ATI Mental Health Exam Questions With Answers

ATI Mental Health Exam Questions With Answers Mini-mental state examination (MMSE) tests what? - ANSWER- exam used to objectively assess a client's cognitive status by evaluation orientation to time and place, attention span and ability to count backwards by seven, following commands, ability to write, recalling objects Stupor us - ANSWER- The client requires vigorous or painful stimuli to elicit a brief response. She might not be able to respond verbally. Decorticate rigidity - ANSWER- Flexion and internal rotation of upper-extremity joints and legs Decerebrate rigidity - ANSWER- Neck and elbow extension, wrist and finger flexion Mood vs affect - ANSWER- mood: emotion affect: objective expression of mood (such as flat affect or a lack of facial expressions) Milieu Therapy - ANSWER- orienting the client to the physical setting, identifying rules and boundaries of the setting, ensuring a safe environment for the client, assisting the client to participate in appropriate activities A charge nurse is discussing mental status examinations with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (select all that apply) A. "To assess cognitive ability, I should ask the client to count backward by sevens." B. "To assess affect, I should observe the client's facial expression." C. "To assess language ability, I should instruct the client to write a sentence." D. "To assess remote memory, I should have the client repeat a list of objects." E. "To assess the client's abstract thinking, I should ask the client to identify our most recent presidents." - ANSWER- Correct- A, B, C D is incorrect because asking the client to repeat a list of objects is appropriate to assess immediate, rather than remote memory. E is incorrect because asking the client to identify recent presidents is appropriate to assess cognitive knowledge rather than abstract thinking. A nurse is planning care for a client who has a mental health disorder. Which of the following actions should the nurse include as a psychobiological intervention? A. Assist the client with systematic desensitization therapy B. Teach the client appropriate coping mechanisms C. Assess the client for comorbid health conditions. D. Monitor the client for adverse effects of medications - ANSWER- Correct- D A- Incorrect: assisting with systematic desensitization therapy is a cognitive and behavioral, rather than a psychobiological intervention. B- Incorrect: Teaching appropriate coping mechanisms is a counseling or health teaching intervention. C- Incorrect: assessing for comorbid heath conditions is a health promotion and maintenance intervention A nurse in an outpatient entail health clinic is preparing to conduct an initial client interview. When conducting the interview, which of the following actions should the nurse identify as the priority? A. Coordinate holistic care with social services. B. Identify the client's perception of her mental health status. C. Include the client's family in the interview. D. Teach the client about her current mental health disorder. - ANSWER- Correct- B. All are appropriate, but B is the best answer because assessment is the priority action when using the nursing process. A nurse is told during change-of-shift report that a client is stuporous. When assessing the client, which of the following findings should the nurse expect? A. The client arouses briefly in response to a sternal rub. B. The client has a Glasgow Coma Scale score less than 7. C. The client exhibits decorticate rigidity. D. The client is alert but disoriented to time and place. - ANSWER- Correct- A B- incorrect: This indicates comatose C- incorrect: This indicates comatose D- incorrect: A client that is stuporous is not alert A nurse is planning a peer group discussion about the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Which of the following information is appropriate to include in the discussion? (select all that apply) A. The DSM-5 includes client education handouts for mental health disorders B. The DSM-5 establishes diagnostic criteria for individual mental health disorder C. Th DSM-5 indicates recommended pharmacological treatment for mental health disorders D. The DSM-5 assists nurses in planning care for client's who have mental health disorders. E. The DSM-5 indicates expected assessment findings of mental health disorders. - ANSWER- Correct: B, D, E A-Incorrect: It does not include client education handouts C- incorrect: it does not indicate pharmacological treatment for mental health disorders Beneficence - ANSWER- The quality of doing good; can be described as charity Veracity - ANSWER- Honesty when dealing with a client A nurse in an emergency mental health facility is caring for a group of clients. The nurse should identify that which of the following clients requires a temporary emergency admission? A. A client who has schizophrenia with delusions of grandeur B. A client who has manifestations of depression and attempted suicide a year ago C. A client who has borderline personality disorder and assaulted a homeless man with a metal rod. D. A client who has bipolar disorder and paces quickly around the room while talking to himself. - ANSWER- Correct- C A- incorrect: The presence of delusions does not constitute a clear reason for a temporary emergency admission unless they present a danger for the client or others. B- Incorrect: Clinical finding of depression do not constitute a clear reason for a temporary emergency admission unless the client is currently at risk for suicide. D- incorrect: a client who is pacing does not constitute a clear reason for a temporary emergency admission. A nurse decides to put a client who has a psychotic disorder in seclusion overnight because the unit is very short-staffed, and the client frequently fights with other clients. The nurse's actions are an example of which of the following torts? A. invasion of privacy B. False imprisonment C. Assault D. Battery - ANSWER- Correct- C A client tells a nurse "Don't tell anyone, but I hid a sharp knife under my mattress in order to protect myself from my roommate, who is always yelling at me and threatening me." Which of the following actions should the nurse take? A. Keep the client's communication confidential, but talk to the client daily, using therapeutic communication to convince him to admit to hiding the knife B. Keep the client's communication confidential, but watch the client and his roommate closely. C. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others. D. Report the incident to the health care team, but do not inform the client of the intention of doing so. - ANSWER- Correct- C A nurse is caring for a client who is in mechanical restraints. Which of the following statements should the nurse include in the documentation? (select all the apply) A. "Client at most of his breakfast." B. "Client was offered 8 oz of water ever hr." C. "Client shouted obscenities at assistive personnel." D. "Client received chlorpromazine 15mg by mouth at 1000." E. "Client acted out after lunch." - ANSWER- Correct- B, C, D A nurse hears a newly licensed nurse discussing a client's hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first? A. Notify the nurse manager B. Tell the nurse to stop discussing the behavior C. Provide an in-service program about confidentiality D. Complete an incident report - ANSWER- Correct- B A nurse is caring for an older adult client with dementia who has wondered into the day room looking for her deceased partner. Which of the following actions should the nurse take? A. Move the client to a room near the nurse's station B. Limit visitors until the client is oriented to her environment C. Tell the client that her partner is deceased D. Talk to the client about activities she enjoyed with her partner - ANSWER- CorrectD: Talking about positive memories can help distract the client from her disorientation. A nurse is educating 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 - ANSWER- Correct- D