ATI RN Mental Health Proctored Exam NGN Version 2 With Answers (65 Solved Questions)

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ATI RN Mental Health Proctored Exam NGN Version 2 With Answers (65 Solved Questions) - Page 1 preview image

VERSION2ATIMENTAL HEALTHPROCTORED EXAM1.Acharge nurse is discussing mental status examinations with a newly licensed nurse.Which of the following statements by the newly licensed nurse indicates an understandingof the teaching? (select all that apply.)A. “To assess cognitive ability,I should ask the client to count backward by sevens.”counting backward by 7s is an appropriate technique to assess a client’s cognitive ability.B. “To assess affect, I should observe the client’s facial expression.” Observing a client’sfacial expression is appropriate when assessing affect.

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C. “To assess language ability, I should instruct the client to write a sentence.” Writing asentence is an indication of language ability.2.A nurse is planning care for a client who has a mental health disorder. Which of thefollowing actions should the nurse include as a psychobiological intervention?D. Monitor the client for adverse effects of medications. Monitoring for adverse effectsof medications is an example of a psychobiological intervention.3.A nurse in an outpatient mental health clinic is preparing to conduct an initial clientinterview. When conducting the interview, which of the following actions should thenurse identify as the priority?B. Identify the client’s perception of her mental health status. assessment is the priorityaction when using the nursing process approach to client care. identifying the client’sperception of her mental health status provides important information about the client’spsychosocial history.4.Anurse is told during change‐of‐shift report that a client is stuporous. When assessing theclient,which of the following findings should the nurse expect?A. The client arouses briefly in response to a sternal rub. A client who is stuporousrequiresvigorous or painful stimuli to elicit a response.5.A nurse is planning a peer group discussion about theDiagnostic and Statistical Manualof Mental Disorders, 5th edition (DsM‐5). Which of the following information isappropriate to include in the discussion? (select all that apply.)B. the DSM‐5 establishes diagnostic criteria for individual mental health disorders.D. the DSM‐5 assists nurses in planning care for client’s who have mental healthdisorders.E. the DSM‐5 indicates expected assessment findings ofmental health disorders.Chapter 21.A nurse in an emergency mental health facility is caring for a group of clients. the nurseshould identify that which of the following clients requires a temporary emergencyadmission?C. Aclient who has borderline personality disorder and assaulted a homelessman witha metal rod. A client who is a current danger to self or others is a candidate for atemporary emergency admission.2.A nurse decides to put a clientwho has a psychotic disorder in seclusion overnightbecause the unit is very short‐staffed, and the client frequently fights with other clients.

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the nurse’s actions are an example of which of the following torts?B. False imprisonment. A civil wrong that violates a client’s civil rights is a tort. in thiscase, it is false imprisonment, which is the confining of a client to a specific area, such asa seclusion room, if the reason for such confinement is for the convenience of staff.3.A client tells a nurse, “don’t tell anyone, but i hid a sharp knife under my mattress inorder to protectmyself from my roommate, who is always yelling at me and threateningme.” Which of the followingactions should the nurse take?C. Tell the client that this must be reported to the health care team because itconcernsthe health and safety of the client and others. The information presented bythe client is a serious safety issue that the nurse must report to the health care team. usingthe ethical principle of veracity, the student tells the client truthfully what must be doneregarding the issue.4.A nurse is caring for a client who is in mechanical restraints. Which of the followingstatements should the nurse include in the documentation? (select all that apply.)B. “Client was offered 8 oz of water every hr.”how much water was offered and howoften it was offered is objective data that the nurse should document when caring for aclient in mechanical restraints.C. “Client shouted obscenities at assistive personnel.”A description of the client’s verbalcommunication is objective data that the nurse should document whencaring for aclient in mechanical restraints.D. “Client received chlorpromazine 15 mg by mouth at 1000.”The dosage and time ofmedication administration is objective data that the nurse should document when caringfor a client in mechanicalrestraints5.A nurse hears a newly licensed nurse discussing a client’s hallucinationsin the hallwaywith another nurse. Which of the following actions should the nurse take first?B. tell the nurse to stop discussing the behavior. The greatest risk to this client is aninvasion of privacy through the sharing of confidential information ina public place. thefirst action the nurse should take is to tell the newly licensed nurseto stop discussingthe client’s hallucinations in a public location.Chapter 31.A charge nurse is conducting a class on therapeutic communication toa group ofnewly licensed nurses. Which of the following aspects of communication should thenurse identify as a component of verbal communication?D. intonation. The nurse should identify intonation as a component of verbalcommunication. intonation is the tone of one’s voice and can communicate a varietyof feelings.

