ATI RN MENTAL HEALTH ONLINE PRACTICE B
CONCEPT REVIEW GUIDE 2026 MENTAL
HEALTH ASSESSMENT AND CRISIS
INTERVENTION
◉ a nurse on a mental health unit is caring for a client who has
schizophrenia.after reviewing the clients medical record, the nurse
should notify the provider of which of the following findings?select
the 5 unexpected findings that require notification of the provider.
exhibit 1:Nurses' Notes1200:Female client diagnosed with
schizophrenia approximately 2 years ago after experiencing
psychosis. Client has taken chlorpromazine and loxapine with
minimal improvement in positive and negative symptoms. Client
attends a local community college and works at a grocery store.
exhibit 2:Vital Signs0800:Blood pressure 112/66 mm HgHeart rate
88/minRespiratory rate 16/minTemperature 37.7° C (99.9°
F)Oxygen saturation 98% on room air1200:Bloor pressure 104/60
mm HgHeart rate 106/minRespiratory rate 20/minTemperature
38.3° C (100.9° F)Oxygen saturation 97% on room air
exhibit 3: WBC, ANC, RBC, HGB, HCT...
Answer: When taking actions, the nurse should identify an elevated
temperature, hypoactive bowel sounds, a decreased ANC level,
myalgia along with an increased heart rate can be adverse effects of
the medication clozapine. Therefore, the nurse should report these
findings to the client's provider
,◉ A nurse is caring for a client who has impaired cognition.A nurse
is updating the client's plan of care. For each of the following
potential nursing interventions, click to specify if the potential
intervention is anticipated, nonessential, or contraindicated for the
client.
exhibit 1 Medical History
Day 1, 0800: Client treated for UTI 8 months ago.
Day 3, 0830:Client fell getting out of bed to go to the bathroom last
night. Client sustained bruise to the left knee; no further injuries
noted.
Exhibit 2 Vital Signs
Day 1, 0800:Temperature 36.9° C (98.4° F)Heart rate
92/minRespiratory rate 26/minBlood pressure 132/80 mm Hg
Day 3, 0830:Temperature 37.3° C (99.1° F)Heart rate
106/minRespiratory rate 32/minBlood pressure 144/86 mm Hg
Exhibit 3 Nurses' Notes Day 1, 0800:Client is able to assist with self-
care. Client is easily startled by sudden changes and loud noises. Day
3, 0830:Client has wandered into other client
Answer: When addressing the client, approach them from the front
when possible is anticipated. A client who is unexpectantly
approached or touched from someone out of view is easily startled,
which can promote aggressive behavior in the client.
Use a vest restraint to keep the client in a medical recliner is
contraindicated. The client has the right to be free from the use of
restraints except in the case of an emergency.
, Ensure the bed is kept at a working height for the nurse is
contraindicated. The client's bed should be placed in the lowest
position to decrease the risk for falls, or lessen injury severity if the
client does fall.
Provide the client with high-calorie protein drinks hourly is
nonessential. This is nonessential for this client because they are
taking in nutrition. The nurse should provide the client who has
mania with this type of dietary supplement.
Give directions to the client slowly and in a moderate tone of voice is
anticipated. Providing directions slowly and in a moderate tone of
voice will increase client comprehension. Loud voices can cause the
client to feel uncomfortable and can even cause feelings of anger.
Decrease sensory stimulation is anticipated. A highly stimulating
environment can cause the client to become anxious and further
disoriented, which can impair client safety.
Keep the lights off in the client's bedroom and bathroom at night is
contraindicated. This can increase the client's risk for falls. Keeping
a light on can decrease wandering.
Assign the client to a room near the nurses' station is anticipated.
This promotes client safety by allowing staff to observe the client
frequently.
