Ati mental health proctored 2019 PDF

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ATI proctored exam for mental health...

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1. 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. B. C. D.

Co-dependents support group Desensitization therapy Dual diagnosis treatment group Dialectical behavior treatment group

2. A nurse in an alcohol rehabilitation facility is creating a discharge plan for a client who has alcohol use disorder. Which of the following recommendations should the nurse include in the plan? A. B. C. D.

Refer the client to a self-help group. Request a discharge prescription for buprenorphine for the client Contact a close relative of the client to discuss the discharge plan. Teach the client to practice systematic desensitization

3. 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 of monopolizer? A. B. C. D.

The father who intervenes whenever the siblings argue The adolescent son who refuses to share personal feelings The adolescent daughter who attempts to dominate the discussion The mother who expresses hostility toward the spouse.

4. A nurse is caring for a client who has just received a terminal cancer diagnosis from his provider. Which of the following actions should the nurse take? A. B. C. D.

Change the subject when the client becomes upset. Allow the client unlimited time for the grieving process Discourage the client from forming new relationships Offer the client advice about various treatment choices

5. A nurse is assessing a client who has anorexia nervosa and began treatment 1 month ago. Which of the following finding indicates the client’s adherence to the treatment plan? A. B. C. D.

The client potassium level is 3.2 mEq/L The client reports following various cooking blogs The client states that she knows she cannot be perfect The client’s current BMI is 14.

6. A nurse is teaching about deep-breathing exercises with a client who reports experiencing intense stress at work. Which of the following statements by the client indicates an understanding of the teaching? A. B. C. D.

“I will focus on how the muscles in my stomach feel with each breath.” “I will focus on the causes of my stress during the exercises.” “I will hold my breath for 5 or 6 seconds each time.” “I will inhale through my mouth and exhale through my nose.”

7. A nurse is leading a critical incident stress debriefing with a group of staff members following a mass trauma incident. Which of the following interventions should the nurse take first? A. B. C. D.

Have staff members discuss their involvement in the event. Ask staff members to describe their most traumatic memories of the event Provide stress-management exercises to the staff members Reassure staff members that the debriefing is confidential.

8. A charge nurse is making room assignments for new client admissions. Which of the following client should the nurse place closest to the nurse’s station? A. B. C. D.

A client who has schizotypal personality disorder A client who has a history of alcohol use disorder A client who has a history of dependent personality disorder A client who has moderate-stage Alzheimer’s disease.

9. A nurse is caring for a client who has anorexia nervosa. Which of the following findings requires immediate intervention by the nurse? A. B. C. D.

+2 edema of the lower extremities BUN 21 mg/dL Blood pH 7.60 Lanugo covering the body.

10. A nurse in a mental health facility is reviewing the laboratory results of a client who is taking lithium carbonate. Which of the following findings places the client at risk for lithium toxicity? A. B. C. D.

WBC 6,000/mm3 Aspartate aminotransferase 40 units/L Sodium 132 mEq/L Calcium 10.0mg/dL

11. A nurse in a provider’s office is assessing a school-age child who has a spiral fracture. The parent of the child provides different accounts of the cause of the injury. Which of the following actions should the nurse take first?

A. B. C. D.

Determine the immediately safety needs of the child Report suspected abuse to Child Protective Services Ask the child how the injury occurred Request that the parent leave the room while interviewing the child

12. A nurse is providing discharge teaching about expected adverse effects to a client who has a new prescription for lithium. Which of the following adverse effects should the nurse include? (Select all that apply). A. B. C. D. E.

Thirst Sedation Weight loss Decreased urination Dry skin

13. A nurse is assessing a client who has schizophrenia. Which of the following finding should the nurse document as positive symptoms of schizophrenia? (Select all that apply.) A. B. C. D. E.

Flight of ideas Delusions of grandeur Decreased motivation Auditory hallucinations Impaired memory

14. 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 mechanisms is the client demonstrating? A. B. C. D.

Compensation Rationalization Displacement Denial

15. 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. B. C. D.

Discourage the client from expressing feelings of anger Keep a bright light on in the client’s room at night Encourage physical activity for the client during the day Identify and schedule alternative group activities for the client

Question 12- A nurse is assessing a client who recently experienced the loss of their partner. Which of the following question is the priority for for nurse to ask during situational crisis? a. What do you usually do to cope in your life.

b. Are you having thoughts of harming yourself? c. Who do you talk to when you need help? d. How do you think this event is affecting your life right now? Question 13 – A nurse is caring for a client who was involuntary committed ans is scheduled to receive ECT. The client refuses treatment and will not disscuss why with the health care team. Which of the following actions should the nurse take? a. b. c. d. e. f. g. h.