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2.A nurse in an acute mental health facility is communicating with a client. the clientstates, “I can’t sleep. I stay up all night.” the nurse responds,“You are having difficulty sleeping?” Which ofthe following therapeuticcommunication techniques isthe nurse demonstrating?D. Restating. Restating allows the nurse to repeat the main idea expressed.3.A nurse is communicating witha client who was just admittedfor treatment of asubstance usedisorder. Which of the following communication techniques should thenurse identify as a barrier to therapeutic communication?A. Offering advice. Offering advice to a client is a barrier to therapeuticcommunication that the nurse should avoid using. advice tends to interfere with theclient’s ability to make personal decisions and choices.4.A nurse caring for a client who hasanorexia nervosa. Whichof the followingexamples demonstrates the nurse’s use of interpersonal communication?C. the nurse asks the client about her body image perception.The nurse’s one‐on‐onecommunication with the client is an example of interpersonal communication.5.A nurse is caring for the parents of a child who has demonstrated recent changes inbehavior and mood. When the mother of the child asks the nurse for reassuranceabout her son’s condition, which of the following responses should the nurse make?D. “I understand you’re concerned. Let’s discuss what concerns you specifically.”The therapeutic response reflects upon, and accepts, the parents’ feelings, and itallows them to clarify what they are feeling.Chapter 41.A nurse is caringfor a client who smokes and has lung cancer. the client reports,“I’m coughing because I have that cold that everyone has been getting.” The nurseshould identify that the client is using which of the following defensemechanisms?B. denial. This is an example of denial, which is pretending the truth is not realityto manage the anxiety of acknowledging what is real.2.A nurse is providing preoperative teaching for a client who was just informed thatshe requires emergency surgery. the client, has a respiratory rate 30/min, and says,

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“this is difficult to comprehend. I feel shaky and nervous.” the nurse shouldidentify that the client is experiencing which of the following levels of anxiety?B. Moderateanxiety decreases problem‐solving and may hamper the client’sability to understand information. Vital signs may increase somewhat, and theclient is visibly anxious.3.A nurse is caring for a client who is experiencing moderate anxiety. Which of thefollowing actions should the nurse take when trying to give necessary informationto the client? (Select all that apply.)B. Discuss prior use of coping mechanisms with theclient.This assists the client inidentifying ways of effectively coping with the current stressor.D. Demonstrate a calm manner while using simple and clear directions.Providinga calm presence assists the client in feeling secure and promotes relaxation. clientsexperiencing moderate levels of anxiety often bene t from the direction of others..Chapter 51.A nurse is talking with a client who is at risk for suicide following the death of hisspouse. Which of the following statements should thenurse make?C. “Losing someone close to you must be very upsetting.”This statement is anempathetic response that attempts to understand the client’s feelings.2.A charge nurse is discussing the characteristics of a nurse-client relationship with a newlylicensed nurse. Which of the following characteristics should the nurse include in thediscussion? (Select all that apply.)C. It is goal-directed.A therapeutic nurse-client relationship is goal-directed.D. Behavioral change is encouraged.A therapeutic nurse-client relationship encouragespositive behavioral change.E. Atermination date is established. A therapeutic nurse-client relationshiphas anestablished termination date.3.A nurse is in the working phase of a therapeutic relationship with a client who hasmethamphetamine use disorder. Which of the following actions indicates transferencebehavior?B. The client accuses the nurse oftelling him what to do just like his ex-girlfriend.Whena client views the nurse as having characteristics of another person who has beensignificant to his personallife, such as his ex-girlfriend, this indicates transference.

