ATI Mental Health Proctored Exam 2019

1.A client is fearful of driving and enters a behavioral therapy program to help him overcome his anxiety. Using systematic desensitization, he is able to drive down a familiar street without experiencing a panic attack. The nurse should recognize that to continue positive results, the client should participate in which of the following? a. Biofeedback b. Therapist modeling c. Frequent pacing d. Positive reinforcement - A 2. A nurse is counseling a client following the death of the client's partner 8 months ago. Which of the following client statements indicates maladaptive grieving? a. "I am so sorry for the times I was angry with my partner." b. "I like looking at his personal items in the closet." c. "I find myself thinking about my partner often." d. "I still don't feel up to returning to work." - D 3. A nurse in an inpatient mental health facility is assessing a client who has schizophrenia and is taking haloperidol (antipsychotic, 1st gen). Which of the following clinical findings is the nurse's priority? a. Headache b. Insomnia c. Urinary hesitancy d. High fever - D 4. A nurse is planning care for a client who has obsessive compulsive disorder. Which of the following recommendations should the nurse include in the client's plan of care? a. Reality Orientation therapy b. Operant Conditioning c. Thought Stopping d. Validation Therapy - C 4. A nurse is providing teaching to the daughter of an older client who has obsessivecompulsive disorder. Which of the following statements by the daughter indicates an understanding of the teaching? a. "I will provide my mother with detailed instructions about how to perform self-care." b. "I will limit my mother's clothing choices when she is getting dressed." c. "I will wake my mother up a couple of times in the night to check on her." d. "I will discourage my mother from talking about her physical complaints." - B 5. A nurse is caring for a client who is in the manic phase of bipolar disorder. Which of the following actions should the nurse take? a. Provide in depth explanation of nursing expectations b. Encourage the client to participate in group activities c. Avoid power struggles by remaining neutral d. Allow the client to set limits for his behavior - C 6. A nurse is providing behavioral therapy for a client who has OCD. The client repeatedly checks that the doors are locked at night. Which of the following instructions should the nurse give the client when using thought stopping technique? a. "Keep a journal of how often you check the locks each night." b. "Ask a family member to check the locks for you at night." c. "Focus on abdominal breathing whenever you go to check the locks" d. "Snap a rubber band on your wrist when you think about checking the locks." - D 7. A nurse is caring for a client who has a cocaine use disorder. Which of the following manifestations should the nurse expect the client to have during withdrawal? a. Hand tremors b. Fatigue c. Seizures d. Rapid speech - B 8. A nurse is reviewing the medical record of a client who is taking clozapine. For which of the following findings should the nurse withhold the medication and notify the provider? a. WBC count b. Heart rate c. Report of photosensitivity d. Blood glucose level - A 9. A nurse is creating a plan of care for a client who has major depressive disorder. Which of the following interventions should the nurse include in the plan? a. Keep the ring light on in the client's room at night b. Encourage physical activity for the client during the day c. Identity and schedule alternative group activities for the client d. Discourage the client from expressing feeling of anger - B 10. A nurse is assessing a client who is experiencing acute alcohol withdrawal. Which of the following findings should the nurse expect? a. Diminished reflexes b. Hypotension - increased BP c. Insomnia d. Bradycardia - C 11. A nurse is caring for a client who has schizophrenia and displays severe symptoms of the disorder. Which of the following actions should the nurse take? a. Use medication to decrease frequency of auditory and visual hallucinations b. Assist the client to identify somatic and thought broadcast delusion c. Manage the client's loud, rambling, and incoherent communication patterns d. Direct the client to perform her own daily hygiene and grooming tasks - D 12. A nurse is caring for a client who was involuntarily committed and is scheduled to receive electroconvulsive therapy. The client refuses the treatment and will discuss why with the healthcare team. Which of the following actions should the nurse take? a. Document the client's refusal of the treatment in the medication record b. Tell the client he cannot refuse the treatment because he was involuntarily committed c. Inform the client the ECT does not require client consent d. Ask the client family to encourage the client to receive ECT - A 13. A nurse is providing crisis intervention for a client who was involved in a violent mass casualty situation in the community. Which of the following actions should the nurse