NGN ATI MENTAL HEALTH 2024 EXAM /
NGN ATI MENTAL HEALTH 2024
PROCTORED EXAM 2 VERSIONS EACH
WITH 70 QUESTIONS WITH DETAILED
ANSWERS AND RATIONALES
... [Show More] /A+
GRADE ASSURED BRAND NEW!!
A nurse is assessing a client who has major depressive disorder
and has been receiving amitriptyline for 1 week. Which of the
following outcomes should the nurse expect?
1. Rapid improvement in affect within 30 to 60 min after taking
the medication
2. Greater risk of attempting suicide as affect and energy improve
3. Onset of frequent loose stools
4. Development of physiologic dependence on the medication -
...ANSWER...2. Greater risk of attempting suicide as affect and
energy improve
Rationale: An initial response to amitriptyline can develop in 1
week. For a client who has been severely depressed with suicidal
ideation, the energy to carry out a plan is more possible after 1
week of treatment
A client who has bipolar disorder is to be discharged home with a
prescription for lithium. Which of the following statements
indicates that client teaching regarding the medication has been
effective?
1. "I should eat a regular diet with normal amounts of salt and
fluids."
2. "I should discontinue the lithium when I begin to feel better."
3. "I need to be careful to avoid becoming addicted to the
lithium."
4. "I can skip a dose of medication if my stomach is upset." -
...ANSWER...1. "I should eat a regular diet with normal amounts
of salt and fluids."
Rationale: This statement indicates that the client understands
the teaching because normal levels of sodium and fluid need to be
maintained to ensure adequate excretion of lithium. If sodium
levels are low, the body compensates by decreasing lithium
excretion, which can lead to toxicity.
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?
1. Weight gain
2. Tinnitus
3. Tachycardia
4. Increased salivation - ...ANSWER...3. Tachycardia
Rationale: The nurse should monitor the child for tachycardia,
which is an adverse effect of methylphenidate
A nurse in an outpatient mental health setting is collecting a
health history from a client who is taking paroxetine for
depression. The client reports to the nurse that he also takes
herbal supplements. The nurse should advise the client that which
of the following supplements interacts adversely with paroxetine?
1. St. John's wort
2. Saw palmetto
3. Echinacea
4. Ginkgo - ...ANSWER...1. St. John's wort
Rationale: St. John's wort is an herbal preparation that decreases
the reuptake of serotonin. The nurse should advise the client that
taking St. John's wort with another medication that also inhibits
the reuptake of serotonin, such as paroxetine, places the client at
risk for serotonin syndrome.
A nurse is caring for a client who was admitted following an
overdose of amitriptyline. The nurse should monitor the client for
which of the following adverse effects associated with this
medication?
1. Loose stools
2. Urinary retention
3. Fever
4. Dyspnea - ...ANSWER...2. Urinary retention
Rationale: Urinary retention is an anticholinergic effect of
amitriptyline. Therefore, the nurse should monitor for this as an
adverse effect.
A nurse who is working on a mental health unit should recognize
that which of the following are indications for the use of
electroconvulsive therapy (ECT)?
1. A client who is suicidal and in need of rapid treatment
2. A client who has recently been diagnosed with severe
depression
3. A client who has bipolar disorder with rapid cycling
4. A client who has mania and has not responded to medication
therapy
5. A client whose depression is secondary to situational
difficulties - ...ANSWER...1. A client who is suicidal and in need
of rapid treatment
2. A client who has bipolar disorder with rapid cycling
3. A client who has mania and has not responded to medication
therapy
Rationale: ECT can be used when there is a need for a rapid,
definitive response for a client who is suicidal. ECT works best
for a client who has bipolar disorder with rapid cycling. ECT is
indicated for clients who have mania and have not responded to
medication therapy
A nurse is teaching a client who has a depressive disorder about
fluoxetine. Which of the following information should the nurse
include in the teaching?
1. "You may notice an increase in saliva while taking this
medication."
2. "You may experience difficulties with sexual functioning while
taking this medication."
3. "You should expect an improvement in symptoms of
depression in 3 to 4 days."
4. "You may notice a temporary ringing in the ears when starting
this medication." - ...ANSWER...2. "You may experience
difficulties with sexual functioning while taking this medication."
Rationale: Fluoxetine is a selective serotonin reuptake inhibitor
that can cause sexual dysfunction such as anorgasmia and
impotence. The nurse should instruct the client to notify the
provider if sexual dysfunction occurs.
A nurse is teaching the parent of a 10-year-old child who has
ADHD and a new prescription for dextroamphetamine. Which of
the following instructions should the nurse include in the
teaching?
1. "You should expect you child to gain weight while taking
medication."
2. "Administer the first dose of medication to your child 30
minutes before breakfast."
3. "You should expect your child to have diarrhea while taking
this medication."