Ask the client family to encourage to talk Client refuses treatment will not discuss why? Document the refusal of the treatment in the medical record. Inform client the ECT doesn’t required. Question 12 Answer: Option C. Who do you talk to when you need help? Question 13 Answer: Option C. Document the refusal of the treatment in the medical record.

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A nurse in an alcohol rehabilitation facility is creating a discharge plan for a client who has alcohol use disorder. Which of the following recommentaions should the nruse include in the plan o Request a discharge prescription for buprieno. o Because, Suddenly stopping this medication may cause withdrawal, especially if you have used it for a long time or in high doses. To prevent withdrawal, your doctor may lower your dose slowly. Tell your doctor or pharmacist right away if you have any withdrawal symptoms such as restlessness, mental/mood changes (including anxiety, trouble sleeping, thoughts of suicide), watering eyes, runny nose, nausea, diarrhea, sweating, muscle aches, or sudden changes in behavior.

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A nurse is leading a grief support group for bereaved client. Which of the following statements should the nurse report to the provider as an indication of clincal depression. o I feel like I am angry at the whole world right now A nure is leading a critical indicdent tress debeifing with a group of staff members following a mass trauma incident. Which of the following interventions should the nurse take first? o Reassure staff members that the debriefing event is confidential

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1. A nurse is caring for a client who is undergoing electroconvulsive therapy. Which of the following tasks should the nurse delegate to assistive personnel? A. B. C. D.

Assist the client to ambulate for the first time following the procedure Check the client’s condition after the procedure Witness the client’s signature on the consent for the procedure Give the client atropine 30 mins before the procedure

2. A nurse is caring for a client who has depression following a recent job loss. Which of the following questions should the nurse ask to assess the client’s personal coping skills?

A. B. C. D.

“How have you deal with similar situations in the past?” “Do you see your current situation affecting your future?” “How does this situation affect your life?” “Can you describe how you are currently feeling?”

3. A nurse conducting an admission interview with a new client who tells the nurse. “My life is so stressful. I can’t take it anymore.” Which of the following responses should the nurse take first? A. B. C. D.

“How have you dealt with stress in the past?” “Let’s talk more about what you are experiencing.” “Are you thinking of harming yourself?” “Tell me what makes you feel stressed.”

4. A nurse is caring for a client who is experiencing alcohol withdrawal and notes visible tremors and an elevated blood pressure and heart rate. Which of the following mediations should the nurse prepare to administer? A. B. C. D.

Naltrexone Lorazepam Methadone Disulfiram

5. A nurse is caring for a school-age child who has a diagnosis of attention-deficit hyperactivity disorder. The nurse should anticipate a prescription for which of the following medications? A. B. C. D. E.

Valproate Methylphenidate Lithium Risperidone 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/L B. Heart Rate 56/min C. Temperature 35.6C (96.1F) D. Weight 10% below ideal weight F. 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 G. 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?

H.

I.

J.

K.

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 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 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 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 A nurse is planning overall strategies to address problems for a client who 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

12. A nurse is providing discharge teaching about expected adverse effects to a client who has a new prescription for lithium. Which of the following adverse effects should the nurse include? (Select all that apply). 1. 2. 3. 4. 5.

Thirst Sedation Weight loss Decreased urination Dry skin

13. A nurse is assessing a client who has schizophrenia. Which of the following finding should the nurse document as positive symptoms of schizophrenia? (Select all that apply.) 1. Flight of ideas

2. 3. 4. 5.

Delusions of grandeur Decreased motivation Auditory hallucinations Impaired memory

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33. A nurse is caring for a client whose partner died 6 months ago. Which of the following findings is the nurse's priority?

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A. The client says he feels guilty about not spending more time with his partner

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B. The client states that he is unable to eat more than once a day

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C.

