ATI RN Mental Health Proctored Exam NGN Version 4 With Answers (70 Solved Questions)

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VERSION 4ATI MENTAL HEALTH PROCTORED FINAL EXAM1. A nurse is planning care for aclient who has borderline personality disorderwho self-mutilates. Which of the following test approaches should the nurse planto take?a. Restrict participation in group therapy sessions.The nurse should encourage the client who has borderline personalitydisorder to participate in group therapy sessions to encourage appropriateinteraction with other clients.b. Establish consequences for self-mutilation.

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The nurse should respond to self-mutilation with a neutral affect andencourage the client to write down feelings that occurred leading up to theincident.c. Maintain close observation of the client.Clients who have borderline personality disorder are at risk for self-harm during times of increased anxiety. Maintaining close observationreducesthe client's risk of injury.d. Provide an unstructured environment.Providing an unstructured environment for a client who has borderlinepersonality disorder is not an effective treatment approach because it doesnot provide a safe environment to protect the client from impulsive andself-injurious behavior.2. A nurse is assessing a client who has Stage 4 Alzheimer's disease. Which of thefollowing findings should the nurse expect?a. The client requires assistance with eating.The nurse should expectthe client who has Stage 4 Alzheimer’s disease tostill have the ability to eat without assistance. Clients who have Alzheimer’sdisease maintain this ability until Stage 7.b. The client independently manages personal finances.The nurse should expect theclient who has Stage 4 Alzheimer’s disease tohave difficulty performing complex tasks, such as managing personalfinances.c. The client has bladder incontinence.The nurse should expect the client who has Stage 4 Alzheimer’s disease tobe able to usethe toilet independently. Clients who have Alzheimer’sdisease maintain continence until Stage 6.d. The client is able to identify the names of family members.The nurse should expect the client who has Stage 4 Alzheimer’s disease torecognize and identify family members. Clients who have Alzheimer’sdisease maintain this ability until Stage 6.3. A nurse is caring for a client who reports that the television set in the room isreally a two-way radio and states, "voices are coming from the TV and everythingwe say in the room is being recorded." Which of the following responses shouldthe nurse make?a. "What we say is not being recorded."

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The nurse should avoid negating the client’s beliefs about the delusion. Thisresponse can promote a defensive client response and interfere with thedevelopment of trust in the nurse-client relationship.b. "Let's ignore the voices and talk about something else."The nurse should ask the client directly about what the voices are saying todetermine if there is a safetyrisk. The nurse should also avoidvalidating that the voices are real, which promotes the client’s beliefsabout the delusion.c. "That must be very frightening."The nurse should respond to the client’s delusion in a calm and empatheticmanner. By acknowledging to the client that the delusion must befrightening, the nurse promotes the nurse-client relationship.d. "Why do you think the TV is a two-way radio?"The nurse should avoid asking the client a "why" question, which promotesa defensive client response.4. A nurse is planning care for a newly admitted client who has bipolar disorderand is experiencing acute mania. Which of the following client goals should thenurse identify as the priority?a. Practicing problem-solving skillsThe nurse shouldencourage the client to practice problem-solving skillsduring the continuation phase of treatment; however, there is anotherintervention that is the priority during the acute phase of bipolar disorder.b. Understanding of medication regimenThe nurse should ensure that the client understands the medicationregimen during the continuation phase of treatment; however, there isanother intervention that is the priority during the acute phase of bipolardisorder.c. Identifying indications of relapseThe nurse should teach the client to recognize indications of relapse duringthe continuation phase of treatment; however, there is anotherintervention that is the priority during the acute phase of bipolardisorder.d.Maintaining adequate hydrationThe nurseshould identify that the priority goal is to prevent physicalexhaustion, maintain health, and meet nutritional and rest needs duringthe acute phase of the client’s manic episode. The nurse should consider

