ATI MENTAL HEALTH/MENTAL HEALTH ATI PROCTORED EXAM REAL EXAM 70 QUESTINS AND CORRECT ANSWERS| A GRADE

1. A nurse is admitting a client who has schizophrenia. During the initial interview, the client takes off his belt and screams, “A snake!” Which of the following responses is appropriate? a. “You know that is you belt and not a snake, don’t you?” b. “Your belt doesn’t look like a snake.” c. “This is your belt. I understand how this is scary for you.” d. “Why do you think your belt is a snake?” 2. A nurse working in the emergency department is assessing a client who has generalized anxiety disorder. Which of the following actions should the nurse take first? a. Move the client to a quiet area b. Allow the client time to express his feelings c. Instruct the client to use guided imagery d. Assist the client to identify his coping skills 3. A nurse is caring for a client who has dementia. Which of the following is an appropriate nursing intervention? a. Encourage the client to make choices regarding care. b. Advise family to visit frequently as a group c. Maintain a low-stimulation environment d. Assign several tasks at the same time. 4. A nurse is counseling an adult client whose parent just died. The client states, “My son is 4, and I don’t know how he’ll react when he finds out that his grandpa died.” The nurse should inform the client that the preschool-age child commonly has which of the following concepts of death? (Peds ATI p. 98) a. Death is contagious and can cause other people he loves to die b. Death creates an interest in the physical aspects of dying c. Death is not permanent and the loved one may come back to life. d. Death is a part of life that eventually happens to everyone. 5. A nurse in the emergency department is admitting a client who has a history of alcohol use disorder. The client has a blood alcohol level of 0.26 g/dL. The nurse should anticipate a prescription for which of the following medications? (p. 156) a. Chlordiazepoxide b. Disulfram c. Acamprosate d. Naltrexone 6. A nurse is advising an assistive personnel (AP) on the care of a client who has major depressive disorder. The AP states that he is irritated by the client’s depression. Which of the following statements by the nurse is appropriate? a. “Please don’t take what the client said seriously when she is depressed” b. “I’ll change your assignment to someone who doesn’t have depressive disorder.” c. “It’s important that the client feel safe verbalizing how she is feeling.” d. “Everybody feels that way about this client, so don’t worry about it.” 7. A nurse is caring for a client who reports he is angry with his partner because she thinks he is trying to seek attention. When the nurse questions the client, he becomes angry and tells her to leave. Which of the following defense mechanisms is the client demonstrating? (p. 30) a. Compensation b. Displacement c. Denial d. Rationalization 8. A nurse working in a mental health facility has just put a client in provider-prescribed seclusion. Which of the following is the nurse required to document? (Select all that apply) a. The client’s feelings about being secluded b. The client’s behaviors that resulted in the need for seclusion c. Previous interventions used to prevent the need for seclusion d. The client’s vital signs e. The time the client entered seclusion 9. A nurse is assessing a client who has major depressive disorder. The client states, “I may as well be dead. I have always been a failure.” Which of the following is an appropriate response by the nurse? a. “Let’s discuss these feelings further.” b. “why do you think you feel this way?” c. “Feeling like a failure is expected with depression.” d. “You have a great deal to offer in life.” lOMoAR cPSD| 10. A nurse is planning care for a group of clients in an outpatient facility. For which of the following clients should the nurse plan to provide assistance with ADLs? a. A client who has intense manifestations of agoraphobia b. A client who has negative manifestations of schizophrenia c. A client who is in treatment for hypomania d. A client who is in treatment for alcohol use disorder 11. A nurse Is planning care for a client who has anorexia nervosa and is admitted to an inpatient eating disorder unit. Which of the following is an appropriate intervention? (p. 167) a. Use systematic desensitization to address the client’s fears regarding weight gain b. Allow the client to select meal times c. Initiate a relationship built on trust with the client. d. Negotiate with the client the opportunity to reweigh. 