ATI Mental Health Proctored A Exam
ATI Mental Health Proctored A Exam
1. A nurse is planning overall strategies to address problems for a client who
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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. encourage the client to attend weekly support group meetings
c. assist the client to maintain awareness of her thoughts and feelings
d. implement measures to prevent intentional self-inflicted injury
2) A nurse is admitting a client who has generalized anxiety disorder. Which
of the following actions should the nurse plan to take first?
a. Provide the client with a quiet environment
b. Determine how the client handles stress.
c. Teach the client to use guided imagery.
d. Ask the client to identify her strengths
3) A nurse is conducting an admission interview with a client who is
experiencing mania. Which of the following should the nurse report to the
provider?
a. States that he hasn’t bathed in 2 days
b. Reports eating twice in the past two weeks.
c. Makes inappropriate sexual comments.
d. Speaks in rhyming sentences.
4) A nurse is planning care for a client who has obsessive-compulsive
disorder. Which of the following recommendation should the nurse include in
the clients plan of care?
a. Validation therapy
b. Thought stopping
c. Operant conditioning
d. Reality orientation therapy
5) A nurse is caring for a client who has bipolar disorder and is experiencing
a manic episode. Which of the following actions should the nurse take?
a. Encourage the client to join group activities
b. Dim the lights in the client’s room
c. Provide detailed explanations to the client
d. Administer methylphenidate
6) A nurse is leading a crisis intervention group for adolescents who
witnessed the suicide of a classmate. Which of the following actions should
the nurse take first?
a. Initiate referrals
b. Review community resources
c. Identify prior coping skills
d. Discuss the importance of confidentiality
7) A nurse overhears a client saying"I am a spy, a spy for the FBI .I am an
I,an eye for 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. Echolalia
b. Word salad
c. Neologism
d. Clang association
8) An older adult client is brought to the mental health clinic by her daughter.
The daughter reports that her mother is not eating and seems uninterested
in routine activities. The daughter states "Im so worried that my mother is
depressed" which of the following responses should the nurse make?
a. Everyone gets depressed from time to time.
b. You shouldnt worry about this because depressive disorder is easily
treated.
c. Older adults are usually diagnosed with depressive disorder as they
age.
d. Tell me the reasons you think your mother is depressed.
9) 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 care?
a. Meets own needs without manipulating others.
b. Initiates social interactions with caregivers.
c. Changes behavior as a result of peer pressure.
d. Acknowledges his delusions are not real.
10) A nurse is providing behavior therapy for a client who has obsessivecompulsive disorder. 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. Snap a rubber band on your wrist when you think about checking
the locks.
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. Keep a journal of how often you check the locks each night.
11) A nurse is caring for a client who is starting treatment for substance use
disorder. Which of the following actions indicate the nurse is practicing the
ethical principle of nonmaleficence?
a. Provide the client with quality care regardless of their ability to pay
for treatment.
b. Educating the client about legal rights concerning treatment.
c. Withholding the prescribed medication that is causing adverse
effects for the client.
d. Being truthful with the client about the manifestations of withdrawal.
12) A nurse in a group home facility is caring for a client who is
developmentally disabled. The client has been stealing belongings from
other clients. Which of the following techniques should the nurse use?
a. Crisis intervention to decrease anxiety.
b. Aversion therapy to provide distraction
c. Positive reinforcement to increase desired behavior.
d. Systematic desensitization to extinguish the behavior.
13) A nurse is caring for a client who is experiencing a panic attack. Which of
the following actions should the nurse take?
a. Ask the client to discuss precipitating events
b. Speaks to the client in a high-pitched voice.
c. Place the client in seclusion
d. Have the client breathe into a paper bag.
14) The 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 mechanisms?
a. Repression
b. Displacement
c. Rationalization
d. Denial
15) A nurse is caring for a client who has anorexia nervosa. Which of the
following findings require immediate intervention by the nurse?
a. +2 edema of the lower extremities
b. BUN 21 mg dL
c. Lanugo covering the body
d. Blood pH 7.60
16) A nurse is caring for a client in a mental health facility. The client is
agitated and threatens to harm herself and others. Which of the following is
the priority intervention?
a. Place the client in restraints
b. Administer an anti-anxiety medication to the client
c. Put the client in seclusion
d. Set limits on the clients behavior
17) Dosage Calculation: 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
18) A nurse is caring for a client who was involuntarily committed and is
scheduled to receive electroconvulsive therapy (ECT). The client refuses the
treatment and will not discuss why with the health care team. Which of the
following actions should the nurse take?
a. Ask the clients family to encourage the client to receive ECT
b. Inform the client that ECT does not require a consent.
c. Document the clients refusal of the treatment in the medical record.
d. Tell the client he cannot refuse the treatment because he was
involuntarily committed.
