ATI Mental Health Proctored
k k k
k k k k k k k k k k k k k k k k
A nurse is caring for a client who is in mechanical restraints. Which of the following statem
k k k k k k k k k k k
ents should the nurse include in the documentation? (Select all that apply)
k k k k k k
A. "Client ate most of his breakfast."
k k k k k k k k k
B. "Client was offered 8 oz of water every hr."
k k k k k k
C. "Client shouted obscenities at assistive personnel."
k k k k k k k k k
D. "Client received chlorpromazine 15 mg by mouth at 1000."
k k k k k
E. "Client acted out after lunch."
Aknursekhearskaknewlyklicensedknursekdiscussingkakclient'skhallucinationskinkthekhallwaykwit
hkanotherknurse.kWhichkofkthekfollowingkactionskshouldktheknursektakekfirst?
k k k k
A. Notify the nurse manager.
k k k k k k k k
B. Tell the nurse to stop discussing the behavior.
k k k k k k
C. Provide an in-service program about confidentiality.
k k k k
D. Complete an incident report.
k k k k k k k k k k k k k k k k
A nurse is caring for the parents of a child who has demonstrated changes in behavior and
k k k k k k k k k k k k k k k k
mood. When the mother of the child asks the nurse for reassurance about her son's condi
k k k k k k k k k
tion, which of the following responses should the nurse make?
k k k k k k k k k k k
A. "I think your son is getting better. What have you noticed."
k k k k k k k k k k k k
B. "I'm sure everything will be okay. It just takes time to heal."
k k k k k k k k k k k k k
C. "I'm not sure whats wrong. Have you asked the doctor about your concerns?"
k k k k k k k k k k
D. "I understand you're concerned. Let's discuss what concerns you specifically."
Aknursekiskcaringkforkakclientkwhoksmokeskandkhasklungkcancer.kThekclientkreports,k"I'mkcou
ghingkbecausekIkhavekthatkcoldkthatkeveryonekhaskbeenkgetting."kTheknursekshouldkidentifyk
thatkthekclientkiskusingkwhichkofkthekfollowingkdefensekmechanisms?
A.kReactionkformation
B.kDenial
C.kDisplacement
D.kSublimation
Aknursekiskprovidingkpreoperativekteachingkforkakclientkwhokwaskjustkinformedkthatkshekrequ
ireskemergencyksurgery.kThekclientkhaskakrespiratorykratek30/minkandksays,k"Thiskiskdifficult
ktokcomprehend.kIkfeelkshakykandknervous."kTheknursekshouldkidentifykthatkthekclientkiskexpe
riencingkwhichkofkthekfollowingklevelskofkanxiety?
,A.kMild
B.kModerate
C.kSevere
D.kPanic
Aknursekiskcaringkforkakclientkwhokiskexperiencingkmoderatekanxiety.kWhichkofkthekfollowingk
actionskshouldktheknursektakekwhenktryingktokgiveknecessarykinformationktokthekclient?k(Sel
ectkallkthatkapply.)
A.kReassurekthekclientkthatkeverythingkwillkbekokay.
B.kDiscusskpriorkusekofkcopingkmechanismskwithkthekclient.
C.kIgnorekthekclient'skanxietyksokthatkshekwillknotkbekembarrassed.
D.kDemonstratekakcalmkmannerkwhilekusingksimplekandkclearkdirections.
E.kGatherkinformationkfromkthekclientkusingkclosed-endedkquestions.
Aknursekisktalkingkwithkakclientkwhokiskatkriskkforksuicidekfollowingkthekdeathkofkhiskspouse.kW
hichkofkthekfollowingkstatementskshouldktheknursekmake?
A.k"Ikfeelkveryksorrykforktheklonelinesskyoukmustkbekexperiencing."
B.k"Suicidekisknotkthekappropriatekwayktokcopekwithkloss."
C.k"Losingksomeonekclosektokyoukmustkbekverykupsetting."
D.k"Ikknowkhowkdifficultkitkisktoklosekaklovedkone."
Akchargeknursekiskdiscussingkthekcharacteristicskofkaknurse-
clientkrelationshipkwithkaknewlyklicensedknurse.kWhichkofkthekfollowingkcharacteristicskshoul
dktheknursekincludekinkthekdiscussion?k(Selectkallkthatkapply)
A.kThekneedskofkbothkparticipantskarekmet.
B.kAnkemotionalkcommitmentkexistskbetweenkthekparticipants.