12. A nurse is planning an inservice for new nurses about cultural beliefs and their impact on mental health care. The nurse should identify that which of the following beliefs differs from the western perspective held by most nurses in the United States? (Not sure) a. Mental health is the absence of a mental health disorder. b. Clients should make independent decisions about their mental health care c. Mental health care places value on veracity and confidentiality d. Clients who have a mental health disorder should be passive in their care. 13. A nurse is caring for a client who is admitted to a mental health facility after attempting suicide. Which of the following actions should the nurse take first? (p. 286) a. Implement continuous one-to-one observation b. Ask the client to sign a no-suicide contract c. Encourage client to participate in group therapy d. Establish a rapport to foster trust 14. A nurse is caring for a client in an out-patient mental health facility. The client tells the nurse that she wants to tell her a secret and asks her to promise not to tell. Which of the following responses by the nurse is appropriate? (p. 37) a. “Go on. Tell me more.” b. “Why do you want to keep the information a secret?” c. “Have you shared your secret with anyone else?” d. “I can’t promise that I will keep your secret.” 15. A nurse is reviewing the laboratory findings for a client who is taking carbamazepine for bipolar disorder. Which of the following findings should the nurse report to the provider? (p. 205) a. Platelets 90,000/mm3 (blood discracias) b. Urine specific gravity 1.029 c. Urine pH 5.6 d. RBC 4.7 million/dL 16. A nurse is building a therapeutic relationship with a client who has an eating disorder. Which of the following activities should the nurse initiate during the relationship’s orientation phase? (p. 37) a. Discussing the incorporation of new strategies into daily life b. Mutually deciding and agreeing on the goals of the relationship c. Teaching and encouraging the use of problem-solving skills d. Using memories to validate the relationship experience 17. A nurse is planning care for a client who demonstrates prolonged depression related to the loss of her partner 6 months ago. Which of the following actions should the nurse take? (p. 103 Cant really find it but this should be the answer) a. Direct the client to maintain an unstructured daily routine. b. Discourage the client from reliving the events surrounding her loss c. Suggest that the client avoid social interactions that remind her of her partner. d. Explain that it can take a year or more to learn to live with a loss. 18. A nurse in a mental health facility is assessing a client for suicide risk factors using the SAD PERSONS scale. Which of the following findings indicates a risk for suicide? (Googled) a. The client is married b. The client has diabetes mellitus c. The client is 50 years of age d. The client is female lOMoAR cPSD| 19. A nurse is providing teaching for the family of a client who has dementia. Which of the following should the nurse include as factors that can worsen the client’s manifestations? (p. 137 Not too sure) a. Participation in group therapy b. Reminiscing about the client’s life c. Increased activity level d. Evening hours of the day (sun downing) 20. A nurse in a community mental health center is admitting a client who has schizophrenia. Which of the following manifestations should the nurse expect? a. Preoccupied with details b. Cognitive distortions c. Engaging in exploitive activities d. Manipulative behavior 21. A nurse in an inpatient mental health facility is assessing a client who is taking haloperidol for schizophrenia. Which of the following findings is the priority? (p. 215) a. Urinary hesitancy b. Headache c. High fever (Neuroleptic Malignant Syndrome) d. Insomnia 22. A nurse is conducting a follow-up interview with a client who is recovering from a substance use disorder. Which of the following client findings indicates a constructive use of reaction formation? (p. 30 not too sure) a. The client talks about how he admires his provider and wishes he was just like him b. The client verbalizes his understanding that the treatment requires abstinence c. The client speaks with youth groups about the dangers of substance abuse use. d. The client apologizes to family members for the problems caused by his substance use 23. A nurse is providing instructions to the parents of a child who has a new prescription for a methylphenidate transdermal patch/ Which of