19) 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. Request a mental health consult for the client.
b. Ask the client if she has thought about harming herself.
c. Encourage the client to attend a grief support group.
d. Discuss the clients coping skills.
20) 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. Dual diagnosis treatment group
b. Dialectical Behavior treatment group
c. Desensitization therapy
21) The 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. Diphenhydramine
c. Benztropine
d. Haloperidol
22) A nurse is counseling a client following the death of a 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 find myself thinking about my partner often.
c. I still don’t feel up to returning to work.
d. I like looking at his personal items in the closet.
23) A nurse is caring for a client who has borderline personality disorder.
Which of the following outcomes should the nurse include in the treatment
plan?
a. The client will report a decrease in hallucinations.
b. The client will communicate needs
c. The client will verbalize improved mood
d. The client will attend to personal hygiene.
24) A nurse is caring for a client who is prescribed massage therapy to treat
panic disorder. The client states "I cant stand to be touched by another
person." Which of the following responses should the nurse make?
a. Why don't you like to be touched by others
b. Don't worry about it. Your anxiety will lessen once the massage
begins.
c. I will tell your provider you would like a treatment other than a
massage.
d. I will request that the massage therapist wear gloves during your
treatment.
25) 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. Encourage physical activity for the client during the day
b. Discourage the client from expressing feelings of anger
c. Keep a bright light on in the clients room at night.
d. Identify and schedule alternative group activities for the client.
26) A nurse is providing counseling for a family that consists of two parents
and their two adolescent children. Which of the following family members
should the nurse identify as acting in the role as the monopolizer?
a. The mother who expresses hostility toward her spouse.
b. The adolescent son who refuses to share personal feelings.
c. The father who intervenes whenever the siblings argue.
d. The adolescent daughter who attempts to dominate the
conversation.
27) 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 plan?
a. The client might have a headache after treatment.
b. The client will experience seizure during treatment.
c. The client will require intubation after treatment.
d. The client is at risk for aspiration during treatment.
28) A nurse is providing teaching about disulfiram to a client who has a
history of alcohol use. Which of the following instructions should the nurse
include in the teaching? (Select all that apply)
a. "You will need to take the medication once daily"
b. "you will receive treatment in an inpatient setting"
c. “You should avoid using mouthwash that contains alcohol”
d. "you should avoid drinking carbonated beverages while taking the
medication" e. "you can expect to develop a physical dependence to
the medication"
29) 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. Avoid power struggles by remaining neutral
b. Allow the client to set limits for his behavior
c. Provide in-depth explanation of nursing expectations
d. Encourage the client to participate in group activities
30) A nurse is assessing a young adult female client for schizophrenia. Which
of the following findings should the nurse identify as a risk factor for this
condition?
a. Environmental stress
b. Gender
c. Depression
d. Birth order
31) 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 exhibits an inflated sense of self
b. The client develops an inability to concentrate
c. The client increases participation in social activities
d. The client begins sleeping more than usual
32) A nurse is assessing a client who is restless and constantly mutters to
himself. Which of the following findings should lead the nurse to suspect
delirium?
a. The client is unable to recognize objects.
b. The client manifestations developed suddenly
c. The client has a flat affect
d. The client's speech is slow and repetitious
33) A nurse is caring for a client in an inpatient mental health facility. The
client tells the nurse that the government is reading her mail. Which of the
following responses should the nurse make?
a. " You know that's not true, because it is against the law for others to
read your mail"
b. "All of your letters come sealed, so that seems unlikely"
c. "It must be frightened to think that someone is reading your mail"
d. "why do you think the government wants to read your mail?"
34) A nurse is assessing a client who has neuroleptic malignant syndrome.
Which of the following clinical findings should the nurse expect?
a. Heart rate 48 min
b. Temperature 40 C (104 F)
c. WBC 3,000 mm3
d. Hypotonicity
35) 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. Blood glucose level
c. Report of photosensitivity
d. Heart Rate
36) A nurse is caring for a client who has personality disorder and is using
transference to cope. Which of the following behaviors should the nurse
expect?
a. Talking negatively about other staff members
b. Expressing frustration regarding unit rules
c. Reacting to the nurse as though she were his mother
d. Refusing to participate in group activities
37) A nurse in a mental health facility is caring for a newly admitted client.