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Maslow’s hierarchy of needs, which includes fivelevels of priority whenplanning care for this client. The first level consists of physiological needs;the second level consists of safety and security needs; the third levelconsists of love and belonging needs; the fourth level consists of personalachievement and self-esteem needs; and the fifth level consists ofachieving full potential and the ability to problem solve and cope with lifesituations. When applying Maslow’s hierarchy of needs priority-settingframework the nurse should review physiological needs first. The nurseshould then address the client’s needs by following the remaining fourhierarchical levels. It is important, however, for the nurse to consider allcontributing client factors, as higher levels of the pyramid can competewith those at the lower levels, depending on the specific client situation.The fourth level of Maslow’s hierarchy of needs includes usefulness, self-worth, and self-confidence in fulfilling self-esteem needs.5. A nurse is preparing to administer benzodiazepineto a client with GeneralizedAnxiety Disorder. The nurse should tell the client to expect with of the followingadverse reactions?a. TinnitusTinnitus is not an adverse effect of benzodiazepines.b. BradycardiaTachycardia, rather thanbradycardia, is a potential adverse effect ofbenzodiazepines.c. HalitosisHalitosis is not an adverse effect of benzodiazepines.d.SedationThe nurse should tell the client to expect sedation as an adverse effectof benzodiazepines because of the CNS depression effects.6. A nurse in a mental health unit is planning care for a client who is receivingtreatment for self-inflicted injuries. The nurse should identify which of thefollowing interventions as the priority when planning care for this client?a.Promoting and maintaining client safetyThe nurse should recognize that the client who has self-inflicted injuriesis at risk for further self-harm or suicide; therefore, the client’s safety is thepriority. The nurse should apply the safety and risk reduction priority-setting framework when planning care for this client. This framework

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assigns priority to the factor or situation posing the greatest safety risk tothe client. When there are several risks to client safety, the one posing thegreatest threat is the highest priority. The nurse should use Maslow’shierarchy of needs, the ABC priority-setting framework, or nursingknowledge to identify which risk poses the greatest threat to the client.b. Discussing reasons for the client's behaviorThe nurse should communicate with the client to discuss reasons for theclient’s behavior; however, there is another action that is the priority.c. Assisting the client to recognize feelingsThe nurse should assist the client to recognize feelings; however, there isanother action that is the priority.d. Teaching the client alternative coping strategiesThe nurse should teach the client alternative coping strategies; however,there is another action that is the priority.7. A nurse is providing teaching to a client who has a new prescription fordisulfiram for management of alcohol dependence. Which of the following dietarychoices should the nurse instruct the client to avoid?a. Peppermint candyIt is not necessary for the client to avoid peppermint while takingdisulfiram.b.Pure vanilla extractThe nurse should instruct the client to avoid alcohol and alcohol-containing substances, such as pure vanilla extract, while takingdisulfiram. The ingestion of alcohol while taking this medication causes adisulfiram-alcohol reaction, which is manifested by hyperventilation,dizziness, vomiting, and hypotension.c. SaltThough certain medications require areduction in sodium intake, it is notnecessary for the client to avoid salt while taking disulfiram.d. ChocolateThough certain medications require a reduction in caffeine-containingsubstances such as chocolate, it is not necessary for the client to avoidchocolate while taking disulfiram.