◉ a nurse is caring for a newly admitted client.for each potential
assessment finding, click to specify if the finding is consistent with
positive or negative symptoms of schizophrenia.
exhibit 1:Vital Signs
CONCEPT REVIEW GUIDE 2026 MENTAL
HEALTH ASSESSMENT AND CRISIS
INTERVENTION
◉ a nurse on a mental health unit is caring for a client who has
schizophrenia.after reviewing the clients medical record, the nurse
should notify the provider of which of the following findings?select
the 5 unexpected findings that require notification of the provider.
exhibit 1:Nurses' Notes1200:Female client diagnosed with
schizophrenia approximately 2 years ago after experiencing
psychosis. Client has taken chlorpromazine and loxapine with
minimal improvement in positive and negative symptoms. Client
attends a local community college and works at a grocery store.
exhibit 2:Vital Signs0800:Blood pressure 112/66 mm HgHeart rate
88/minRespiratory rate 16/minTemperature 37.7° C (99.9°
F)Oxygen saturation 98% on room air1200:Bloor pressure 104/60
mm HgHeart rate 106/minRespiratory rate 20/minTemperature
38.3° C (100.9° F)Oxygen saturation 97% on room air
exhibit 3: WBC, ANC, RBC, HGB, HCT...
Answer: When taking actions, the nurse should identify an elevated
temperature, hypoactive bowel sounds, a decreased ANC level,
myalgia along with an increased heart rate can be adverse effects of
the medication clozapine. Therefore, the nurse should report these
findings to the client's provider
,◉ A nurse is caring for a client who has impaired cognition.A nurse
is updating the client's plan of care. For each of the following
potential nursing interventions, click to specify if the potential
intervention is anticipated, nonessential, or contraindicated for the
client.
exhibit 1 Medical History
Day 1, 0800: Client treated for UTI 8 months ago.
Day 3, 0830:Client fell getting out of bed to go to the bathroom last
night. Client sustained bruise to the left knee; no further injuries
noted.
Exhibit 2 Vital Signs
Day 1, 0800:Temperature 36.9° C (98.4° F)Heart rate
92/minRespiratory rate 26/minBlood pressure 132/80 mm Hg
Day 3, 0830:Temperature 37.3° C (99.1° F)Heart rate
106/minRespiratory rate 32/minBlood pressure 144/86 mm Hg
Exhibit 3 Nurses' Notes Day 1, 0800:Client is able to assist with self-
care. Client is easily startled by sudden changes and loud noises. Day
3, 0830:Client has wandered into other client
Answer: When addressing the client, approach them from the front
when possible is anticipated. A client who is unexpectantly
approached or touched from someone out of view is easily startled,
which can promote aggressive behavior in the client.
Use a vest restraint to keep the client in a medical recliner is
contraindicated. The client has the right to be free from the use of
restraints except in the case of an emergency.
, Ensure the bed is kept at a working height for the nurse is
contraindicated. The client's bed should be placed in the lowest
position to decrease the risk for falls, or lessen injury severity if the
client does fall.
Provide the client with high-calorie protein drinks hourly is
nonessential. This is nonessential for this client because they are
taking in nutrition. The nurse should provide the client who has
mania with this type of dietary supplement.
Give directions to the client slowly and in a moderate tone of voice is
anticipated. Providing directions slowly and in a moderate tone of
voice will increase client comprehension. Loud voices can cause the
client to feel uncomfortable and can even cause feelings of anger.
Decrease sensory stimulation is anticipated. A highly stimulating
environment can cause the client to become anxious and further
disoriented, which can impair client safety.
Keep the lights off in the client's bedroom and bathroom at night is
contraindicated. This can increase the client's risk for falls. Keeping
a light on can decrease wandering.
Assign the client to a room near the nurses' station is anticipated.
This promotes client safety by allowing staff to observe the client
frequently.
◉ a nurse is caring for a newly admitted client.for each potential
assessment finding, click to specify if the finding is consistent with
positive or negative symptoms of schizophrenia.
exhibit 1:Vital Signs
