ATI RN Mental Health 2019/Mental Health ATI 160 Questions and
100% Correct Answers and Explanations.
A nurse is reviewing the medication administration record for a client who is experiencing
adverse effects of chlorpromazine. The nurse should administer benztropine to relieve which of
the following adverse effects?
A. Blurred vision
B. Orthostatic hypotension
C. Dry mouth
D. Acute dystonia - The nurse should administer benztropine, an anticholinergic agent, to
relieve acute dystonia, which is an extrapyramidal adverse effect of chlorpromazine.
A nurse is planning discharge teaching with a family member of a client who has diagnosis of
depression. Which of the following information about relapse should the nurse include?
A. Additional acute episodes of depression are unlikely following inpatient care.
B. Early identification of changes, such as decreased social involvement, is important.
C. Medication compliance will prevent further need for inpatient hospitalization.
D. It is helpful to regularly reinforce to the client that things will get better.
B. Early identification of changes, such as decreased social involvement, is important.
Decreased social involvement is a manifestation of depression, and early identification of
findings can lead to early intervention.
A nurse is assessing a client who is experiencing opioid withdrawal. Which of the following
manifestations should the nurse expect?
A. Sedation
B. Rhinorrhea
C. Bradycardia
D. Hypothermia
Rhinorrhea - The nurse should expect the client who is experiencing opioid withdrawal to have
rhinorrhea and flu-like manifestations such as yawning, sneezing, and abdominal pain.
A nurse is assessing a family's dynamics during a counseling session. The nurse should
recognize which of the following findings as an indication of a boundary issue?
A. An adolescent family member who questions parental authority
B. A family with three generations in the same household
C. Older children who are responsible for their younger siblings
D. Two adults and their children from prior relationships in the same household
C. Older children who are responsible for their younger siblings
This is an example of enmeshed boundaries in which there are no distinctions between the roles
of family members.
A nurse is assisting a client who has a terminal illness adjust to progressive loss of
,independence. Which of the following statements by the client indicates acceptance of her
illness?
A. "I am going to order a wheelchair for when I'm unable to walk."
B. "I am going to stop paying my bills since I won't be around much longer."
C. "I wish you would go take care of somebody who actually needs you."
D. "I am sure I'm going to be able to continue to care for myself without help."
A. "I am going to order a wheelchair for when I'm unable to walk."
The client is recognizing the reality of continued loss of independence and is anticipating the
need for assistive devices, which indicates the behavioral response of acceptance.
A nurse is caring for a child who is taking methylphenidate. The nurse should monitor the child
for which of the following findings as an adverse effects of methylphenidate?
A. Weight gain
B. Tinnitus
C. Tachycardia
D. Increased salvation
C. Tachycardia - The nurse should monitor the child for tachycardia, which is an adverse effect of
methylphenidate.
, A nurse is creating a plan of care for a client who has been placed in seclusion after threatening
to harm others or the unit. Which of the following interventions should the nurse include in the
plan?
A. Document the client's behavior every 8 hr.
B. Limit the client's fluid intake to 50 mL/hr.
C. Renew the prescription for the client every 4 hr.
D. Toilet the client every 4 hr.
C. Renew the prescription for the client every 4 hr.
The nurse should assess the client's behavior frequently during seclusion and should renew the
prescription for seclusion for an adult client every 4 hr, for a maximum of 24 hr.
A nurse observes a client on a mental health unit pushing on the locked unit door. Which of
the following statements should the nurse make?
A. "It appears as though you would like to open the door."
B. "You will feel more comfortable after you've been here for a while."
C. "It is okay to not want to be here."
D. "You really shouldn't be pushing on the door."
A. "It appears as though you would like to open the door."
This statement is an example of the therapeutic technique of making observations. This
technique encourages the client to notice the behavior so that they can describe thoughts and
feelings related to that behavior.
A nurse is education the parent of a child who has a new diagnosis of autism spectrum
disorder. Which of the following manifestations of this disorder should the nurse include in the
teaching?
A. Fear of abandonment
B. Motor and verbal tics
C. Hostile behavior
D. Language delay - The nurse should identify that language delays are a manifestation of autism
spectrum disorder.
A nurse is discussing a 12-step program with a client who has alcohol use disorder and is in an
acute care facility undergoing
detoxification. Which of the following information should the nurse include in the teaching?
A. The program will help the client accept responsibility for the disorder.
B. The client should obtain a sponsor before discharge for an increased chance of recovery.
C. The client will need to identify individuals who have contributed to the disorder.
D. The program will need a prescription from the client's provider prior to attendance.
B. The client should obtain a sponsor before discharge for an increased chance of recovery.
The nurse should teach the client that peer support has been shown to increase program
attendance and the chances of recovery. If the client does not have a sponsor, they can be
assigned one when they begin attending the program.
A charge nurse on a mental health unit is discussing client rights with a newly licensed nurse.
Which of the following statements should the charge nurse make?
A. "Clients can't refuse to take medications if they are admitted involuntarily."
B. "You can notify a client's family if they are admitted involuntarily."
C. "Clients who are admitted involuntarily maintain the right to give informed consent for
procedures."
D. "You can remove a client's privileges if they are admitted involuntarily and refuse to attend
therapy sessions."