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8. A nurse is planning care for a client with a physical dependence of Alprazolamand must discontinue the medication. Which of the following should the nurseinclude in the plan?a.Taper the medicationgradually over several weeks.The nurse should plan to taper the dosage of alprazolam gradually overseveral weeks, possibly months. This gradual reduction in dosage reducesthe manifestations of withdrawal.b. Encourage participation in stimulating physical activity.The nurse should provide the client with a calm, low-stimulationenvironment to decrease the anxiety and physical manifestations that canresult from alprazolam withdrawal.c. Monitor the client for a return of anxiety for up to 72 hr followingdiscontinuation of the medication.The nurse should plan to monitor the client for at least 3 weeks followingdiscontinuation of the medication for a return of anxiety manifestations.d. Implement restraints and seclusion as needed.It is not necessaryto restrain or seclude the client during withdrawal fromalprazolam. Restraints are considered restrictive, and the nurse shouldwork to promote the least restrictive environment.9. A nurse is caring for a newly admitted client who is receiving treatment foralcohol use disorder. the client tells the nurse “I have not had a drink for 6 hours.”Which findings should the nurse expect during alcohol withdrawals.a. Low body temperatureThe nurse should expect the client who is experiencing alcohol withdrawalto have an elevated temperature.b.InsomniaThe nurse should expect the client who is experiencing alcoholwithdrawal to have insomnia and restlessness.c. Muscle flaccidityThe nurse should expect the client who is experiencing alcohol withdrawalto have muscle tremors.d. BradycardiaThe nurse should expect the client who is experiencing alcohol withdrawalto have tachycardia.

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10. A nurse is caring for a client who is receiving treatment for alcoholdetoxification. Which of the following medications should the nurse expect toadminister during this phase of the client's care?a. BuprenorphineThe nurse should expect to administer buprenorphine to a client duringopiate detoxification.b. DiazepamThe nurse should expect to administer diazepamto a client duringalcohol detoxification. Anti-anxiety agents, such as chlordiazepoxideand diazepam, are long-acting CNS depressants that are used to minimizethe manifestations of alcohol withdrawal.c. VareniclineThe nurse should expect toadminister varenicline to a client who hasnicotine use disorder.d. RimonabantThe nurse should expect to administer rimonabant to a client who hasnicotine use disorder.11. A nurse is speaking to a community group about the diagnosis and treatmentof clients who have Alzheimer's. The nurse should conclude that the members ofthe group need further teaching when she identifies the following asmanifestations of Alzheimer Disease.a. Impaired judgmentThe nurse should identify impaired judgment as a common manifestationassociated with Alzheimer Disease.b.Sudden confusionThe nurse should clarify that the client who has Alzheimer’s disease isexpected to exhibit confusion that develops slowly over a period of months.Clients who have delirium exhibit sudden confusion.c. Personality changeThe nurse should identify that clients who have Alzheimer’s disease areexpected to exhibit changes in personality as the disease progresses.d. Remote memory lossThe nurse should identify recent and remotememory loss as commonmanifestations associated with Alzheimer’s disease.

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12. A nurse is providing teaching to a client with Generalized Anxiety Disorder anda new prescription for Buspirone. The nurse should inform the client that which ofthe followingmanifestations is a common adverse effect of this medication?a. ConfusionConfusion is not an adverse effect of buspirone, though the client mightexperience decreased concentration and headache.b. BradycardiaTachycardia and palpitations, not bradycardia, are possible adverseeffects of buspirone.c.DizzinessThe nurse should inform the client that dizziness is a common adverseeffect of buspirone. The nurse should instruct the client to avoid drivingand operating heavy machinery until the presence of adverse effects isdetermined.d. InsomniaDrowsiness, not insomnia, is an adverse effect of buspirone.13. A nurse is reviewing the medications of a client who has bipolar disorder and anew prescription for lithium. The nurse should identify that itis safe to administerwhich of the following medications while the client is taking lithium?a. IbuprofenIbuprofen is not safe to administer to a client who is taking lithium becauseit can cause increased kidney absorption of lithium, which can lead tolithium toxicity.b. HaloperidolHaloperidol is not safe to administer to a client who is taking lithiumbecause the combination of these medications increases the client’s riskfor extrapyramidal adverse effects and tardive dyskinesia.c. Valproic acidValproic acid and lithium are both indicated for the treatment of bipolardisorder. It is safe for the nurse to administer both of these medications tothe client.d. HydrochlorothiazideHydrochlorothiazide is not safe to administer to a client who is takinglithium because it promotes sodium loss, which can lead to lithium toxicity.