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4.A nurse is planning care for the termination phase of a nurse-client relationship. Which ofthe following actions should the nurse include in the plan of care?A. Discussing ways to use new behaviorsinto life is an appropriate task for thetermination phase.5.A nurse is orienting a new clientto a mental health unit. When explaining the unit’scommunity meetings, which of the following statements should the nurse make?C.“You and the other clients will meet with staff to discuss common problems.”Community meetings are anopportunity for clients to discuss common problems orissues affecting all members of the unit.Chapter 61.A nurse is caring for several clients who are attending community‐based mental healthprograms. Whichof the following clients should the nurse plan to visit first?C. A client who says he is hearing a voice that tells him he is not worthy of livinganymore. A client who hears a voice telling him he is not worthy is at greatest risk forself‐harm, and the nurse should visit this client first.2.A community mental health nurse is planning care to address the issue of depressionamong older adult clients in the community. Which of the following interventions shouldthe nurse plan as a method of tertiary prevention?C. establishing rehabilitationprograms to decrease the effects of depression.Rehabilitation programs are an example of tertiary prevention. tertiary prevention dealswith prevention of further problems in clients already diagnosed with mental illness.3.A nurse is working in a community mental health facility. Whichof the followingservices doesthis type of program provide? (select all that apply.)A. educational groupsB. Medication dispensing programsC. individual counseling programsE. Family therapy4.A nurse in anacute mental health facility is assisting with discharge planning for a clientwho has a severe mental illness and requires supervision much of the time. the client’swife works all day but is home by late afternoon. Which of the following strategiesshould the nurse suggest as appropriate follow‐up care?

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C. attending a partial hospitalization program. A partial hospitalization program canprovide treatment during the day while allowing the client to spend nights at home, aslong as a responsible family member is present.5.A nurse is caring for a group of clients. Which of the following clients should a nurseconsider for referral to an assertive community treatment (act) group?1.B. a client who lives at home and keeps “forgetting” to come in for hismonthlyantipsychotic injection for schizophrenia. An ACT group works with clients who arenonadherent with traditional therapy, such as the client in a home setting who keeps“forgetting” his injection.Chapter 71.Anurse is teaching a client who has an anxiety disorder and is scheduled to beginclassical psychoanalysis. Which of the following client statements indicates anunderstanding of this form of therapy?2.B. “The therapist will focus on my past relationships during our sessions.”Classicalpsychoanalysis places a common focus on past relationships to identify the cause of theanxiety disorder.2.A nurse is discussing free association as a therapeutic tool with aclient who has majordepressive disorder. Which of the following client statements indicates understanding ofthis technique?D.“Ishould say thefirst thing that comes to my mind.”Free association is thespontaneous, uncensored verbalization of whatever comes to a client’s mind.3.A nurse is preparing to implement cognitive reframing techniques for a client who has ananxiety disorder. Which of the following techniques should thenurse include in the planof care? (select all that apply.)A. Priority restructuringB. Monitoring thoughtsD. Journal keeping