C.kItkiskgoal-directed.
D.kBehavioralkchangekiskencouraged.
E.kAkterminationkdatekiskestablished.
Aknursekiskinkthekworkingkphasekofkaktherapeutickrelationshipkwithkakclientkwhokhaskmetham
phetaminekusekdisorder.kWhichkofkthekfollowingkactionskindicatesktransferencekbehavior?
A.kThekclientkasksktheknursekwhetherkshekwillkgokoutktokdinnerkwithkhim.
B.kThekclientkaccusesktheknurseskofktellingkhimkwhatktokdokjustklikekhiskex-girlfriend.
C.kThekclientkremindsktheknursekofkakfriendkwhokdiedkfromkaksubstancekoverdose.
D.kThekclientkbecomeskangrykandkthreatensktokharmkhimself.
Aknursekiskplanningkcarekforkthekterminationkphasekofkaknurse-
clientkrelationship.kWhichkofkthekfollowingkactionskshouldktheknursekincludekinkthekplankofkcare?
A.kDiscussingkwaysktokuseknewkbehaviors
,B.kPracticingknewkproblem-solvingkskills
C.kDevelopingkgoals
D.kEstablishingkboundaries
Akchargeknursekiskdiscussingkmentalkstatuskexamskwithkaknewlyklicensedknurse.kWhichkofkt
hekfollowingkstatementskbyktheknewlyklicensedknursekindicateskankunderstandingkofkthektea
ching?k(Selectkallkthatkapply)
A.k"Tokassesskcognitivekability,kIkshouldkaskkthekclientktokcountkbackwardkbyksevens."
B.k"Tokassesskaffect,kIkshouldkobservekthekclient'skfacialkexpression."
C.k"Tokassessklanguagekability,kIkshouldkinstructkthekclientktokwritekaksentence."
D.k"Tokassesskremotekmemory,kIkshouldkhavekthekclientkrepeatkaklistkofkobjects."
E.k"Tokassesskthekclient'skabstractkthinking,kIkshouldkaskkthekclientktokidentifykourkmostkrece
ntkpresidents."
Aknursekiskplanningkcarekforkakclientkwhokhaskakmentalkhealthkdisorder.kWhichkofkthekfollowi
ngkactionskshouldktheknursekincludekaskakpsychobiologicalkintervention?
A.kAssistkthekclientkwithksystematickdesensitizationktherapy.
B.kTeachkthekclientkappropriatekcopingkmechanisms.
C.kAssesskthekclientkforkcomorbidkhealthkconditions.
D.kMonitorkthekclientkforkadversekeffectskofkthekmedications.
Aknursekinkankoutpatientkmentalkhealthkclinickiskpreparingktokconductkankinitialkclientkintervie
w.kWhenkconductingkthekinterview,kwhichkofkthekfollowingkactionskshouldktheknursekidentifyk
askthekpriority?
A.kCoordinatekholistickcarekwithksocialkservices.
B.kIdentifykthekclient'skperceptionkofkherkmentalkhealthkstatus.
C.kIncludekthekclient'skfamilykinkthekinterview.
D.kTeachkthekclientkaboutkherkcurrentkmentalkhealthkdisorder.
Aknursekisktoldkduringkchangekofkshiftkreportkthatkakclientkiskstuporous.kWhenkassessingkthek
client,kwhichkofkthekfollowingkfindingskshouldktheknursekexpect?
A.kThekclientkarouseskbrieflykinkresponsektokaksternalkrub.
B.kThekclientkhaskakglasgowkcomakscalekscoreklesskthank7.
C.kThekclientkexhibitskdecorticatekrigidity.
D.kThekclientkiskalertkbutkdisorientedktoktimekandkplace.
, AknursekiskplanningkakpeerkgroupkdiscussionkaboutkthekDSM-
5.kWhichkofkthekfollowingkinformationkiskappropriatektokincludekinkthekdiscussion?k(Selectkall
kthatkapply)
A.kThekDSM-5kincludeskclientkeducationkhandoutskforkmentalkhealthkdisorders.
B.kThekDSM-5kestablisheskdiagnostickcriteriakforkindividualkmentalkhealthkdisorders.
C.kThekDSM-
5kindicateskrecommendedkpharmacologicalktreatmentkforkmentalkhealthkdisorders.
D.kThekDSM-
5kassistsknurseskinkplanningkcarekforkclient'skwhokhavekmentalkhealthkdisorders.