take during the initial session with the client? a. Identify the client's usual coping style. b. Encourage the client to display anger toward the cause of the crisis. c. Tell the client that this life will soon return to normal d. Help the client focus on a wide variety of topics regarding the crisis - A 14. A nurse in the emergency department is caring for a client who reports feeling sad, worthless, and hopeless 9 months after the death of her son. Which of the following actions should the nurse take first? a. Encourage the client to attend a grief support group b. Discuss the client's coping skills c. Request a mental health consult for the client d. Ask the client if she has thought about harming herself - D 15. A nurse is planning care for an adolescent who has autism spectrum disorder. Which of the following outcomes should the nurse include in the plan of care? a. Acknowledges that his delusions are not real b. Changes behavior as a result of peer pressure c. Initiate social interactions with caregiver d. Meets own needs without manipulating others. - C 16. A nurse is caring for a client who is experiencing active auditory hallucination. Which of the following should the nurse take? a. Avoid asking direct questions about the client's experience b. Tell the client her experience is not real c. Convey sympathy for her client's experience d. Focus the client on reality based activities - D 17. A nurse is conducting an admission interview with a client who is experiencing mania. Which of the following findings the nurse reports to the provider? a. Reports eating twice in the past week b. States that he hasn't bathed in 2 days c. Speaks in rhyming sentences d. Makes inappropriate sexual comments - A 18. A nurse is caring for a client who has anorexia nervosa. Which of the following findings requires immediate intervention by the nurse? a. Lanugo covering the body b. Blood pH 7.40 c. +2 edema of the lower extremities d. BUN 21 mg/dL - C 19. A nurse is planning care for a client who has a recent diagnosis of antisocial personality disorder. Which of the following outcomes should the nurse in the care plan? a. The client treats others with respect b. The client recognizes the importance of others c. The client reduces self-dramatization d. The client conforms to social norms regarding clothing choices - A 20. A nurse is caring for a client who is prescribed massage therapy to treat panic disorder. The client states "I can't stand to be touched by another person". Which of the following response should the nurse make? a. Why don't you like to be touched by others? b. I will request that the massage therapist wear gloves during your treatment c. I will tell your provider know that you would like a treat other than a message d. Don't worry about it. Your anxiety will lessen once the massage begins - C 21. A nurse in a group home facility is caring for a client who is developmentally disabled. The client has been stealing belongings from the other clients. Which of the following techniques should the nurse use? a. Crisis intervention to decrease anxiety b. Aversion therapy to provide distraction c. Systematic desensitization to extinguish the behavior d. Positive reinforcement to increase desired behavior - B 22. A nurse in a mental facility is caring for a newly admitted client. Which of the following resources should the nurse recommend to help the client adapt to the healthcare setting? a. A Community meeting b. A Mediation group c. A Symptom management group d. A Self-help meeting - A 23. A nurse is teaching the caregiver of a client who has advanced Alzheimer's disease about home safety. Which of the following statements by the caregiver indicates an understanding of the teaching? a. I will give his most recent photo to the police b. I will place a sliding bolt lock just above the doorknob c. I will ensure the bedroom is dark while he is sleeping at night d. I will notify law enforcement within 2 hours if he cannot be found - B 24. A nurse is beginning a therapeutic relationship with a client. The nurse should plan to accomplish which of the following tasks during the working phase? a. Establish boundaries between the nurse and client. b. evaluate progress toward predetermined goals c. inform the client about confidentiality d. set short and long term objectives for the future. - B 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? 