ATI MENTAL HEALTH B 2019 PROCTORED EXAM 70
QUESTIONS WITH ANSWERS HIGHLITED
1. A nurse is reviewing the medical record of a client who has a new prescription for
haloperidol. Which of the following findings should the nurse identify as a contraindication to
this medication?
A. Glaucoma
B. Parkinson's disease
C. Hypertension
D. Hypothyroidism
Correct Answer: B. Parkinson's disease
Rationale: Haloperidol is a first-generation antipsychotic that blocks dopamine receptors.
Clients with Parkinson's disease already have depleted dopamine levels; blocking dopamine
further can severely worsen parkinsonian symptoms (rigidity, tremor, bradykinesia). Glaucoma,
hypertension, and hypothyroidism are not absolute contraindications.
2. A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the
following findings should the nurse expect?
A. Bradycardia
B. Hypotension
C. Tremors
D. Constricted pupils
Correct Answer: C. Tremors
Rationale: Alcohol withdrawal manifests with autonomic hyperactivity: tremors,
tachycardia, hypertension, diaphoresis, anxiety, and insomnia. Bradycardia, hypotension, and
constricted pupils are signs of intoxication/overdose, not withdrawal.
3. A nurse is teaching a client about the adverse effects of lithium carbonate. Which of the
following statements by the client indicates understanding?
A. "I should increase my sodium intake while taking this medication."
B. "I need to maintain a consistent fluid and sodium intake."
C. "I should decrease my fluid intake to prevent edema."
D. "I can stop the medication once my mood stabilizes."
, Correct Answer: B. "I need to maintain a consistent fluid and sodium intake."
Rationale: Lithium levels are inversely affected by sodium and fluid levels. Decreased
sodium/fluid intake causes lithium retention and toxicity. Clients must maintain consistent (not
increased) sodium and fluid intake. Lithium is lifelong therapy and is never abruptly
discontinued.
4. A nurse is assessing a client who has been taking clozapine for 2 weeks. Which of the
following findings requires immediate intervention?
A. Weight gain of 1 kg (2.2 lb)
B. Temperature of 38.9°C (102°F)
C. Dry mouth
D. Sedation
Correct Answer: B. Temperature of 38.9°C (102°F)
Rationale: Clozapine carries a risk of agranulocytosis, which can present with fever, sore
throat, and infection. A fever requires immediate CBC with differential. Weight gain, dry mouth,
and sedation are common expected adverse effects.
5. A nurse is using the CAGE questionnaire to assess a client for alcohol use disorder. Which of
the following questions is part of this screening tool?
A. "Have you ever felt you should cut down on your drinking?"
B. "How many drinks do you have per week?"
C. "Do you drink alone or in social settings?"
D. "What type of alcohol do you prefer?"
Correct Answer: A. "Have you ever felt you should cut down on your drinking?"
Rationale: CAGE stands for: Cut down, Annoyed by criticism, Guilty about drinking, Eye-
opener (morning drinking). Quantity, setting, and type of alcohol are not part of CAGE.
6. A nurse is caring for a client who has serotonin syndrome. Which of the following
medications should the nurse anticipate administering?
A. Cyproheptadine
B. Benztropine
C. Naloxone
D. Flumazenil
, Correct Answer: A. Cyproheptadine
Rationale: Cyproheptadine is a serotonin antagonist used as an antidote for serotonin
syndrome. Benztropine treats extrapyramidal symptoms, naloxone reverses opioid overdose,
and flumazenil reverses benzodiazepine overdose.
7. A nurse is assessing a client who has neuroleptic malignant syndrome (NMS). Which of the
following findings should the nurse expect?
A. Hypothermia
B. Muscle rigidity
C. Bradycardia
D. Hypotension
Correct Answer: B. Muscle rigidity
Rationale: NMS presents with "lead-pipe" muscle rigidity, high fever, altered mental status,
tachycardia, labile blood pressure, and diaphoresis. Hypothermia, bradycardia, and hypotension
are not characteristic.
8. A nurse is planning care for a client who has a new prescription for valproic acid. Which of
the following laboratory values should the nurse monitor?
A. Serum potassium
B. Liver function tests
C. Serum calcium
D. Thyroid-stimulating hormone
Correct Answer: B. Liver function tests
Rationale: Valproic acid is hepatotoxic and can cause fatal hepatotoxicity, especially in
children under 2 years. LFTs should be monitored at baseline and periodically. It can also cause
thrombocytopenia, so platelet counts should be monitored.
