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Mental Health Proctored Practice Exam A with Answers (60 Solved Questions)

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    Mental Health Proctored Practice A 1. 14 mL 110 lb x (1 kg/2.2 lb) = 50 kg 50 kg x 0.55 mg = 27.5 mg 27.5 mg x(5 mL/10 mg) = 14 mL A nurse is preparing to administer chlorpro- mazine 0.55 mg/kg PO to an adolescent who weighs 110 lb. Available is chlorpromazine syrup 10 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number) 2. B. "She won't let me take the trash from her room. I'm concerned about what she has in there." The client might be binge eating and attempting to hide her food contain- ers, which is a common behavior among clients who have bulimia ner- vosa. The mother's state- ment indicates aware- ness of her daughter's behavior. A nurse in an emergency department is caring for a female adolescent who has a diagnosis of bulimia nervosa and had a fainting episode during a ballet performance. Which of the following state- ments by the mother acknowledges her daugh- ter's diagnosis? A. "She works so hard at ballet. Will she still be able to perform?" B. "She won't let me take the trash from her room. I'm concerned about what she has in there." C. "She told me she was tired, so I did her chores for her today." D. "She is happier with her appearance now that she's lost some weight." 3. A. The client needs ex- cessive external input to make everyday deci- sions. Clients who have depen- dent personality disor- der need excessive in- put from others to make everyday decisions. While observing group therapy, a nurse recog- nizes that a client is behaving in a way suggestive of dependent personality disorder. Which of the following behaviors is consistent with this condi- tion? A. The client needs excessive external input to make everyday decisions. B. The client demonstrates a dedication to his job that excludes time for leisure activities. C. The client adheres to a rigid set of rules. D. The client has difficulty starting new relation- ships unless he feels accepted. 1 / 22

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    Mental Health Proctored Practice A 4. C. Tachycardia The nurse should mon- itor the child for tachycardia, which is an adverse effect of methylphenidate. A nurse is caring for a child who is taking methylphenidate. The nurse should monitor the child for which of the following findings as an adverse effect of methylphenidate? A. Weight gain B. Tinnitus C. Tachycardia D. Increased salivation 5. B. "To whom do you talk when you feel over- whelmed?" By asking this question, the nurse is assessing the client's support sys- tems, which is an impor- tant factor in the client's ability to cope with the situation. A nurse is interviewing a client at a temporary shelter after surviving the destruction of her home by a tornado. When assessing the client, the nurse should ask which of the following questions to determine the client's ability to cope with this situation? A. "Don't you think you'll get through this in time?" B. "To whom do you talk when you feel over- whelmed?" C. "Have you thought about rebuilding your home on the same site?" D. "Would you like me to find a therapist for you to speak with?" 6. A. Shuffling gait Benztropine is used to treat parkinsonism mani- festations, such as shuf- fling gait. A nurse is caring for a client who has schizophre- nia and was prescribed a conventional antipsy- chotic medication yesterday. Which of the follow- ing findings indicates the nurse should administer benztropine 2 mg IM? A. Shuffling gait B. Hypotension C. Decreased WBC count D. Blurred vision 7. B. A client who has a sodium level of 128 mEq/L A nurse is reviewing routine laboratory values for several clients who are taking lithium carbonate. Which of the following clients should the nurse as- 2 / 22

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    Mental Health Proctored Practice A A sodium level of 128 mEq/L should alert the nurse that the client is at risk for lithium toxicity because renal excretion of lithium is decreased in the presence of a low sodium level. sess further for findings indicating lithium toxicity? A. A client who has a fasting blood sugar of 80 mg/dL B. A client who has a sodium level of 128 mEq/L C. A client who has a BUN of 18 mg/dL D. A client who has a potassium level of 3.6 mEq/L. 8. B. "You're saying that you think you are fat and are using laxatives because you are afraid of gaining weight." The nurse is using the therapeutic technique of summarizing to review the key points of the dis- cussion. A nurse is counseling an adolescent who has anorexia nervosa and reports excessive laxative use and a fear of gaining weight. The client states, "I'm so fat I can't even stand to look at my- self." Which of the following therapeutic respons- es demonstrates the nurse's use of summariz- ing? A. "You've discussed several concerns about your weight. Let's go back and talk about your belief that you are fat." B. "You're saying that you think you are fat and are using laxatives because you are afraid of gaining weight." C. "You don't want to look at yourself because you think you are fat." D. "You and I can work together to overcome your fears of gaining weight." 9. D. Mild The nurse should plan to teach the client relax- ation techniques during the mild level of anxiety, The is when the client will be able to concen- trate and process infor- mation. A nurse is planning care for a client who has gen- eralized anxiety disorder. At which of the following levels of anxiety should the nurse plan to teach the client relaxation techniques? A. Panic B. Moderate C. Severe D. Mild 3 / 22