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4.A nurse is caring for a client who has a new prescription for disulfiram for treatment ofalcohol use disorder. The nurseinforms the client that this medication can cause nauseaand vomiting if he drinks alcohol. Which of the following types of treatment is thismethod an example?A.Aversion therapy pairs a maladaptive behavior with unpleasant stimuli to promote achange inbehavior.B.A nurse is assisting with systematic desensitization for a client who has an extremefear of elevators. Which of the following actions should the nurse implement with thisform of therapy?C. Gradually expose the client to an elevator while practicing relaxation techniques.systematic desensitization is the planned, progressive exposure to anxiety‐provokingstimuli. during this exposure, relaxation techniques suppress the anxiety response.Chapter 8–Group and Family Therapy1.A nurse wants to use democratic leadership with a group whose purpose is to learnappropriate conflict resolution techniques. The nurse is correct in implementing this formof group leadership when she demonstrates which of the following actions?C. asks for group suggestions oftechniques and then supports discussion. Democraticleadership supports group interaction and decision making to solve problems2.A nurse is planning group therapy for clients dealing with bereavement. Which of thefollowing activities should the nurseinclude in the initial phase? (Select all that apply.)B. Define the purpose of the group.C. Discuss termination of the group.E. Establish an expectation of confidentiality within the group.3.A nurse working on an acute mental health unit forms agroup to focus on self‐managementof medications. at each of the meetings, two of the members use theopportunity to discuss their common interest in gambling on sports. This is an example ofwhich of the following concepts?D. hidden agendais when some group members have a different goal than the statedgroup goals. The hidden agendais often disruptive to the effective functioning of thegroup.

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4.A nurse is conducting a family therapy session. The adolescent son tells the nurse that heplans ways to make his sister look bad so his parents will think he’s the better sibling,which he believes will give him more privileges. The nurse should identifythisdysfunctional behavior as which of the following?B. manipulationis the dysfunctional behavior of using dishonesty to support anindividual agenda.5.A nurse is working withan established group and identifies various member roles. Whichof thefollowing should the nurse identify as an individual role?C. Amemberwho brags about accomplishments. An individual who brags aboutaccomplishments is acting in an individual role that does not promote the progression ofthe group toward meeting goals.Chapter 9–Stress Management1.A nurse is preparing to provide an educational seminar on stress to other nursingstaff. Which of the following information should the nurse include in the discussion?A. excessive stressors cause the client to experience distress.Distress is the result ofexcessive or damaging stressors, such as anxiety or anger.2.A nurse is discussing acute vs. prolonged stress with a client. Which of the followingeffects should the nurse identify as an acute stress response? (Select all that apply.)B. Depressed immune systemC. Increasedblood pressureE. Unhappiness3.A nurse is teaching a client about stress‐reduction techniques. Which of thefollowingclient statements indicates understanding of the teaching?A.“Cognitive reframing will help me change my irrational thoughts to somethingpositive.”Cognitive reframing helps the client look at irrational cognitions (thoughts)in a more realistic light and to restructure those thoughts in a more positive way.4.A client says she is experiencing increased stress because her significant other is“pressuringme and my kids to go live with him. I love him, but I’m notready todo that.” Which of the following recommendations should the nurse make to promotea change in the client’s situation?B. Use assertiveness techniques. Assertive communication allows the client to asserther feelings and then make a change in thesituation.

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5.A nurse is caring for a client who states, “I’m so stressed at work because of mycoworker. He expects me to finish his work because he’s too lazy!” When discussingeffective communication, which of the following statementsby the client to hiscoworker indicates client understanding?D. “When I have to pick upextra work, I feel very overwhelmed. I need to focuson my own responsibilities.” This response demonstrates assertive communication,which allows the client to state his feelings about the behavior and then promote achange.Chapter 10–Brain stimulation Therapies1.A nurse is providing teaching for a client who is scheduled to receive eCt for thetreatment of major depressive disorder. Which of the following client statementsindicates understanding of the teaching?D. “Iwill receive a muscle relaxant to protect me from injury during ECT.”Amuscle relaxant, such as succinylcholine, is administered to reduce the risk forinjury during induced seizure activity.2.Acharge nurse is discussing TMSwith a newly licensed nurse. Which of thefollowing statements by the newly licensed nurse indicates an understanding ofthe teaching?D.“Iwill schedule the client for daily TMStreatments for thefirst severalweeks.”TMS is commonly prescribed daily for a period of 4 to 6 weeks.3.A nurse is assessing a client immediately following an ECTprocedure. Which ofthe following findings should the nurse expect? (Select all that apply.)C. memory lossD. nauseae. Confusion4.A nurse is leading a peer group discussion about the indications for ECT. Whichof the following indications should the nurse include in the discussion?C. Bipolar disorder with rapid cycling5.A nurse is planning care for a client followingsurgical implantation of a VNSdevice. the nurse should planto monitor for which of the following adverseeffects? (Select all that apply.)