9. A nurse is providing teaching to a client who has a new prescription for sertraline. Which of
the following instructions should the nurse include?
A. "Take the medication at bedtime to prevent insomnia."
B. "It may take 4 to 6 weeks to notice improvement."
C. "Stop the medication immediately if you feel better."
D. "Avoid foods containing tyramine."
, Correct Answer: B. "It may take 4 to 6 weeks to notice improvement."
Rationale: SSRIs such as sertraline take 4–6 weeks for full therapeutic effect. They are taken
in the morning (can cause insomnia). They should never be stopped abruptly (discontinuation
syndrome). Tyramine restrictions apply to MAOIs, not SSRIs.
10. A nurse is assessing a client who has been taking olanzapine. Which of the following
findings is the priority for the nurse to report?
A. Weight gain of 3 kg (6.6 lb) in 1 month
B. Fasting blood glucose of 180 mg/dL
C. Drowsiness in the morning
D. Dry mouth
Correct Answer: B. Fasting blood glucose of 180 mg/dL
Rationale: Atypical antipsychotics such as olanzapine can cause hyperglycemia and new-
onset diabetes. A fasting glucose of 180 mg/dL is significantly elevated (normal 70–100 mg/dL)
and requires immediate provider notification. Weight gain, drowsiness, and dry mouth are
expected adverse effects.
11. A nurse is reviewing the medical history of a client who is scheduled to receive
electroconvulsive therapy (ECT). Which of the following findings should the nurse report to
the provider?
A. History of migraine headaches
B. Recent myocardial infarction
C. History of asthma
D. Controlled hypertension
Correct Answer: B. Recent myocardial infarction
Rationale: ECT causes an initial parasympathetic surge (bradycardia, hypotension) followed
by sympathetic stimulation (tachycardia, hypertension), which increases myocardial oxygen
demand. Recent MI (within 3 months) is a relative contraindication. Migraines, asthma, and
controlled hypertension are not contraindications.
12. A nurse is caring for a client who has been prescribed disulfiram. Which of the following
statements by the client indicates a need for further teaching?
A. "I should avoid mouthwash that contains alcohol."
QUESTIONS WITH ANSWERS HIGHLITED
1. A nurse is reviewing the medical record of a client who has a new prescription for
haloperidol. Which of the following findings should the nurse identify as a contraindication to
this medication?
A. Glaucoma
B. Parkinson's disease
C. Hypertension
D. Hypothyroidism
Correct Answer: B. Parkinson's disease
Rationale: Haloperidol is a first-generation antipsychotic that blocks dopamine receptors.
Clients with Parkinson's disease already have depleted dopamine levels; blocking dopamine
further can severely worsen parkinsonian symptoms (rigidity, tremor, bradykinesia). Glaucoma,
hypertension, and hypothyroidism are not absolute contraindications.
2. A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the
following findings should the nurse expect?
A. Bradycardia
B. Hypotension
C. Tremors
D. Constricted pupils
Correct Answer: C. Tremors
Rationale: Alcohol withdrawal manifests with autonomic hyperactivity: tremors,
tachycardia, hypertension, diaphoresis, anxiety, and insomnia. Bradycardia, hypotension, and
constricted pupils are signs of intoxication/overdose, not withdrawal.
3. A nurse is teaching a client about the adverse effects of lithium carbonate. Which of the
following statements by the client indicates understanding?
A. "I should increase my sodium intake while taking this medication."
B. "I need to maintain a consistent fluid and sodium intake."
C. "I should decrease my fluid intake to prevent edema."
D. "I can stop the medication once my mood stabilizes."
, Correct Answer: B. "I need to maintain a consistent fluid and sodium intake."
Rationale: Lithium levels are inversely affected by sodium and fluid levels. Decreased
sodium/fluid intake causes lithium retention and toxicity. Clients must maintain consistent (not
increased) sodium and fluid intake. Lithium is lifelong therapy and is never abruptly
discontinued.
4. A nurse is assessing a client who has been taking clozapine for 2 weeks. Which of the
following findings requires immediate intervention?
A. Weight gain of 1 kg (2.2 lb)
B. Temperature of 38.9°C (102°F)
C. Dry mouth
D. Sedation
Correct Answer: B. Temperature of 38.9°C (102°F)
Rationale: Clozapine carries a risk of agranulocytosis, which can present with fever, sore
throat, and infection. A fever requires immediate CBC with differential. Weight gain, dry mouth,
and sedation are common expected adverse effects.