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D. The client relates that he is angry that the provider did not save his partner's life

The client frequently recalls negative experiences that occurred during his marriage

A nurse is caring for a client who has bipolar disorder and is refusing to take prescribed medications. Which of the following ethical principles to the nurse displaying when he supports the clients refusal of medication?

o Autonomy  Answers

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Q: 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. Co-dependents support group B. Desensitization therapy C. Dual diagnosis treatment group D. Dialectical behavior treatment group Ans: D. Dialectical behaviour treatment group. Explanation of ans: Here the right answer is Dialectical behaviour treatment group. Dialectical behaviour treatment is a type of Cognitive behavioral therapy. It helps people to survive in better way. Dialectical behaviour treatment is specially used for BPD or Borderline Personality Disorder, evidence based.

1. Answer Option A. Assist the client to ambulate for the first time following the procedure Option A is correct as after the electroconvulsive therapy, the client usually feel disoriented after the procedure and requires assistance to ambulate as the disorientation can last from few minutes to few hours and assistance given by assistive personnel is important to prevent any risk of fall or injury with proper observation required.

Option B is incorrect as client's condition after the procedure is required to be checked by a qualified physician or a nurse so as to notice all the symptoms and determine the client's well being and safety from a medical stand point and not a job of assistive personnel Option C is incorrect as it is the registered nurse's and responsibility of the physician to verify the consent forms Option D is incorrect as assistive personnel cannot administer or prescribe any medication to the patient.

2. Answer Option A. “How have you deal with similar situations in the past?” Option A is correct as the client's past experience with dealing with such situation will provide the nurse with the information if and whether the client has the coping skills and ability to deal with such situation and its effect with depression. Similar situation helps us to get access to the clients mindset and can help in correct diagnosis and assessment. Option B is incorrect as asking about future is unpredictable and coping skills cannot be properly assessed by this question Option C is incorrect as asking about the impact of job loss on life will only help in getting depression details and not the coping skills Option D is incorrect as his current feelings are unstable and the answer given will only help with emotional assessment and not the coping skills 3. Answer Option B. “Let’s talk more about what you are experiencing.” Option B is correct as the nurse has to obtain a clear picture before determining any harm or suicidal behavior and making a note in the interview. Most of the time the indications of stress do not lead to harm and even might have some other reasons. So asking about the current emotions and feelings the client is experiencing the nurse can further explore and get an idea of the root of the prole and its entire scope which can help in diagnosis and treatment Option A is incorrect as past experiences cannot determine the current problem that the client is facing in terms of stress and experiences Option C is incorrect as directly confronting the client with such question can lead to the client changing the topic or not revealing any further details and might not cooperate when asked on point directly Option D is incorrect as asking about potential stressors can be helpful but also can be incorrect as the client might point to a problem which may not have the reason for his current feeling s and here the wider picture can help in the interview and assessments.

4, Answer Option A. Naltrexone Option A is correct as Naltrexone is usually used for treatment in alcohol abuse and opioid dependence reduction. So a client when experiencing the symptoms of alcohol withdrawal and notes visible tremors and an elevated blood pressure and heart rate can be given naltrexone. It can help with reducing the blood pressure to normal and also with tremor symptoms Option B is incorrect as Lorazepam will not help in controlling the blood pressure and heart rate Option C is incorrect as have adverse effects with reducing the blood pressure drastically further initiating the complications Option D is incorrect as disupfram is used for sleep and acute alcohol sensitivity and cannot be used in this symptoms. 

b. Heart rate 56/min:The complication of anorexia nervosa is heart problems such as mitral valve prolapse, abnormal heart rhythms.

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d. Recent head injury: Because head injury can cause seizures. Bupriopion is contraindicated for patient with seizures. b. Identify the client usual coping style: As in the crisis intervention technique by the nursing to help in identify the client’s usual coping style a. rationalization: It is a type of defense mechanism. b. Decreased the prescribed doe by half when mood improves it can tackle the situation of associated insomnia. a. Give detailed instructions for completion of self care activities. c.assist the client to maintain awareness of her thoughts and feelings: The best suited planning strategy for the borderline personality disorder patient to have control on the feelings, emotion and thoughts.

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1. Option B normal sodium level is 135-145mEq/l. Salt consumption can effect serum lithium levels. A sudden decrease in sodium intake (a component of salt) may result in higher serum lithium levels. Sodium level 132 mEq/L is low level that cause lithium toxicity. Other options are in normal range and they don't effect directly lithium level. 2. Option A is correct If person feels guilty it might be symptom of depression and can lead to a danger situation. So nurse should aware about the negative behavior of client.

It is normal due to loss person feel less appetite. He also blame to others for death. 3. Adverse effects are•Thirst •Sedation ( drowsiness and dizziness ) •Dry sk...