the following instructions should the nurse include? (p. 228) a. Cleanse the skin with alcohol prior to placement of the patch b. Leave the patch in place for 9 hr. c. Use the patch at bedtime d. Cover the patch with a gauze pad after application 24. A nurse is caring for a client in a mental health facility. The client is agitated and threatens to harm herself and others. Which of the following is the nurse’s priority intervention? a. Administer an anti-anxiety medication to the client b. Set limits on the client’s behavior c. Place the client in restraints d. Put the client in seclusion 25. A nurse is assessing a client who has schizophrenia. The client tells the nurse, “My heart exploded and my blood is draining out.” The nurse should interpret this statement as which of the following manifestations? (p. 119 Not too sure) a. Paranoia b. Concrete thinking c. A somatic delusion d. A visual hallucination 26. A nurse is assessing a client who is restless and constantly mutters to himself. Which of the following findings should lead the nurse to suspect delirium? (p. 137) a. The client is unable to recognize objects b. The client’s speech is slow and repetitious c. The client has a flat effect d. The client’s manifestations developed suddenly 27. A nurse is assessing a client who has bulimia nervosa. Which of the following findings should the nurse expect? (p. 166) a. Hyponatremia b. Amernorrhea c. Acrocyanosis d. Lanugo 28. A nurse is admitting a client who has a diagnosis of antisocial personality disorder. Which of the following behaviors should the nurse expect to observe? a. Self-mutilation lOMoAR cPSD| b. Delusional behavior c. Splitting d. Lack of remorse 29. A nurse is preparing to administer morning medications to a client who has schizophrenia. After reviewing the client’s chart, which of the following actions should the nurse take first? (Click on the “Exhibit” button below to view the chart. There are three tabs that contain separate categories of data.) a. Request a prescription for acetaminophen b. Administer a PRN doze of diazepam c. Give the regularly scheduled dose of chlorpromazine d. Provide the dose of diphenhydramine Tab 1 Tab 2 Tab 3 Medication Record Vital Signs Progress Notes Amantadine PO at 0700 and Chlorpromazine 100 mg PO at 0700, BP 152/90 mm Hg Received diazepam 5mg IV bolus 1500, and 2300 HR 124/min 0700 Diphenhydramine 50 mg PO at 0700, Resp 24/min Dry/flushed skin 1500, and 2300 Temp 39.4oC (102.9oF) Absent bowel sounds Diazepam 5mg IV bolus every 4 hr PRN for anticholinergic side effects Dilated pupils Increased Agitation 30. A nurse is preparing to administer lorazepam 0.05 mg/kg IV bolus to a school-age child who weighs 30 kg (66 lb). Available is lorazepam injection 2mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if applicable. Do not use a trailing zero.) a. 0.8mL 31. A nurse is caring for a client who has borderline personality disorder and has been engaging in self-mutilation. The nurse should encourage the client to participate in which of the following groups? a. Co-dependents support group b. Dialectical behavior treatment group c. National Alliance on Mental Illness d. Dual diagnosis treatment group 32. A nurse is caring for a client who has tardive dyskinesia. Which of the following assessment tools is appropriate? a. SAD PERSONS Scale b. Abnormal Involuntary Movement Scale (AIMS) c. Hamilton Rating Scale for Anxiety d. CAGE Assessment 33. A nurse is assessing a client who has bipolar disorder and whose mother brought her to the emergency department. Which of the following is the highest priority finding? a. The client reports not attending group therapy. b. The client reports not taking medication for the past 2 weeks. c. The client speaks to the nurse in a demanding tone. d. The client reports sleeping 2 to 3 hr per night. 34. A nurse is assessing several clients in a community mental health facility. Which of the following clients is experiencing adventitious crisis? a. A client who is experiencing acute grief following his father’s death b. A client who is depressed following a devastating fire in her home c. A client who is experiencing postpartum depression following the birth of her first child d. A client who has a new diagnosis of severe bipolar disorder. 