5. A nurse is using the CAGE questionnaire to assess a client for alcohol use disorder. Which of
the following questions is part of this screening tool?
A. "Have you ever felt you should cut down on your drinking?"
B. "How many drinks do you have per week?"
C. "Do you drink alone or in social settings?"
D. "What type of alcohol do you prefer?"
Correct Answer: A. "Have you ever felt you should cut down on your drinking?"
Rationale: CAGE stands for: Cut down, Annoyed by criticism, Guilty about drinking, Eye-
opener (morning drinking). Quantity, setting, and type of alcohol are not part of CAGE.
6. A nurse is caring for a client who has serotonin syndrome. Which of the following
medications should the nurse anticipate administering?
A. Cyproheptadine
B. Benztropine
C. Naloxone
D. Flumazenil
, Correct Answer: A. Cyproheptadine
Rationale: Cyproheptadine is a serotonin antagonist used as an antidote for serotonin
syndrome. Benztropine treats extrapyramidal symptoms, naloxone reverses opioid overdose,
and flumazenil reverses benzodiazepine overdose.
7. A nurse is assessing a client who has neuroleptic malignant syndrome (NMS). Which of the
following findings should the nurse expect?
A. Hypothermia
B. Muscle rigidity
C. Bradycardia
D. Hypotension
Correct Answer: B. Muscle rigidity
Rationale: NMS presents with "lead-pipe" muscle rigidity, high fever, altered mental status,
tachycardia, labile blood pressure, and diaphoresis. Hypothermia, bradycardia, and hypotension
are not characteristic.
8. A nurse is planning care for a client who has a new prescription for valproic acid. Which of
the following laboratory values should the nurse monitor?
A. Serum potassium
B. Liver function tests
C. Serum calcium
D. Thyroid-stimulating hormone
Correct Answer: B. Liver function tests
Rationale: Valproic acid is hepatotoxic and can cause fatal hepatotoxicity, especially in
children under 2 years. LFTs should be monitored at baseline and periodically. It can also cause
thrombocytopenia, so platelet counts should be monitored.
9. A nurse is providing teaching to a client who has a new prescription for sertraline. Which of
the following instructions should the nurse include?
A. "Take the medication at bedtime to prevent insomnia."
B. "It may take 4 to 6 weeks to notice improvement."
C. "Stop the medication immediately if you feel better."
D. "Avoid foods containing tyramine."
, Correct Answer: B. "It may take 4 to 6 weeks to notice improvement."
Rationale: SSRIs such as sertraline take 4–6 weeks for full therapeutic effect. They are taken
in the morning (can cause insomnia). They should never be stopped abruptly (discontinuation
syndrome). Tyramine restrictions apply to MAOIs, not SSRIs.
10. A nurse is assessing a client who has been taking olanzapine. Which of the following
findings is the priority for the nurse to report?
A. Weight gain of 3 kg (6.6 lb) in 1 month
B. Fasting blood glucose of 180 mg/dL
C. Drowsiness in the morning
D. Dry mouth
Correct Answer: B. Fasting blood glucose of 180 mg/dL
Rationale: Atypical antipsychotics such as olanzapine can cause hyperglycemia and new-
onset diabetes. A fasting glucose of 180 mg/dL is significantly elevated (normal 70–100 mg/dL)
and requires immediate provider notification. Weight gain, drowsiness, and dry mouth are
expected adverse effects.
11. A nurse is reviewing the medical history of a client who is scheduled to receive
electroconvulsive therapy (ECT). Which of the following findings should the nurse report to
the provider?
A. History of migraine headaches
B. Recent myocardial infarction
C. History of asthma
D. Controlled hypertension
Correct Answer: B. Recent myocardial infarction
Rationale: ECT causes an initial parasympathetic surge (bradycardia, hypotension) followed
by sympathetic stimulation (tachycardia, hypertension), which increases myocardial oxygen
demand. Recent MI (within 3 months) is a relative contraindication. Migraines, asthma, and
controlled hypertension are not contraindications.
12. A nurse is caring for a client who has been prescribed disulfiram. Which of the following
statements by the client indicates a need for further teaching?
A. "I should avoid mouthwash that contains alcohol."