E.kThekDSM-5kindicateskexpectedkassessmentkfindingskofkmentalkhealthkdisorders.
Aknursekinkankemergencykmentalkhealthkfacilitykiskcaringkforkakgroupkofkclients.kTheknurseksh
ouldkidentifykthatkwhichkofkthekfollowingkclientskrequireskaktemporarykemergencykadmission
?
A.kAkclientkwhokhaskschizophreniakwithkdelusionskofkgrandeur
B.kAkclientkwhokhaskmanifestationskofkdepressionkandkattemptedksuicidekakyearkago
C.kAkclientkwhokhaskborderlinekpersonalitykdisorderkandkassaultedkakhomelesskmankwithkak
metalkrod
D.kAkclientkwhokhaskbipolarkdisorderkandkpaceskquicklykaroundkthekroomkwhilektalkingktokhi
mself
k k k k k k k k k k k k k k k
A nurse decides to put a client who has a psychotic disorder in seclusion overnight becaus
k k k k k
e the unit is very short-
k k k k k k k k k k k k k k
staffed, and the client frequently fights with other clients. The nurse's actions are an exam
k k k k k k
ple of which of the following torts?
k k k
A. Invasion of privacy
k k
B. False imprisonment
k
C. Assault
k
D. Battery
k k k k k k k k k k k k k k k k k k k
A client tells a nurse, "Don't tell anyone but I hid a sharp knife under my mattress in order t
k k k k k k k k k k k k k k k
o protect myself from my roommate, who is always yelling at me and threatening me." Whi
k k k k k k k k
ch of the following actions should the nurse take?
k k k k k k k k k k k k k
A. Keep the client's communication confidential, but talk to the client daily, using therapeut
k k k k k k k k k k
ic communication to convince him to admit to hiding the knife.
k k k k k k k k k k k k k
B. Keep the client's communication confidential, but watch the client and his roommate clo
sely.
k k k k k k k k k k k k k k k k k
C. Tell the client that this must be reported to the health care team because it concerns the
k k k k k k k k
health and safety of the client and others.
k k k k k k k k k k k k k k k k k k
D. Report the incident to the health care team, but do not inform the client of the intention t
k k
o do so.
k k k
k k k k k k k k k k k k k k k k
A nurse is caring for a client who is in mechanical restraints. Which of the following statem
k k k k k k k k k k k
ents should the nurse include in the documentation? (Select all that apply)
k k k k k k
A. "Client ate most of his breakfast."
k k k k k k k k k
B. "Client was offered 8 oz of water every hr."
k k k k k k
C. "Client shouted obscenities at assistive personnel."
k k k k k k k k k
D. "Client received chlorpromazine 15 mg by mouth at 1000."
k k k k k
E. "Client acted out after lunch."
Aknursekhearskaknewlyklicensedknursekdiscussingkakclient'skhallucinationskinkthekhallwaykwit
hkanotherknurse.kWhichkofkthekfollowingkactionskshouldktheknursektakekfirst?
k k k k
A. Notify the nurse manager.
k k k k k k k k
B. Tell the nurse to stop discussing the behavior.
k k k k k k
C. Provide an in-service program about confidentiality.
k k k k
D. Complete an incident report.
k k k k k k k k k k k k k k k k
A nurse is caring for the parents of a child who has demonstrated changes in behavior and
k k k k k k k k k k k k k k k k
mood. When the mother of the child asks the nurse for reassurance about her son's condi
k k k k k k k k k
tion, which of the following responses should the nurse make?
k k k k k k k k k k k
A. "I think your son is getting better. What have you noticed."
k k k k k k k k k k k k
B. "I'm sure everything will be okay. It just takes time to heal."
k k k k k k k k k k k k k
C. "I'm not sure whats wrong. Have you asked the doctor about your concerns?"
k k k k k k k k k k
D. "I understand you're concerned. Let's discuss what concerns you specifically."
Aknursekiskcaringkforkakclientkwhoksmokeskandkhasklungkcancer.kThekclientkreports,k"I'mkcou
ghingkbecausekIkhavekthatkcoldkthatkeveryonekhaskbeenkgetting."kTheknursekshouldkidentifyk
thatkthekclientkiskusingkwhichkofkthekfollowingkdefensekmechanisms?