35. A nurse on a mental health unit is caring for a client who begins throwing objects at other clients. Which of the following is the priority nursing intervention? a. Administer an anti-anxiety medication b. Place the client in seclusion c. Tell the client to stop the behavior d. Attempt to restrain the client’s arms. 36. A nurse is caring for a client who has generalized anxiety disorder and a history of substance use disorder. Which of the following medications should the nurse expect the provider to prescribe? (p. 92) a. Clonazepam b. Alprazolam lOMoAR cPSD| c. Chlordiazepoxide d. Buspirone 37. A nurse is discussing exercise activities with an inpatient client who has schizophrenia and is overweight due to psychotropic medications. The client refuses to participate in an aerobic exercise class and instead requests to walk in the facility’s gym. Which of the following responses by the nurse is appropriate? a. “Can you tell me why you do not want to participate in the planned group activity?” b. “Do you understand that psychotropic medications cause weight gain?” c. “The aerobics class will be more effective at burning calories than walking.” d. “It sounds as if you have come up with an alternative exercise that works for you.” 38. A nurse in an urgent care clinic is caring for a client who has broken ribs and bruises on her arms. The client is tearful and states she doesn’t know why her partner hit her because, “It’s been peaceful at home lately/” Which of the following responses by the nurse is appropriate? a. “Your partner can be charged with assault and battery.” b. “Describe what it is like at home now.” c. “Why have you stayed with your partner?” d. “Have you had to seek emergency treatment before?” 39. A nurse working in the emergency department is caring for a client following an overdose of pentobarbital sodium. The nurse should assess the client for which of the following? a. Liver failure b. Respiratory depression c. Acute kidney injury d. Cerebrovascular accident 40. A nurse in a provider’s office is collecting data from an older adult client. Which of the following findings is a risk factor for Alzheimer’s disease? (p. 136) a. Recurrent exposure to viral infections b. Prior radiation treatments c. Chronic corticosteroid use d. History of head injury 41. A nurse is caring for a client who suddenly directs profanities at her, then abruptly hangs his head and says, “Please forgive me, I’m not sure what came over me! I don’t know why I said those things.” The nurse interprets this behavior as which of the following? (p. 99) a. Neologism b. Emotional lability c. Flight of ideas d. Confabulation 42. A home health nurse is planning care for a client who has dementia. Which of the following interventions should the nurse recommend to the client’s family?” (p. 139 not sure) a. Set water heater at 54oC (130oF) b. Place a soft mat in front of the toilet c. Limit fluid intake after evening meal d. Encourage client to nap in the late afternoon 43. A nurse is caring for a client who is having command auditory hallucinations. The client reports hearing angry voices. Which of the following responses by the nurse is the priority? a. “I know you are frightened, but I don’t hear any voices.” b. “Tell the voices to go away.” c. “What are the voices saying?” d. “The voices you hear cant harm you.” 44. A nurse is preparing to teach a client who has moderate anxiety about what to expect after his upcoming cardiac catheterization. Which of the following is the appropriate method for the nurse to use? (p. 32) a. Draw picture diagrams. b. Provide detailed explanations c. Use short, simple sentences d. Show a 30-min teaching DVD. 45. A nurse is conducting a risk assessment for clients who are prescribed medications that can cause orthostatic hypotension. Which of the following medications requires follow-up by the nurse? (Double check) a. Escitalopram oxalate lOMoAR cPSD| b. Phenelzine c. Galantamine d. Naltrexone 46. A nurse is caring for a client who has schizophrenia and is being discharged from an inpatient mental health setting. Which of the following should be included in the discharge plan? a. Refer the client to respite care services b. Provide a list of primary preventive mental health groups c. Enroll the client in a 12 step program d. Contact an intensive outpatient program 47. A nurse is assessing a client who is experiencing alcohol withdrawal. For which of the following findings should the nurse anticipate administration lorazepam? a. Afebirle b. Hypertension c. Stupor d. Bradycardia 48. A nurse is caring for a client who is starting treatment for substance use disorder. Which of the following actions indicates the nurse is practicing the ethical principle of nonmaleficence? (Leadership p. 64 double check) a. Withholding a prescribed medication that is causing adverse effects for the client b. Providing the client with quality care regardless of ability to pay for the treatment c. Educating the client about legal rights concerning treatment. d. Being truthful with the client about the manifestations of withdrawal. 