PN ati Proctored mental health 2020 Exam with Answers

  1. A nurse is caring for an adult client who has visible injuries as a result of intimate partner violence. Which of the following actions should the nurse take? Answer: Encourage the client to develop a safety plan 2. A nurse in an urgent care clinic is collecting data from a client whose friend reports a suspicion of cocaine use. The nurse should identify that which of the following manifestations is an indicator of the client’s use of this substance? Answer: Hypertension 3. A nurse in a mental health facility is caring for a client who has dementia. The client’s agitation is increasing. Which of the following actions should the nurse take first? Answer: Offer diversionary activities 4. A nurse is caring for a client who has bipolar disorder. The client suddenly appears agitated and begins pacing at the end of the hallway with clenched fists. Which of the following actions should the nurse take first? Answer: Determine the client’s intentions 5. A nurse is reinforcing discharge teaching with a client who has a new prescription for alprazolam. Which of the following instructions is the priority for the nurse to include? Answer: Do not drive until your reaction to the medication is determined 6. A nurse is caring for a client who is 2 days postoperative following a hip arthroplasty. When a news report about military action comes on the television, the client says to the nurse, “My youngest child died 6 months ago while serving in the military.” Which of the following responses should the nurse make? Answer: -This must be very difficult time for you -Your child’s death must be a terrible loss -Tell me something you remember about your child 7. A nurse is contributing to the plan of care for a client who has bipolar disorder and is exhibiting mania, Which of the following interventions should the nurse include to improve the nutritional status of the client? Answer: Have the client’s favorite snacks available at all times. 8. A nurse is collecting data from a client who has paranoid personality disorder. Which of the following manifestations should the nurse expect? Answer: Projects blame onto others 9. A nurse on and inpatient unit is assisting with a group therapy session. During the session, a client begins to shout using aggressive language. Which of the following statements should the nurse make to the client? Answer: When you raise your voice, it makes me feel uncomfortable and unsafe.” 10. A nurse in a mental health facility is caring for a client who has schizophrenia. The client becomes violent in the dayroom and begins throwing objects at staff and other clients. After calling for assistance. Which of the following actions should the nurse take next? Answer: Tell the client calmly to sit down 11. A nurse caring for a group of clients on a mental health unit. Which of the following client behaviors should the nurse reports to the charge nurse? Answer: A client who is manic has been pacing the unit for several hours 12. A nurse is collecting data from a client who is taking valproic acid for the treatment of bipolar disorder. The nurse should identify that which of the following findings is priority to report to the provider? Answer: Bleeding gums 13. A nurse is attempting to resolve an ethical dilemma that involves a client’s medical decisions and his own personal values. After collecting data and identifying the problem, which of the following actions should the nurse take next? Answer: Determine the benefits and consequences of respecting the client’s medical decisions 14. A LPN/LVN observes that a client is pacing, agitated, and presenting aggressive gestures. The client's speech pattern is rapid, and affect is belligerent. Based on these observations, the nurse's immediate priority of care is to: Answer: Provide safety for the client and other clients on the unit 15. Select the nursing interventions for a hospitalized client with mania who is exhibiting manipulative behavior. Select all that apply. Answer: 1) Communicate expected behaviors to the client 3) Assist the client in identifying ways of setting limits on personal behaviors 4) Follow through about the consequences of behavior in a non-punitive manner 6) Be clear with the client regarding the consequences of exceeding limits that have been set regarding behavior 16. A nurse determines that the wife of an alcoholic client is benefitting from attending an Al- Anon group when the nurse hears the wife say: Answer: "I no longer feel that I deserve the meetings my husband inflicts on me." 17. A nurse is reinforcing teaching about stress management techniques with a client who has mild anxiety. Which of the following statements should the nurse make? Answer: You should listen to music when you feel stress 18. A nurse is caring for a client who is undergoing outpatient electroconvulsive therapy (ECT) to treat rapid-cycling bipolar disorder. Following the procedure, which of the following action should the nurse take?