100% Correct Answers and Explanations.
A nurse is reviewing the medication administration record for a client who is experiencing
adverse effects of chlorpromazine. The nurse should administer benztropine to relieve which of
the following adverse effects?
A. Blurred vision
B. Orthostatic hypotension
C. Dry mouth
D. Acute dystonia - The nurse should administer benztropine, an anticholinergic agent, to
relieve acute dystonia, which is an extrapyramidal adverse effect of chlorpromazine.
A nurse is planning discharge teaching with a family member of a client who has diagnosis of
depression. Which of the following information about relapse should the nurse include?
A. Additional acute episodes of depression are unlikely following inpatient care.
B. Early identification of changes, such as decreased social involvement, is important.
C. Medication compliance will prevent further need for inpatient hospitalization.
D. It is helpful to regularly reinforce to the client that things will get better.
B. Early identification of changes, such as decreased social involvement, is important.
Decreased social involvement is a manifestation of depression, and early identification of
findings can lead to early intervention.
A nurse is assessing a client who is experiencing opioid withdrawal. Which of the following
manifestations should the nurse expect?
A. Sedation
B. Rhinorrhea
C. Bradycardia
D. Hypothermia
Rhinorrhea - The nurse should expect the client who is experiencing opioid withdrawal to have
rhinorrhea and flu-like manifestations such as yawning, sneezing, and abdominal pain.
A nurse is assessing a family's dynamics during a counseling session. The nurse should
recognize which of the following findings as an indication of a boundary issue?
A. An adolescent family member who questions parental authority
B. A family with three generations in the same household
C. Older children who are responsible for their younger siblings
D. Two adults and their children from prior relationships in the same household
C. Older children who are responsible for their younger siblings
This is an example of enmeshed boundaries in which there are no distinctions between the roles
of family members.
A nurse is assisting a client who has a terminal illness adjust to progressive loss of
,independence. Which of the following statements by the client indicates acceptance of her
illness?
A. "I am going to order a wheelchair for when I'm unable to walk."
B. "I am going to stop paying my bills since I won't be around much longer."
C. "I wish you would go take care of somebody who actually needs you."
D. "I am sure I'm going to be able to continue to care for myself without help."
A. "I am going to order a wheelchair for when I'm unable to walk."
The client is recognizing the reality of continued loss of independence and is anticipating the
need for assistive devices, which indicates the behavioral response of acceptance.
A nurse is caring for a child who is taking methylphenidate. The nurse should monitor the child
for which of the following findings as an adverse effects of methylphenidate?
A. Weight gain
B. Tinnitus
C. Tachycardia
D. Increased salvation
C. Tachycardia - The nurse should monitor the child for tachycardia, which is an adverse effect of
methylphenidate.
, A nurse is creating a plan of care for a client who has been placed in seclusion after threatening
to harm others or the unit. Which of the following interventions should the nurse include in the
plan?
A. Document the client's behavior every 8 hr.
B. Limit the client's fluid intake to 50 mL/hr.
C. Renew the prescription for the client every 4 hr.
D. Toilet the client every 4 hr.
C. Renew the prescription for the client every 4 hr.
The nurse should assess the client's behavior frequently during seclusion and should renew the
prescription for seclusion for an adult client every 4 hr, for a maximum of 24 hr.
A nurse observes a client on a mental health unit pushing on the locked unit door. Which of
the following statements should the nurse make?
A. "It appears as though you would like to open the door."
B. "You will feel more comfortable after you've been here for a while."
C. "It is okay to not want to be here."
D. "You really shouldn't be pushing on the door."
A. "It appears as though you would like to open the door."
This statement is an example of the therapeutic technique of making observations. This
technique encourages the client to notice the behavior so that they can describe thoughts and
feelings related to that behavior.
A nurse is education the parent of a child who has a new diagnosis of autism spectrum
disorder. Which of the following manifestations of this disorder should the nurse include in the
teaching?
A. Fear of abandonment
B. Motor and verbal tics
C. Hostile behavior
D. Language delay - The nurse should identify that language delays are a manifestation of autism
spectrum disorder.
A nurse is discussing a 12-step program with a client who has alcohol use disorder and is in an
acute care facility undergoing
detoxification. Which of the following information should the nurse include in the teaching?
A. The program will help the client accept responsibility for the disorder.
B. The client should obtain a sponsor before discharge for an increased chance of recovery.
C. The client will need to identify individuals who have contributed to the disorder.
D. The program will need a prescription from the client's provider prior to attendance.
B. The client should obtain a sponsor before discharge for an increased chance of recovery.
The nurse should teach the client that peer support has been shown to increase program
attendance and the chances of recovery. If the client does not have a sponsor, they can be
assigned one when they begin attending the program.
A charge nurse on a mental health unit is discussing client rights with a newly licensed nurse.
Which of the following statements should the charge nurse make?
A. "Clients can't refuse to take medications if they are admitted involuntarily."
B. "You can notify a client's family if they are admitted involuntarily."
C. "Clients who are admitted involuntarily maintain the right to give informed consent for
procedures."
D. "You can remove a client's privileges if they are admitted involuntarily and refuse to attend
therapy sessions."
