohol Use Disorder
Q32. A nurse is caring for a client who takes naltrexone for the treatment of alcohol use disorder. Which client statement indicates the medication is effective?
ANSWER: I drink less alcohol in a day while taking naltrexone
Electroconvulsive Therapy (ECT)
Q33. A nurse is caring for a client who is scheduled for electroconvulsive therapy (ECT). Which action should the nurse take prior to the procedure?
ANSWER: Administer atropine sulfate IM (reduces oral secretions and prevents bradycardia)
Q34. A nurse is caring for a client who has a depressive disorder and declines ECT despite the provider’s recommendation. Which ethical principle is demonstrated?
ANSWER: Autonomy (supporting the client’s right to make their own decisions)
ADHD & Pediatric Mental Health
Q35. A nurse is reinforcing teaching with the parent of a child who has ADHD and is exhibiting disruptive behaviors at home. Which action should the nurse instruct the parent to take?
ANSWER: Establish consistent routines and clear expectations; use positive reinforcement
Q36. A nurse is reinforcing teaching with an adolescent client who has a history of aggressive behavior. Which statement should the nurse make?
ANSWER: Have you considered participating in a sport to help control your aggression?
Q37. What should parents do for children with behavioral issues?
ANSWER: Instruct the child to apologize for behavior that negatively affects others
Personality Disorders
Q38. A nurse is caring for a client who has antisocial personality disorder and is receiving behavioral therapy through operant conditioning. Which client behavior indicates effectiveness?
ANSWER: Refrains from manipulating others to earn dining room privileges (positive reinforcement for desired behavior)
Q39. A nurse is caring for a client with borderline personality disorder presenting with self-mutilation, impulsivity, and labile behavior. What should be monitored?
ANSWER: Safety, emotional regulation, interpersonal relationships, self-harm behaviors
Therapeutic Communication
Q40. A nurse is discussing confidentiality with a client. When should this occur?
ANSWER: During the orientation phase of the nurse-client relationship
Q41. A nurse is caring for an adult client who is about to undergo screening with the mental status examination (MSE). The client asks about the purpose.
Which response should the nurse make?
ANSWER: This test will give us information about how you remember things
Violence & Aggression
Q42. A nurse is collecting data from a client who has a history of violent behavior. Which condition is a risk factor?
ANSWER: Traumatic brain injury (clients with TBI are more likely to exhibit aggression and violence)
Q43. A nurse in an inpatient mental health unit is supervising clients in the dayroom. The nurse fails to respond to escalating behavior of a client who becomes violent. For which is the nurse liable?
ANSWER: Negligence (failure to intervene appropriately)
Restraints & Seclusion
Q44. A nurse is teaching about the use of mechanical restraints. Which information should be included?
ANSWER: Complete documentation about the client’s status every hour while in restraints; provider must make in-person evaluation within 1 hour
Q45. A charge nurse is discussing restraints with a newly licensed nurse.
Which statement demonstrates understanding?
ANSWER: The provider should make an in-person evaluation of the client within 1 hr of initiating the restraints
Group Therapy
Q46. A nurse is assisting with planning group therapy. Which action should be included in the working phase?
ANSWER: Facilitate behavioral changes (working phase focuses on achieving goals)
Ethical & Legal Issues
Q47. A nurse is caring for a client in a mental health facility. The nurse overhears another staff member make derogatory comments to the client.
Which action should the nurse take?
ANSWER: Report the occurrence to the charge nurse (charge nurse and manager confront the staff member)
Q48. A nurse is attempting to resolve an ethical dilemma involving a client’s medical decisions and their own personal values. What should the nurse do?
ANSWER: Consult with the ethics committee and prioritize the client’s autonomy
Key Nursing Priorities & Concepts
• Safety First: Always prioritize client safety – wandering, self-harm, violence, and command hallucinations require immediate intervention
• Least Restrictive: Use the least restrictive intervention first (verbal de-escalation before restraints)
• Therapeutic Communication: Use open-ended questions, validation, and active listening
• Medication Knowledge: Know drug classifications, dosing calculations, and side effects (lithium, MAOIs, antipsychotics)
• Autonomy & Ethics: Respect client’s right to refuse treatment while ensuring informed consent
• Documentation: Frequent monitoring and documentation required for restraints, high-risk behaviors, and medication administration
• Phases of Relationship: Orientation (build rapport, discuss confidentiality), Working (facilitate change), Termination (closure)
Study Tips for Mental Health Nursing
• Master Therapeutic Communication: Know the difference between therapeutic and non-therapeutic responses
• Understand Psychotropic Medications: Focus on MAOIs (tyramine restrictions), lithium (toxicity signs), antipsychotics (side effects)
• Prioritize Safety: In mental health, safety concerns always take precedence – wandering, command hallucinations, violence
• Know Restraint Protocols: Understand legal requirements including 1-hour provider evaluation and hourly documentation
• Recognize Crisis Situations: Identify signs of relapse in bipolar disorder, delirium tremens in alcohol withdrawal
• Practice Calculations: Be comfortable with medication dosing calculations (mg to mL, capsule counts)
IMPORTANT DISCLAIMER: This study guide is compiled from publicly available ATI practice materials and educational resources for the PN Mental Health Online Practice 2023 B exam. It should be used as a supplemental study tool only. Always refer to official ATI testing materials, current evidence-based practice guidelines, and your nursing program’s resources. This information is for educational purposes and may not reflect the most current updates to mental health nursing standards.