4. "Administer the last dose of medication to your child 6 hours
before bedtime." - ...ANSWER...4. "Administer the last dose of
medication to your child 6 hours before bedtime."
Rationale: An adverse effect of dextroamphetamine is insomnia.
Therefore, the nurse should instruct the parent to administer the
last dose of medication to the child 6 hr before bedtime.
A nurse is assessing a client who recently used cocaine. Which of
the following findings should the nurse expect?
1. Polyphagia
2. Hypertension
3. Decreased temperature
4. Depressed mood - ...ANSWER...2. Hypertension
Rationale: Cocaine is a stimulant that increases blood pressure. It
also increases heart rate, body temperature, energy levels, and
metabolism.
A nurse is caring for a client who is undergoing electroconvulsive
therapy (ECT) and will receive succinylcholine. The client asks
the nurse about this medication. What is an appropriate response
by the nurse?
1. "Succinylcholine will enhance the therapeutic effects of this
treatment."
2. "Succinylcholine is given to reduce muscle movements during
therapy."
3. "Succinylcholine will decrease the anxiety level that you might
experience with this treatment."
4. "Succinylcholine is used as a general anesthetic to make sure
you are sleeping during the procedure." - ...ANSWER...2.
"Succinylcholine is given to reduce muscle movements during
therapy."
Rationale: Succinylcholine is a muscle-paralyzing agent that will
decrease muscle movement during the procedure so that injury is
less likely to occur.
A nurse in the emergency department is admitting a client who
reports a headache along with heart palpitations after having a
glass of wine with dinner a few hours ago. The client has a
history of depression and has a blood pressure of 210/105 mm
Hg. Which of the following questions should the nurse ask first?
1. "Do you have a family history of hypertension?"
2. "When did you last see your primary provider?"
3. "What medications are you currently taking?"
4. "Do you currently use relaxation techniques for increased
stress?" - ...ANSWER...3. "What medications are you currently
taking?"
Rationale: The nurse should verify what medication the client is
currently taking, including MAOI medication to treat depression.
The client's history of depression indicates that this client is at the
greatest risk for hypertensive crisis from MAOI medications used
to treat depression. These medications can precipitate a
hypertensive crisis if consumed with tyramine-containing foods,
including wine.
A nurse in a mental health clinic is planning care for a client who
has a new prescription for olanzapine. Which of the following
interventions should the nurse identify as the priority?
1. Advise the client to take frequent sips of water.
2. Instruct the client to avoid driving during initial therapy
3. Consult a dietitian for a calorie-controlled diet plan
4. Recommend that the client exercise regularly - ...ANSWER...2.
Instruct the client to avoid driving during initial therapy
Rationale: The greatest risk to this client is injury resulting from
drowsiness or dizziness. Therefore, the nurse's priority
intervention is to instruct the client to avoid activities that require
mental alertness during initial medication therapy.
A nurse is admitting a client who has anorexia nervosa and is at
60% of ideal body weight. Which of the following interventions
should the nurse include in the plan of care?
1. Encourage the client to drink 125 mL of fluid each hour while
awake
2. All the client to eat independently in his room
3. Weigh the client twice weekly
4. Measure the client's vital signs once each day - ...ANSWER...1.
Encourage the client to drink 125 mL of fluid each hour while
awake
Rationale: The nurse should encourage the client to drink 125 mL
of fluid each waking hour to maintain hydration
A nurse is admitting a client who has major depressive disorder
and a new prescription for tranylcypromine. Which of the
following over-the-counter medications that the client reports
taking should alert the nurse to a potential adverse reaction?
1. Lansoprazole
2. Naproxen
3. Magnesium hydroxide
4. Phenylephrine - ...ANSWER...4. Phenylephrine
Rationale: Clients who are taking tranylcypromine, an MAOI
antidepressant, should not take phenylephrine and other over-thecounter medications for sinus congestion, colds, or allergies due
to their actions on the sympathetic nervous system, which can
result in severe hypertension.
A nurse is preparing to administer chlorpromazine 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 to the nearest whole number) - ...ANSWER...14
A nurse is planning care for a client who is to undergo
electroconvulsive therapy (ECT). Which of the following actions
should the nurse include in the plan?
1. Administer phenytoin 30 min prior to the procedure
2. Instruct the client to expect a headache following the procedure
3. Place the client in four point restraints prior to the procedure
4. Monitor the client's cardiac rhythm during the procedure -
...ANSWER...4. Monitor the client's cardiac rhythm during the
procedure
Rationale: The seizure induced during ECT can stress that client's
heart. Therefore, the nurse should plan to monitor the client's
cardiac rhythm during ECT via an electrocardiogram
A nurse is caring for a client who has schizophrenia and was
prescribed a conventional antipsychotic medication yesterday.
Which of the following findings indicates the nurse should
administer benztropine 2 mg IM?