Which of the following resources should the nurse recommend to help the
client adapt to the health care setting?
a. A community meeting
b. A medication group
c. A self-help meeting
d. A symptom-management group
38) A nurse is assisting with obtaining informed consent for a client who has
been declared legally incompetent. Which of the following actions should the
nurse take?
a. Request that the client's guardian sign the consent
b. Ask the charge nurse to obtain informed consent
c. Contact the facility social worker to obtain the consent
d. Explain implied consent to the client's family
39) A nurse is caring for a client who has cocaine use disorder. Which of the
following manifestations should the nurse expect the client to have during
withdrawal?
a. Hand tremors
b. Rapid speech
c. Fatigue
d. Seizures
40) A nurse is providing teaching about disorder management for a client
who has posttraumatic stress disorder (PTSD). Which of the following
statements should the nurse include in the teaching?
a. "Avoiding stimuli that trigger memories of the trauma can help you
overcome your PTSD"
b. "Talking about the traumatic experience is recommended"
c. "Response prevention is an effective treatment for PTSD"
d. "You should try to limit the number of hours that you sleep each
day"
41) A nurse is assessing a client who has bipolar disorder and is taking
lamtropine. Which of the following findings is the nurses priority?
a. Thyroid-stimulating hormone (TSH) 4.0 microunits per mL
b. Alanine transaminase (ALT) 20 IU per L
c. Skin rash
d. Epistaxis
42) A nurse is caring for a client who has schizophrenia and displays severe
negative symptoms of the disorder. Which of the following actions should the
nurse take?
a. Manage the client's loud, rambling, and incoherent communication
patterns
b. Direct the client to perform her own daily hygiene and grooming
tasks
c. Assist the client to identify somatic and thought-broadcasting
delusions
d. Use medication to decrease frequency of auditory and visual
hallucination.
43) 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. Inform the client about confidentiality rights
b. Establish boundaries between the nurse and the client
c. Set short and long-term objectives for the future
d. Evaluate progress toward predetermined goals
44) A nurse in a mental health facility is making plans for a client's
discharge. Which of the following interdisciplinary team members should the
nurse contact to assist the client with housing placement?
a. Clinical nurse specialist
b. Recreational therapist
c. Occupational therapist
d. Social worker
45) A nurse is caring for a client who reports that he is angry with his partner
because she thinks 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
46) 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 overcame his habit"
b. "The client needs to accept responsibility for his substance use"
c. "The client generally shares his feelings during group therapy
session"
d. "The client asked me to go on a date with him, but I refuse"
47) A nurse is caring for a client who is admitted to a mental health facility
after attempting suicide. Which of the following actions should the nurse take
first?
a. Establish a rapport to foster trust
b. Implement continuous one-to-one observation
c. Ask the client to sign a no-suicide contract
d. Encourage the client to participate in group therapy
48) A nurse is providing teaching for a newly licensed nurse about the
constructive use of defense mechanism. Which of the following examples
should the nurse include in the teaching?
a. A student who is upset with her teacher writes a story about an
excellent student
b. A school-age child whose mother died 2 years ago talks about her in
present tense.
c. A woman who has health concern postpones a medical appointment
until after a vacation.
d. An adult who was sexually abused as a child is unable to remember
the incident
49) A nurse in an inpatient mental health facility is assessing a client who
has schizophrenia and is taking haloperidol. Which of the following clinical
findings is the nurse's priority?
a. High fever
b. Urinary hesitancy
c. Insomnia
d. Headache
50) 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 include in the care plan?
a. The client recognizes the importance of others
b. The client conforms to social norms regarding clothing choices
c. The client reduces self-dramatization
d. The client treats others with respect
51) A nurse is planning care for a newly admitted client who has anorexia
nervosa. Which of the following interventions should the nurse include in the
plan?
a. Negotiate with the client how much weight she should gain each
week.
b. Decrease the client's daily intake of fiber
c. Weight the client weekly for the first month
d. Notify the client about designated time for meals
52) 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 experience a panic attack. The nurse
should recognize that to continue positive results, the client should
participate in which of the following?