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14. A nurse in the emergency department is caring for a toddler with a fracturedarm. which of the following finding should the nurse suspect as possibleabuse?a.The parentprovides a history that is inconsistent with the child's injury.The nurse should suspect possible abuse when the child’s injury conflictswith the history ofthe injury that is reported by his parent.b. The child is brought to the emergency department immediately following theinjury.The nurse should suspect possible abuse when there is a delay in seekingmedical care following an injury.c. The parent requests to remain present with the child throughout treatment ofthe injury.The nurse should suspectpossible abuse when the parent leaves thetreatment area or facility after bringing the child in for treatment of aninjury.d. The child clings to the parent when the nurse begins to assess the injury.The nurse should suspect possible abuse if the childdisplays fear of theparent.15. A nurse is evaluating a care plan for a client who has an Antisocial PersonalityDisorder. Which of the following client actions indicates he is making progress intreatments? (Select All That Apply)a.Assisting anotherclient who has depression to fill out a menu.Clients who have antisocial personality disorder tend to lack empathyfor others and often display an inability to connect with others. Assistinganother client indicates the client’swillingness to help and connect withothers and demonstrates to the nurse his progress with treatment.b. Nominating himself to chair the client government meeting.Clients who have antisocial personality disorder tend to see themselves assuperior to others. Providing a self-nomination for chairperson statusplaces him in a position of power over others; therefore, this behaviordoes not indicate progress with the treatment.c.Requesting a weekend pass to go home.Clients who have antisocial personality disorder tend to disregard rules andhave a lack of respect for authority. Requesting a weekend pass indicatesthe client’s willingness to follow unit rules and demonstrates to the nursehis progress with the treatment.

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d. Serving as the judge for a unit talent show.Clients whohave antisocial personality disorder tend to see themselves assuperior to others. Serving as a judge places the client in a position ofpower over others; therefore, this behavior does not indicate progress withthe treatment.e. Informing the nurse that the staff provides excellent care to clients.Clients who have antisocial personality disorder often use flattery as a formof manipulation to promote personal gain; therefore, providing acompliment to the nursing staff does not indicate progress with thetreatment.16. A nurse is providing teaching to a client who is to start taking valproic acid.Which of the following instructions should the nurse include?a. "You should expect the provider to gradually decrease your dosageof valproicacid."The nurse should inform the client that the provider will initially prescribe asmall dose, and then gradually increase the dose until a maintenancedosage is achieved.b. "You should take aspirin for pain you have while taking valproic acid."The nurse should instruct the client to avoid aspirin while taking valproicacid because of the increased risk of spontaneous bleeding.c. "You should undergo thyroid function tests every 6 months while takingvalproic acid."The nurse should identify that hypothyroidism is an adverse effect oflithium rather than valproic acid.d. "You should have your liver function levels monitored regularly whiletaking valproic acid"The nurse should inform the client of the need to regularly monitor liverfunction levels due to the risk for hepatotoxicity while taking valproic acid.It is recommended to obtain baseline levels and then repeat every 2months during the first 6 months of therapy.17. A nurse is teaching a client who has Agoraphobia about SystematicDesensitization. Which of the following comments should the nurse include in theteaching?a. "You will watch from a secure location as your therapist goes to public spaces."