49. A nurse is teaching a client about the use of cognitive reframing for stress management. Which of the following statements by the client indicates an understanding of the teaching? (p. 56) a. “I will progressively relax each of my muscle groups when feeling stressed.” b. “I will focus on a mental image while concentrating on my breathing.” c. “I will practice replacing negative thoughts with positive self-statements.” d. “I will learn how to voluntarily control my blood pressure and heart rate.” 50. A nurse is leading an outpatient group therapy session when a client shares with the group that he recently lost his job. Which of the following is an appropriate response by the nurse? a. “It must have been very upsetting for you.” b. “You’ll find another job soon.” c. “Would you like to tell us about your job?” d. “Why do you think you lost your job?” 51. A nurse is receiving report before her shift on a mental health unit. Which of the following clients should the nurse assess first? a. A client who is withdrawing from alcohol and is experiencing hallucinations b. A client who has obsessive-compulsive disorder and whose hands are bright red with cracked skin c. A client who has bipolar disorder and has been pacing all night in the hallway d. A client who has major depressive disorder and has been crying for several hours 52. A nurse is discussing child abuse with a group of nursing students. He describes a situation in which a mother who is physically abusive to her children was instructed to learn stress management techniques. Which of the following strategies does this illustrate? a. Family psychotherapy b. Individual psychotherapy c. Primary prevention d. Tertiary prevention 53. A nurse in a community mental health clinic is caring for a group of clients. The nurse should encourage participation in cognitive-behavioral family therapy in response to which of the following client statements? (p. 66) a. “I want to improve my family’s understanding of each other’s boundaries.” b. “I want each of my family members to be more aware of each other’s feelings.” c. “I want to understand why my past experiences are affecting my family relationships.” d. “I want to learn how to change the way I react to problems within my family.” 54. A nurse is providing teaching to a client who has a new prescription for buspirone. Which of the following statements by the client indicates an understanding of this medication? a. “I should take this medication on an empty stomach.” b. “I need to have my kidney function monitored while taking this medication.” lOMoAR cPSD| c. “I may not see the effects of this medication for several weeks.” d. “I need to watch for signs of dehydration.” 55. A nurse in a mental health clinic is assessing a client who has borderline personality disorder. Which of the following findings should the nurse expect? (p. 129) a. Reluctance to discard worthless objects b. Intense efforts to avoid abandonment c. Inability to maintain employment d. Avoidance of interpersonal relationships 56. A nurse is leading a grief support group for bereaved clients. Which of the following client statements should the nurse report to the provider as an indication of clinical depression? (p. 98) a. “I don’t feel anything but numbness anymore.” b. “It’ll be a long time before I’m happy again.” c. “I don’t know how I could cope if I didn’t have my family’s support.” d. “I feel like I’m angry at the whole world right now.” 57. A nurse in a mental health clinic is reviewing laboratory results for a clients who is prescribed risperidone. The nurse should notify the provider of which of the following findings? a. Blood glucose 175 mg/dL b. Serum sodium 140 mEq/L c. Platelets 250,000/mm3 d. Aspartate aminotransferase 20 units/L 58. A nurse is assessing a client who is taking disulfram. Which of the following findings indicates the client has ingested alcohol and is having an adverse reaction to the medication? (p. 244 not sure) a. Elevated blood pressure b. Somnolence c. Headache d. Tinnitus 59. A nurse is caring for a client who is scheduled for electroconvulsive therapy (ECT). Which of the following medications should the nurse administer 30 min prior to ECT to decrease secretions and counteract vagal stimulation? (p. 