a. Therapist modeling
b. Positive reinforcement
c. Frequent practice
d. Biofeedback
53) 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 form 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
54) A nurse is caring for a client who has prescription for phenelzine. The
nurse should instruct the client to avoid which of the following over-thecounter medications?
a. Ranitidine
b. Pseudoephedrine
c. Ibuprofen
d. Docusate sodium
55) A nurse is caring for a client who is experiencing active auditory
hallucinations. Which of the following actions should the nurse take?
a. Avoid asking direct questions about the client's experience
b. Convey sympathy for the client's experience
c. Tell her client her experience is not real
d. Focus the client on reality-based activities
56) A nurse is caring for a client who has just returned to the unit after
receiving an electroconvulsive therapy treatment. Which of the following
assessments is the nurse's priority?
a. First voiding
b. Short-term memory
c. Presence of gag reflex
d. Return of bowel sounds
57) 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. "I think you should ignore the comment"
b. "You sound upset about today's session"
c. "Why do you think that he said that to you?"
d. "I agree that the comment was inappropriate"
58) A nurse is assessing a client who is experiencing acute alcohol
withdrawal. Which of the following findings should the nurse expect?
a. Hypotension
b. Insomnia
c. Bradycardia
d. Diminished reflexes
59) 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 drink at least 6 liters of water per day"
b. "I should be on a low-sodium diet"
c. "I will call my doctor if I have diarrhea"
d. "I will see my doctor to check my lithium levels annually"
60) 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 a prescription for medication to promote nighttime
sleep while in the facility
b. The client needs to find a place to live after discharge
c. The client needs to begin a group therapy program prior to
discharge
d. The client needs to relearn how to perform skill that require fine
motor coordination 61.
61) 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. Urine specific gravity 1.029
b. Platelets 90,000 per mm3
c. Urine pH 5.6
d. RBC 4.7 per mm3
62) 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 ensure the bedroom is dark while he is sleeping at night
b. I will place a sliding bolt lock just above the doorknob
c. I will notify law enforcement within 2 hours if he cannot be found
d. I will give his most recent photo to the police
63) 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. Hypertensive crisis
b. Cardiac toxicity
c. Serotonin Syndrome
d. Urinary retention
64) A nurse in an outpatient clinic is assessing a client who has anorexia
nervosa. Which of the following findings indicates the need for
hospitalization?
a. Potassium 3.8mEq per L
b. Heart Rate 56 per min
c. Temperature 35.6C (96.1F)
d. Weight 10% below ideal weight
65) A nurse us obtaining a medical history from a client who is requesting a
prescription for bupropion for smoking cessation. Which of the following
assessment finding in the client's history should the nurse report to the
provider?
a. Hepatitis B Infection
b. Hypothyroidism
c. Knee arthroplasty 1 month ago
d. Recent head injury
66) A nurse is providing crisis intervention for a client who was involved in a
violent mass causality situation in the community. Which of the following
actions should the nurse take during the initial session with the client?
a. help the client focus on a wide variety of topics regarding the crisis
b. identify the client's usual coping style
c. tell the client that his life will soon return to normal
d. encourage the client to display anger toward the cause of the crisis
67) A nurse in the community health facility is interviewing a client who
recently lost his job. The client states "I was fired because my boss doesn't
like me" Which of the following defense mechanisms is the client displaying?
a. Rationalization
b. Displacement
c. Dissociation
d. Repression
68) 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. sit on the side of the bed for a few minutes before standing
b. decrease the prescribed dose by half when mood improves
c. avoid over the counter magnesium when taking this medication
d. eat a snack before going to bed
69) A nurse is planning care for a client who has dementia. Which of the
following interventions should the nurse include in the plan?
a. give detailed instructions for completion of self-care activities
b. confront the client when he exhibits inappropriate behavior
c. provide finger foods to enhance caloric intake
d. remove clocks from the client's room
70) A nurse is teaching a client who has schizophrenia about her new
prescription for risperidone. Which of the following statements should the
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 your symptoms improve within 24 hours of taking
this medication."
d. "You should increase your consumption of complex carbohydrates."
71) A nurse is providing teaching to the daughter of an older client who has
obsessive compulsive disorder. Which of the following statements by the
daughter indicated 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.”
72) A nurse in 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 mealtimes.
c. Initiate a relationship built on trust with the client.
d. Negotiate with the client the opportunity to reweigh.
73) 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. [Show Less]