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The nurse should recognize that encouraging the client to watch as thetherapist acts as a role model in anxiety-provoking situations is an exampleof modeling, not systematic desensitization.b. "You will start your therapy by staying in a public space until your anxietydecreases."The nurse should recognize that sudden exposureof the client to theundesirable stimulus is an example of flooding, not systematicdesensitization.c. "You will be instructed to say 'Stop!' out loud when you become anxious inpublic spaces."The nurse should recognize that saying "Stop!" to interrupta negativethought is an example of thought stopping, not systematicdesensitization.d. "You will slowly be exposed to increasing levels of public spaces."The nurse should inform the client that, using systematic desensitization,she will begradually exposed to the feared situation under controlledconditions until she learns to overcome the anxious response.18. A nurse is planning a staff education session about the administration ofantidepressant medications to older adult clients. Whichof the followinginformation should the nurse include in the teaching?a. Older adult clients require a lower initial dose of antidepressantmedication than adult clients.The nurse should recognize that older adult clients are recommended tostart at half the adult dose for antidepressant medications. This is due toaltered rates of absorption and the increased risk for adverse effects.b. Older adult clients should not receive antidepressant medication.The nurse should identify thatantidepressant medications are commonlyprescribed for older adult clients; however, adjustments are needed due tothe clients' altered rates of absorption.c. Older adult clients achieve the therapeutic effects of antidepressantmedications more quickly than adult clients.The nurse should identify that older adult clients have a decreased rate ofabsorption, distribution, and metabolism, resulting in a delay in achievingtherapeutic effects. It can take about 1 month of treatment for the olderadult client to achieve therapeutic effects.

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d. Older adult clients have a decreased risk for adverse effects fromantidepressant medication.The nurse should identify that older adult clients have an increased risk foradverse effects due to a decreased rate of excretion.19. A nurse in an acute mental health facility is reviewing the medication recordsfor a group of clients. The nurse should expect a prescription for memantine for aclient who has which of the following diagnoses?a. Postpartum depressionThe nurse should recognize that memantine, an N-methyl-D-aspartate(NMDA) receptor agonist, is not indicated for the treatment of depression.b. SchizophreniaThe nurse should recognize that memantine, an NMDA receptor agonist, isnot indicated for the treatment of schizophrenia.c. ObesityThe nurse should recognize that memantine, an NMDA receptor agonist, isnot indicated for the treatment of obesity.d. Severe Alzheimer's diseaseThe nurse should expect a prescription for memantine for a client whohas moderate to severe Alzheimer’s disease. Memantine, an NMDAreceptor agonist, is shown to slow the progression of manifestations and toimprove cognitive function.20. A nurse is assessing a client who has Binge-Eating Disorder. Which of thefollowing findings should the nurse expect?a. AmenorrheaClients who have binge-eating disorder often have an increased BMI;therefore, amenorrhea resulting from a low body weight is not expected.b. Abdominal painThe nurse should expect the client who has binge-eating disorder toreport problems with abdominal pain. This is due to the gastrointestinaldilation that occurs as a result of eating excessive volumes of food.c. Restricted caloric intakeClients who have binge-eating disorder often have an increased BMIresulting from eating excessive volumes of food.d. Frequent use of laxatives

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Clients who have binge-eating disorder have repeated episodes of bingingwithout the use of compensatory behaviors, such as the use of laxatives.21. A nurse on an acute care unit isproviding postoperative care for an elderlypatient who developed Delirium. Which of the following actions should thenurse take?a. Request a prescription for an antianxiety medication.The nurse should request a prescription for anantianxiety medication for aclient who develops delirium. Administration of a PRN antianxietymedication can decrease her anxiety and agitation.b. Provide the client with a stimulating activity prior to bedtime.The nurse should maintain a low-stimulation environment for the client todecrease disorientation due to overstimulation.c. Keep the lights in the client's room dim at night.The nurse should keep the client’s room well-lit. Adequate lighting can helpher to remain oriented to place upon wakingat night and will provide forsafety if she becomes ambulatory.d. Encourage the client to make decisions about her daily routine.The nurse should provide the client with a consistent routine and limit herneed to make decisions. These actions will decrease disorientation andanxiety.22. A nurse assessing a client who has Conduct Disorder. Which of the followingfindings should the nurse expect?a. Fearfulness of authority figuresClients who have conduct disorder exhibit a lack of respect for authorityfigures and might attempt to initiate a fight with or intimidate others.b. Flat affectClients who have conduct disorder are easily angered and do not have a flataffect.c. Preoccupation with enforcing rulesClients who have conduct disorder exhibit a lack of respect for rules.d. Aggressive behavior toward othersThe nurse should expect the client who has conduct disorder to exhibitaggression toward others and impulsively violate others' rights.