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 - C 26. A nurse is providing discharge teaching about manifestations of relapse to the family of a client who has schizophrenia. Which of the following information should the nurse include in the teaching? a. The client develops an inability to concentrate b. The client increases participation in social activities c. The client exhibits an inflated sense of self d. The client begins sleeping more than usual - A 27. A nurse in a mental health facility is caring for a client. Which of the following actions should the nurse take during the working phase of the nurse-client relationship? a. Summarize goals and objectives. b. Address confidentiality. c. Promote problem-solving skills. d. Establish a participation contract - C 27. A nurse is planning care for a client who has dementia. Which of the following interventions should the nurse include in the plan? a. Remove clocks from the client's room b. Confront the client when he exhibits inappropriate behavior c. Give detailed instructions for completion of self-care activities d. Provide finger food to enhance caloric intake - D 28. A nurse is developing a teaching plan for the family of an older adult client who is to receive transcranial magnetic stimulation. Which of the following information should the nurse include in the teaching plans? a. The client might have a headache after treatment b. The client will require intubation after treatment c. The client is at risk for aspiration during treatment d. The client will experience a seizure during treatment - A 29. A nurse overhears a client saying, "I am a spy, a spy for the FBI. I am an I, an eye for an eye, an eye in the sky. Sky is up high. The nurse should document the client's statement as which of the following speech alterations? a. Clang association b. Echolalia c. Word salad d. Neologism - A 30. A nurse is assessing a client who has neuroleptic malignant syndrome. Which of the following clinical findings should the nurse expect? a. Hypotonicity b. Temperature (104F) c. Heart rate 48/min d. WBC 3,000/mm - B 31. A nurse in an acute care mental health facility is planning discharge care for a client who sustained a traumatic brain injury. For which of the following needs should the nurse collaborate with a clinical psychologist? a. The client needs to begin a group therapy program prior to discharge b. The client needs to find a place to live after discharge. c. The client needs a prescription for medication to promote nighttime sleep while in the facility d. The client needs to relearn how to perform skills that require fine motor coordination. - A 32. A nurse is caring for a client who reports that he is angry with his partner because she is thinking he is just trying to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to leave. Which of the following defense mechanism is the client demonstrating? a. Denial b. Displacement c. Compensation d. Rationalization - B 33. A nurse is teaching a client who has schizophrenia about her new prescription for risperidone. Which of the following statements should be nurse include in the teaching? a. You should discontinue this medication if you develop muscle rigidity b. You will experience weight loss while taking this medication c. You will notice symptoms improve within 24 hours of taking this medication d. You should increase your consumption of complex carbohydrates - A 34. A nurse is talking to a client following a group therapy session. The client tells the nurse that one of the other clients in the group made an inappropriate comment. Which of the following responses should the nurse make? a. You sound upset about today's session b. I agree that the comment was inappropriate c. Why do you think that he said that to you? d. I think you should ignore the comment - A 35. A nurse is reviewing the laboratory report of a client who is taking carbamazepine for bipolar disorder. Which of the following laboratory results should the nurse report to the provider? a. RBC 4.7/mm b. Platelets 90,000/mm c. Urine specific gravity 1.029 d. Urine pH 5.6 - B 36. A nurse is providing teaching about disorder management for a client who has PTSD. Which of the following statements should the nurse include in the teaching? a. Response prevention is an effective treatment for PTSD b. You should try to limit the number of hours that you sleep each day c. Talking about the traumatic experience is recommended d. Avoiding stimuli that trigger memories of the trauma can help you overcome your PTSD - C 37. A nurse is providing teaching about disulfiram. Which information should the nurse include. SATA a. You will need to take the medication once daily b. You should avoid drinking carbonated beverages while taking the medication c. You can expect to develop a physical dependence to the medication d. You will receive treatment in an inpatient setting e. You should avoid using mouthwash that contain alcohol - AE 38. A nurse in a mental health facility is making plans for client's discharge. Which of the following interdisciplinary team members should the nurse contact to assist the client with housing placement? a. Social worker b. Occupational therapist c. Clinical nurse specialist d. Recreational therapist - A 39. A nurse is providing teaching to a client who has depressive disorder and a new prescription for doxepin. Which of the following instructions should the nurse include in the teaching? a. Decrease the prescribed dose by half when mood improves b. Sit on the side of the bed for a few minutes before standing c. Eat a snack before going to bed d. Avoid over the counter magnesium when taking this medication - B 40. 