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    Mental Health Proctored Practice A 10. C. Hand tremors Fine hand tremors are an expected adverse ef- fect of lithium and can interfere with the client's ADLs, causing the client to stop taking the med- ication. A nurse in a mental health clinic is caring for a client with bipolar disorder and reports that she stopped taking lithium 2 weeks ago. The nurse should recognize which of the following as an expected adverse effect that might have caused the client to stop taking the medication? A. Sore throat B. Photophobia C. Hand tremors D. Constipation 11. D. Easily distracted Extreme distractibility is a hallmark manifestation of delirium. A nurse is performing a cognitive assessment to distinguish delirium from dementia in a client whose family reports episodes of confusion. Which of the following assessment findings sup- ports the nurse's suspicion of delirium? A. Slow onset B. Aphasia C. Confabulation D. Easily distracted 12. A. "Take this medication in the evening at bed- time." The client should take this medication in the evening at bedtime for optimal effectiveness. A nurse is teaching a family member and a client who has a new diagnosis of Alzheimer's disease and is to start taking donepezil. Which of the following statements should the nurse include in the teaching? A. "Take this medication in the evening at bed- time." B. "Expect this medication to reverse the effects of Alzheimer's disease." C. "If you miss a dose, double the next dose." D. "You can crush this medication in applesauce." 13. A. Move the client who has bipolar disorder to a private room. A client who has a recent diagnosis of bipolar disorder is placed in a room with a client who has severe depression. The client who has depres- 4 / 22

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    Mental Health Proctored Practice A Clients who have bipo- lar disorder can disrupt the therapeutic milieu for other clients. Therefore, the nurse should move this client to a private room. sion reports to the nurse, "That man in my room never sleeps and he keeps me up too." Which of the following is an appropriate action for the nurse to take? A. Move the client who has bipolar disorder to a private room. B. Administer sleep medication to the client who has bipolar disorder. C. Move the client who has severe depression to a private room. D. Administer sleep medication to the client who has severe depression. 14. A. "I should eat a regular diet with normal amounts of salt and fluids." This statement indicates that the client under- stands the teaching be- cause normal levels of sodium and fluid need to be maintained to en- sure adequate excretion of lithium. If sodium lev- els are low, the body com- pensates by decreasing lithium excretion, which can lead to toxicity. A client who has bipolar disorder is to be dis- charged home with a prescription for lithium. Which of the following statements indicates that client teaching regarding the medication has been effective? A. "I should eat a regular diet with normal amounts of salt and fluids." B. "I should discontinue the lithium when I begin to feel better." C. "I need to be careful to avoid becoming addict- ed to the lithium." D. "I can skip a dose of medication if my stomach is upset." 15. D. "I will attend dai- ly group therapy ses- sions to practice relax- ation techniques." Relaxation techniques decrease the risk for self-harm by decreasing A nurse is caring for a client who has attempted suicide and has alcohol use disorder. Which of the following statements indicates that the client is using a positive coping mechanism? A. "I will limit my drinking to the weekends." B. "I will stay in my room and avoid others when I'm feeling down." 5 / 22

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    Mental Health Proctored Practice A stress, anxiety, and de- pression C. "I will be dependent on others for the time being." D. "I will attend daily group therapy sessions to practice relaxation techniques." 16. C. Temperature 35.6 de- grees Celsius (96.1 de- grees Fahrenheit) Severe hypothermia, a temperature lower than 36 degrees Celsius (96.8 degrees Fahrenheit) due to loss of subcutaneous tissue or dehydration, re- quires hospitalization. A nurse is caring for a client who has anorexia nervosa. Which of the following criteria requires hospitalization? A. Weight loss 10% of total body weight in 3 months. B. Potassium 3.8 mEq/L C. Temperature 35.6 degrees celsius (96.1 de- grees Fahrenheit) D. Heart rate 54/minute 17. C. Suggest forming a weekly support group for parents who have experi- enced the loss of a child. Support groups are a positive resource in the process of recovery for parents who have lost a child. A nurse is working with a group of parents who recently lost a child. Which of the following actions should the nurse take? A. Encourage the parent to avoid discussing the death with other children in order to protect their feelings. B. Recommend each parent grieve in private to avoid hindering each other's healing. C. Suggest forming a weekly support group for parents who have experienced the loss of a child. D. Advise the parents to begin counseling if they are still grieving in a few months. 18. D. Spending adequate time with a client who is verbally abusive By spending adequate time with a client who is verbally abusive, the nurse is demonstrating A nurse on a mental health unit is caring for a group of clients. Which of the following actions by the nurse is an example of the ethical principle of justice? A. Allowing a client to choose which unit activities to attend B. Attempting alternative therapies instead of re- 6 / 22

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