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23. A nurse in an acute care facility is leading a staff discussion about the legalimplications of involuntary admissions. Which of the following should the nurseinclude?a. A client who is involuntarily admitted must take prescribed medications.Clients who are involuntarily admitted retain the legal rightto refusemedications.b. An involuntary admission of a client is limited to 2 weeks.Clients who are involuntarily admitted might be required to remain in thefacility for up to 60 days. After this time a legal review of the case isrequired to determineif continued involuntary treatment is required.c. A client who is involuntarily admitted can leave the facility against medicaladvice.Clients who are involuntarily admitted retain certain rights; however, theyare unable to leave the health care facility against medical advice. If a clientwho is involuntarily admitted feels that the admission is unjustified, theclient can file a legal petition requesting a review of the admission.d. An involuntary admission is justified if the client is a danger to others.A client who is a danger to others or to himself qualifies for an involuntaryadmission. The inability to meet basic needs due to the need for mentalhealth treatment is also a justification for an involuntary admission.24. A nurse iscaring for a client who has Schizophrenia. The nurse notices that theclient is pacing up and down the hall very rapidly and muttering in an angrymanner. Which of the following actions should the nurse take first?a. Apply mechanical restraints to the client.The nurse might have to place the client in restraints to prevent harm toothers and allow the client to calm down; however, the nurse should use aless restrictive intervention first.b. Administer PRN haloperidol IM to the client.The nurse might have to administer PRN haloperidol to calm the client;however, the nurse should use a less restrictive intervention first.c. Approach the client in a nonthreatening manner.The first action the nurse should take is to approach the client calmly, in anonthreatening manner, to create a nonthreatening environment. Thenurse should apply the least restrictive priority-setting framework whencaring for this client. This framework assigns priority to nursinginterventions that are least restrictive to the client, as long as those

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interventions do not jeopardize client safety. Least restrictive interventionspromote client safety without using restraints. The nurse should only usephysical or chemical restraints when the safety of the client, staff, or othersisat risk.d. Place the client in seclusion.The nurse might have to place the client in seclusion to prevent harm toothers and allow the client to calm down; however, the nurse should use aless restrictive intervention first.25. A nurse is reviewing themedical record of a client who has a new prescriptionfor a benzodiazepine. For which of the following findings should the nursequestion the provider's prescriptions?a. A skeletal muscle injuryBenzodiazepines have muscle relaxant properties and can relieve musclespasms; therefore, a skeletal muscle injury is not a contraindication forreceiving benzodiazepines.b. History of status epilepticusBenzodiazepines can raise the seizure threshold and prevent seizures;therefore, a history of status epilepticus is not a contraindication forreceiving benzodiazepines.c. HypotensionThe nurse should question the provider’s prescription for a benzodiazepinefor a client who has hypotension. Benzodiazepines can cause severehypotension and increase the client’srisk for cardiac arrest.d. InsomniaBenzodiazepines induce sleep for clients who have a sleep disorder;therefore, insomnia is not a contraindication for receiving benzodiazepines.26. A nurse is providing teaching to the parents of a school-age childwho hasattention deficit hyperactivity disorder (ADHD). Which of the followinginstructions should the nurse include in the teaching?a. "Ignore your child's attention-seeking behaviors that are not dangerous."The nurse should instruct the parents about the use of planned ignoring.This technique ignores attention-seeking behaviors that are not dangerousto the child or others. If the child learns that the behavior will not elicit thedesired response, then the behavior should decrease.b. "AdministerADHD medications within 30 minutes of your child's bedtime."

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