A.kReactionkformation
B.kDenial
C.kDisplacement
D.kSublimation
Aknursekiskprovidingkpreoperativekteachingkforkakclientkwhokwaskjustkinformedkthatkshekrequ
ireskemergencyksurgery.kThekclientkhaskakrespiratorykratek30/minkandksays,k"Thiskiskdifficult
ktokcomprehend.kIkfeelkshakykandknervous."kTheknursekshouldkidentifykthatkthekclientkiskexpe
riencingkwhichkofkthekfollowingklevelskofkanxiety?
,A.kMild
B.kModerate
C.kSevere
D.kPanic
Aknursekiskcaringkforkakclientkwhokiskexperiencingkmoderatekanxiety.kWhichkofkthekfollowingk
actionskshouldktheknursektakekwhenktryingktokgiveknecessarykinformationktokthekclient?k(Sel
ectkallkthatkapply.)
A.kReassurekthekclientkthatkeverythingkwillkbekokay.
B.kDiscusskpriorkusekofkcopingkmechanismskwithkthekclient.
C.kIgnorekthekclient'skanxietyksokthatkshekwillknotkbekembarrassed.
D.kDemonstratekakcalmkmannerkwhilekusingksimplekandkclearkdirections.
E.kGatherkinformationkfromkthekclientkusingkclosed-endedkquestions.
Aknursekisktalkingkwithkakclientkwhokiskatkriskkforksuicidekfollowingkthekdeathkofkhiskspouse.kW
hichkofkthekfollowingkstatementskshouldktheknursekmake?
A.k"Ikfeelkveryksorrykforktheklonelinesskyoukmustkbekexperiencing."
B.k"Suicidekisknotkthekappropriatekwayktokcopekwithkloss."
C.k"Losingksomeonekclosektokyoukmustkbekverykupsetting."
D.k"Ikknowkhowkdifficultkitkisktoklosekaklovedkone."
Akchargeknursekiskdiscussingkthekcharacteristicskofkaknurse-
clientkrelationshipkwithkaknewlyklicensedknurse.kWhichkofkthekfollowingkcharacteristicskshoul
dktheknursekincludekinkthekdiscussion?k(Selectkallkthatkapply)
A.kThekneedskofkbothkparticipantskarekmet.
B.kAnkemotionalkcommitmentkexistskbetweenkthekparticipants.
C.kItkiskgoal-directed.
D.kBehavioralkchangekiskencouraged.
E.kAkterminationkdatekiskestablished.
Aknursekiskinkthekworkingkphasekofkaktherapeutickrelationshipkwithkakclientkwhokhaskmetham
phetaminekusekdisorder.kWhichkofkthekfollowingkactionskindicatesktransferencekbehavior?
A.kThekclientkasksktheknursekwhetherkshekwillkgokoutktokdinnerkwithkhim.
B.kThekclientkaccusesktheknurseskofktellingkhimkwhatktokdokjustklikekhiskex-girlfriend.
C.kThekclientkremindsktheknursekofkakfriendkwhokdiedkfromkaksubstancekoverdose.
D.kThekclientkbecomeskangrykandkthreatensktokharmkhimself.
Aknursekiskplanningkcarekforkthekterminationkphasekofkaknurse-
clientkrelationship.kWhichkofkthekfollowingkactionskshouldktheknursekincludekinkthekplankofkcare?
A.kDiscussingkwaysktokuseknewkbehaviors
,B.kPracticingknewkproblem-solvingkskills
C.kDevelopingkgoals
D.kEstablishingkboundaries
Akchargeknursekiskdiscussingkmentalkstatuskexamskwithkaknewlyklicensedknurse.kWhichkofkt
hekfollowingkstatementskbyktheknewlyklicensedknursekindicateskankunderstandingkofkthektea
ching?k(Selectkallkthatkapply)
A.k"Tokassesskcognitivekability,kIkshouldkaskkthekclientktokcountkbackwardkbyksevens."
B.k"Tokassesskaffect,kIkshouldkobservekthekclient'skfacialkexpression."
C.k"Tokassessklanguagekability,kIkshouldkinstructkthekclientktokwritekaksentence."
D.k"Tokassesskremotekmemory,kIkshouldkhavekthekclientkrepeatkaklistkofkobjects."
E.k"Tokassesskthekclient'skabstractkthinking,kIkshouldkaskkthekclientktokidentifykourkmostkrece
ntkpresidents."
Aknursekiskplanningkcarekforkakclientkwhokhaskakmentalkhealthkdisorder.kWhichkofkthekfollowi
ngkactionskshouldktheknursekincludekaskakpsychobiologicalkintervention?