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A. Voice changes are a common adverse effect of VNS due to the proximity ofthe implanted lead on the vagus nerveto the larynx and pharynxD. Dysphagia is a potential adverse effect of VNS. however, this usually subsideswith timeE. neck pain is a potential adverse effect of VNS. however, this usually subsideswith time.Week 2Chapter 15-18, 24, 26Chapter 15–Psychotic Disorders1.A nurse is caring for a client who has substance‐induced psychotic disorder and isexperiencing auditory hallucinations. the client states, “the voices won’t leave me alone!”Which of the following statements should the nurse make? (select all that apply.)A. “When did you start hearing the voices?” The nurse should ask the client directlyabout the hallucination.C. “It must be scary to hear voices.” The nurse should focus on the client’s feelings ratherthan agreeing with the client’s hallucination.D. “Are the voices telling you to hurt yourself?” the nurse should assess for commandhallucinations and the client’s risk for injury to self or others.2.A nurse is completing an admission assessment for a client who has schizophrenia.Whichof the following findings should the nurse document as positive symptoms?(select all that apply.)A. Auditory hallucinationC. Use of clang associationsD. Delusion of persecutionE. Constantly waving arms3.A nurse iscaring for a clientwho has schizoaffective disorder. Which of the followingstatements indicates the client is experiencing depersonalization?B. “I am no one, and everyone is me.”4.A nurse is caring for a client onan acute mental health unit. the client reports hearingvoices that are telling her to “kill your doctor.” Which of the following actions should thenurse take first?

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B. Initiate one‐to‐one observation of the client. A client who is experiencing a commandhallucination is at risk forinjury to self or others. safety is the priority, and initiating one‐to‐one observation is the first action the nurse should take.5.A nurse is speaking with a client who has schizophrenia when he suddenly seems to stopfocusing on the nurse’s questions and begins looking at the ceiling and talkingto himself. Which of the following actions should the nurse take?B. Ask the client, “Are you seeing something on the ceiling?” The nurse should ask theclient directly about the hallucination to identify client needsand assess for a potentialrisk for injury.Chapter 16–Personality Disorders1.A nurse manager is discussing the care of a client who has a personality disorder with anewly licensed nurse. Which of the following statements by the newly licensed nurseindicates an understanding of the teaching?C.“Ishould practice limit‐setting tohelp prevent client manipulation.”2.A nurse is caring for a client who has avoidant personality disorder. Which of thefollowing statements is expected from a client who has this type of personality disorder?A. “I’m scared that you’re going to leave me.”Clients who have avoidant personalitydisorder often have a fear of abandonment. this type of statement is expected.3.A nurse is caring for a client who has borderline personality disorder.the client says, “The nurse on the evening shift is always nice!Youare the meanest nurseever!” the nurse should recognize the client’s statement as an example of which of thefollowing defense mechanisms?B.splitting occurs when a person is unable to see both positive and negative qualities atthe same time. The client who has borderline personality disorder tends to see a person asall bad one time and all good another time.4.A nurse is assisting with a court‐ordered evaluation of a client who has antisocialpersonality disorder. Which of thefollowing findings should the nurseexpect? (selectall that apply.)C. attempts to convince other clients to give him their belongings. exploitation andmanipulation of others is an expected finding of antisocial personality disorder.

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