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-dependent's Support Group b. Dual Diagnosis Treatment Group c. Desensitization Therapy d. Dialectical Behavior Treatment - D 41. A nurse is caring for a client following a physical assault. The client states, "I don't remember what happened to me." The nurse should recognize that the client is using which of the following defense mechanism? A. Rationalization B. Repression C. Denial D. Displacement - B 42. A nurse is preparing to administer haloperidol 7mg IM to a client who is severely agitated. Available is haloperidol injection 5mg/mL. How many mL should the nurse administer? - 1.4 ml 43. A charge nurse is discussing the care of a client who has a substance use disorder with a staff nurse. Which of the following statements by the staff nurse should the charge nurse identify as countertransference? a. The client is just like my brother who finally overcome his habit b. The client generally shares his feelings during group therapy sessions c. The client asked me to go on a date with him, but I refused d. The client needs to accept responsibility for his substance use - A 44. A nurse is teaching a client who has a new prescription for phenelzine to treat depression. The nurse instructs the client to avoid foods with tyramine to prevent which of the following? a. Serotonin syndrome b. Hypertensive crisis c. Urinary retention d. Cardiac toxicity - B 45. A nurse is caring for a client who has a personality disorder and is using transference to cope. Which of the following behaviors should the nurse expect? a. Refusing to participate in group activities b. Reaction to the nurse as though she were his mother c. Expressing frustration regarding unit rules d. Talking negatively about other staff member - B 46. A nurse is admitting a client who has generalized anxiety disorder. Which of the following actions should the nurse plan to take first? a. Determine how the client handles stress b. Ask the client to identify her strengths c. Provide the client with a quiet environment d. Teach the client to use guided imagery - C 47. A nurse is teaching a client who has bipolar disorder and a new prescription for lithium carbonate. Which of the following statements by the client indicates an understanding of the teaching? a. I should be on a low sodium diet b. I should drink at least 6 liters of water per day c. I will see my doctor to check my lithium level annually d. I will call my doctor if I have a diarrhea - D 48. A nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take? a. Place the client in seclusion b. Ask the client to discuss precipitating events c. Have the client breathe into a paper bag d. Speak to the client in a high-pitched voice - A 49. 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? a. Providing the client with quality care regardless of ability to pay for treatment b. Withholding a prescribed meds that is causing adverse effects for the client c. Being truthful with the client about the manifestations of withdrawal d. Educating the client about legal rights concerning treatment - B 50. A nurse is caring for a client who has just returned to the unit after receiving an electroconvulsive therapy treatments. Which of the following assessments is the nurse's priority? a. Return of bowel sounds b. First voiding c. Short term memory d. Presence of gag reflex - D 51. A nurse in the emergency department is counseling a client who reports experiencing intimate partner violence. Which of the following actions should the nurse take? a. Request permission from the client to take photographs of the injuries. b. Offer to help the client escape from the partner the next time violence occurs c. Determine what the client did to trigger the violent incident. d. Tell the client that staying with the partner shows a lack of judgment. - A 52. A nurse is reviewing the medication administration record of a client who has schizophrenia. The nurse should plan to initiate the abnormal involuntary movement scale to monitor for adverse effects of which of the following medications? a. Amantadine b. Benztropine c. Diphenhydramine d. Haloperidol - D 54. A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client's history should the nurse report to the provider? a. Knee arthroplasty 1 month ago b. Hepatitis B infection c. Recent head injury d. Hypothyroidism - C 53. A nurse is planning overall strategies to address problems for a client who has borderline personality disorder. Which of the following strategies is the priority for the nurse to incorporate in the plan of care? a. Discuss the appropriate use of assertive behavior with the client b. Assist the client to maintain awareness of her thoughts and feelings c. Implement measures to prevent intentional self-inflicted injury d. Encourage the client to attend weekly support group meetings - C 55. A nurse is caring for a client who has bipolar disorder and is experience a manic episode. Which of the following actions should the nurse take? a. Administer methylphenidate to the client b. Encourage the client to join group activities c. Dim the lights in the client's room d. Provide detailed explanations to the client - C