A.kAssistkthekclientkwithksystematickdesensitizationktherapy.
B.kTeachkthekclientkappropriatekcopingkmechanisms.
C.kAssesskthekclientkforkcomorbidkhealthkconditions.
D.kMonitorkthekclientkforkadversekeffectskofkthekmedications.
Aknursekinkankoutpatientkmentalkhealthkclinickiskpreparingktokconductkankinitialkclientkintervie
w.kWhenkconductingkthekinterview,kwhichkofkthekfollowingkactionskshouldktheknursekidentifyk
askthekpriority?
A.kCoordinatekholistickcarekwithksocialkservices.
B.kIdentifykthekclient'skperceptionkofkherkmentalkhealthkstatus.
C.kIncludekthekclient'skfamilykinkthekinterview.
D.kTeachkthekclientkaboutkherkcurrentkmentalkhealthkdisorder.
Aknursekisktoldkduringkchangekofkshiftkreportkthatkakclientkiskstuporous.kWhenkassessingkthek
client,kwhichkofkthekfollowingkfindingskshouldktheknursekexpect?
A.kThekclientkarouseskbrieflykinkresponsektokaksternalkrub.
B.kThekclientkhaskakglasgowkcomakscalekscoreklesskthank7.
C.kThekclientkexhibitskdecorticatekrigidity.
D.kThekclientkiskalertkbutkdisorientedktoktimekandkplace.
, AknursekiskplanningkakpeerkgroupkdiscussionkaboutkthekDSM-
5.kWhichkofkthekfollowingkinformationkiskappropriatektokincludekinkthekdiscussion?k(Selectkall
kthatkapply)
A.kThekDSM-5kincludeskclientkeducationkhandoutskforkmentalkhealthkdisorders.
B.kThekDSM-5kestablisheskdiagnostickcriteriakforkindividualkmentalkhealthkdisorders.
C.kThekDSM-
5kindicateskrecommendedkpharmacologicalktreatmentkforkmentalkhealthkdisorders.
D.kThekDSM-
5kassistsknurseskinkplanningkcarekforkclient'skwhokhavekmentalkhealthkdisorders.
E.kThekDSM-5kindicateskexpectedkassessmentkfindingskofkmentalkhealthkdisorders.
Aknursekinkankemergencykmentalkhealthkfacilitykiskcaringkforkakgroupkofkclients.kTheknurseksh
ouldkidentifykthatkwhichkofkthekfollowingkclientskrequireskaktemporarykemergencykadmission
?
A.kAkclientkwhokhaskschizophreniakwithkdelusionskofkgrandeur
B.kAkclientkwhokhaskmanifestationskofkdepressionkandkattemptedksuicidekakyearkago
C.kAkclientkwhokhaskborderlinekpersonalitykdisorderkandkassaultedkakhomelesskmankwithkak
metalkrod
D.kAkclientkwhokhaskbipolarkdisorderkandkpaceskquicklykaroundkthekroomkwhilektalkingktokhi
mself
k k k k k k k k k k k k k k k
A nurse decides to put a client who has a psychotic disorder in seclusion overnight becaus
k k k k k
e the unit is very short-
k k k k k k k k k k k k k k
staffed, and the client frequently fights with other clients. The nurse's actions are an exam
k k k k k k
ple of which of the following torts?
k k k
A. Invasion of privacy
k k
B. False imprisonment
k
C. Assault
k
D. Battery
k k k k k k k k k k k k k k k k k k k
A client tells a nurse, "Don't tell anyone but I hid a sharp knife under my mattress in order t
k k k k k k k k k k k k k k k
o protect myself from my roommate, who is always yelling at me and threatening me." Whi
k k k k k k k k
ch of the following actions should the nurse take?
k k k k k k k k k k k k k
A. Keep the client's communication confidential, but talk to the client daily, using therapeut
k k k k k k k k k k
ic communication to convince him to admit to hiding the knife.
k k k k k k k k k k k k k
B. Keep the client's communication confidential, but watch the client and his roommate clo
sely.
k k k k k k k k k k k k k k k k k
C. Tell the client that this must be reported to the health care team because it concerns the
k k k k k k k k
health and safety of the client and others.
k k k k k k k k k k k k k k k k k k
D. Report the incident to the health care team, but do not inform the client of the intention t
k k
o do so.