79) a. Succinylcholine chloride b. Atropine sulfate c. Thiopental sodium d. Dopamine hydrochloride 60. A nurse is admitting a client who has a history of alcohol dependence. Within 4 to 6 hr, the nurse should anticipate which of the following signs of withdrawal? (p. 152) a. Tremors b. Hypotension c. Bradycardia d. Purpura 61. A nurse is caring for a client in an inpatient mental health unit who experiences mania and is receiving valproic acid. The nurse determine the medication is effective when the client exhibits which of the following behaviors? (p. 104 D could also be the answer) a. The client sits down in the dining room for a meal b. The client easily transitions between topics while talking to others. c. The client exhibits assertive behavior during group sessions d. The client states he feels rested after sleeping 3 hr. 62. A nurse is providing teaching to the family of a client who has schizophrenia. Which of the following statements by a family member indicates a need for further teaching? a. “We will set time limits for discussing her delusions.” b. “We will avoid reacting to her command hallucinations.” c. “She may be having a relapse if she stops attending social events.” d. “She may be more thirsty due to her medications.” 63. A nurse is caring for a client who has schizophrenia. The client’s employer calls to discuss the client’s condition. Which of the following is the appropriate nursing action? (p. 11) a. Contact the facility legal department b. Consult the client’s family c. Consult the client lOMoAR cPSD| d. Contact the provider 64. A nurse is providing teaching for a newly licensed nurse about the constructive use of defense mechanisms. Which of the following examples should the nurse include in the teaching? (p. 29/30 double check) a. A student who is upset with her teacher writes a story about an excellent student b. A school-age child whose mother died 2 years ago talks about her in present tense c. An adult who was sexually abused as a child is unable to remember the incident d. A woman who has a health concern postpones a medical appointment until after a vacation 65. A nurse is preparing to administer chlorpromazine hydrochloride 25 mg PO to an older adult client. Available is chlorpromazine hydrochloride syrup 10mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if applicable. Do not use a trailing zero.) a. 12.5mL 66. A nurse is caring for a school age child who has a fractured arm. The child has other injuries that cause the nurse to suspect abuse. Which of the following actions is appropriate for the nurse to take when assessing the child’s situation? (P. 303) a. Ask clarifying questions as the child explains how the injuries occurred. b. Direct the parents to the waiting room before interviewing the child. c. Interview the child with the provider and social worker present. d. Ask the parents directly if the child’s fracture is due to physical abuse. 67. A nurse is developing a safety plan for a client who has experienced intimate partner abuse. Which of the following items should the nurse include in the plan that will provide immediate safety for the client and her children? (Not sure) a. The phone number of the local shelter b. A referral to a support group c. A code phrase to use when it is time to leave the house d. The phone numbers for law enforcement agencies 68. A nurse is providing teaching to a client who has a new prescription for tranylcypromine. Which of the following over-thecounter medications should the nurse instruct the client to avoid taking due to drug interactions? (p. 92) a. Ranitidine b. Pseudoephedrine c. Magnesium hyrdroxide d. Ibuprofen 69. A nurse is attending an interdisciplinary treatment team meeting for a client who has bipolar disorder with rapid cycling and is being prepared for discharge. The client has been admitted to the inpatient unit of a mental health facility four times in the last year. Which of the following referrals is most appropriate for the client at this time? a. Private counseling b. Support group c. Assertive community treatment d. Vocational rehabilitation services 70. A nurse in an inpatient mental-health unit is planning care for a client who was admitted following a panic attack. Which of the following should the nurse include in the plan of care? (p. 91 could also be a) a. Suggest the client exercise 30 min ever day b. Instruct the client in use of pursed-lip-breathing c. Provide solitude for the client at the onset of a new panic attack d. Encourage frequent visits from family members.