1. Shuffling gait
2. Hypotension
3. Decreased WBC count
4. Blurred vision - ...ANSWER...1. Shuffling gait
Rationale: Benztropine is used to treat parkinsonism
manifestations, such as shuffling gait
A nurse is reviewing laboratory results for a client who has
schizophrenia and is taking clozapine. Which of the following
values should the nurse identify as a contraindication for
receiving clozapine?
1. WBC 2500/mm3
2. Hgb 11.5 mg/dL
3. Platelets 150,000/mm3
4. RBC 3.5 million/mm3 - ...ANSWER...1. WBC 2500/mm3
Rationale: Clozapine can cause agranulocytosis, which can be
fatal due to overwhelming infection. The nurse should identify a
WBC count below 3000/mm3 as a possible manifestation of
agranulocytosis and should withhold the medication and notify
the provider
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 statements should the nurse include in the teaching?
1. "Take this medication in the evening at bedtime."
2. "Expect this medication to reverse the effects of Alzheimer's
disease."
3. "If you miss a dose, double the next dose."
4. "You can crush this medication in applesauce." -
...ANSWER...1. "Take this medication in the evening at bedtime."
Rationale: The client should take this medication in the evening at
bedtime for optimal effectiveness.
A nurse on a medical-surgical unit is assessing a client who
sustained injuries 12 hr ago following a motor-vehicle crash. The
client's admission blood alcohol level was 325 mg/dL. Which of
the following findings should indicate to the nurse that the client
is experiencing alcohol withdrawal?
1. Somnolence
2. Blood pressure 154/96 mm Hg
3. Pinpoint pupils
4. Blood glucose 210 mg/dL - ...ANSWER...2. Blood pressure
154/96 mm Hg
Rationale: Physical manifestations of alcohol withdrawal occur in
addition to psychological effects. A client who is experiencing
alcohol withdrawal is expected to have hypertension, tachycardia,
and fever greater than 38.3 C (101 F). It will be important for the
nurse to rule out infection in the client who has a fever.
A nurse is reviewing routine laboratory values for several clients
who are taking lithium carbonate. Which of the following clients
should the nurse assess further for findings indicating lithium
toxicity?
1. A client who has a fasting blood glucose of 80 mg/dL
2. A client who has a sodium level of 128 mEq/L
3. A client who has a BUN of 18 mg/dL
4. A client who has a potassium level of 3.6 mEq/L -
...ANSWER...2. A client who has a sodium level of 128 mEq/L
Rationale: 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
A nurse in a mental health clinic is caring for a client who has
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?
1. Sore throat
2. Photophobia
3. Hand tremors
4. Constipation - ...ANSWER...3. Hand tremors
Rationale: Fine hand tremors are an expected adverse effect of
lithium and can interfere with the client's ADLs, causing the
client to stop taking the medication.
A nurse is creating a plan of care for a client who has been placed
in seclusion after threatening to harm others on the unit. Which of
the following interventions should the nurse include in the plan?
1. Document the client's behavior every 8 hr
2. Limit the client's fluid intake to 50 mL/hr
3. Renew the prescription for the client every 4 hr
4. Toilet the client every 4 hr - ...ANSWER...3. Renew the
prescription for the client every 4 hr
Rationale: The nurse should assess the client's behavior
frequently during seclusion and should renew the prescription for
seclusion for an adult client every 4 hr, for a maximum of 24 hr.
A nurse is caring for a client who is experiencing a panic attack.
Which of the following actions should the nurse take?
1. Orient the client to person, place, and time
2. Assist the client with deep-breathing exercises
3. Calm the client by using therapeutic touch
4. Have the client sit alone in a quiet room - ...ANSWER...2.
Assist the client with deep-breathing exercises
Rationale: Relaxation techniques, such as deep, abdominal
breathing exercises, help defuse manifestations of anxiety.
A nurse is caring for a client who has a history of substance use
disorder and was involuntarily admitted to a mental health
facility. When the nurse attempts to administer oral lorazepam,
the client refuses to take the medication and becomes physically
aggressive. Which of the following actions should the nurse take?
1. Do not administer the lorazepam
2. Request a prescription for IV lorazepam
3. Request that another nurse attempt to administer the lorazepam
4. Place the lorazepam in the client's food - ...ANSWER...1. Do
not administer the lorazepam
Rationale: Clients who are in a facility due to an involuntary
admission retain the right to refuse treatment. Therefore, the nurse
should hold the medication and document the client's wishes.
A nurse is reviewing the medication administration record for a
client who is experiencing the adverse effects of chlorpromazine.
The nurse should administer benztropine to relieve which of the
following adverse effects?
1. Blurred vision
2. Orthostatic hypotension
3. Dry mouth
4. Acute dystonia - ...ANSWER...4. Acute dystonia [Show Less]