ATI Mental Health Proctored
n n n
n n n n n n n n n n n n n n n n
A nurse is caring for a client who is in mechanical restraints. Which of the following state
n n n n n n n n n n n
ments should the nurse include in the documentation? (Select all that apply)
n n n n n n
A. "Client ate most of his breakfast."
n n n n n n n n n
B. "Client was offered 8 oz of water every hr."
n n n n n n
C. "Client shouted obscenities at assistive personnel."
n n n n n n n n n
D. "Client received chlorpromazine 15 mg by mouth at 1000."
n n n n n
E. "Client acted out after lunch."
Annursenhearsnannewlynlicensednnursendiscussingnanclient'snhallucinationsninnthenhallwaynwi
thnanothernnurse.nWhichnofnthenfollowingnactionsnshouldnthennursentakenfirst?
n n n n
A. Notify the nurse manager.
n n n n n n n n
B. Tell the nurse to stop discussing the behavior.
n n n n n n
C. Provide an in-service program about confidentiality.
n n n n
D. Complete an incident report.
n n n n n n n n n n n n n n n n
A nurse is caring for the parents of a child who has demonstrated changes in behavior an
n n n n n n n n n n n n n n n n
d mood. When the mother of the child asks the nurse for reassurance about her son's con
n n n n n n n n n
dition, which of the following responses should the nurse make?
n n n n n n n n n n n
A. "I think your son is getting better. What have you noticed."
n n n n n n n n n n n n
B. "I'm sure everything will be okay. It just takes time to heal."
n n n n n n n n n n n n n
C. "I'm not sure whats wrong. Have you asked the doctor about your concerns?"
n n n n n n n n n n
D. "I understand you're concerned. Let's discuss what concerns you specifically."
Annursenisncaringnfornanclientnwhonsmokesnandnhasnlungncancer.nThenclientnreports,n"I'mnco
ughingnbecausenInhaventhatncoldnthatneveryonenhasnbeenngetting."nThennursenshouldnidenti
fynthatnthenclientnisnusingnwhichnofnthenfollowingndefensenmechanisms?
A.nReactionnformation
B.nDenial
C.nDisplacement
D.nSublimation
Annursenisnprovidingnpreoperativenteachingnfornanclientnwhonwasnjustninformednthatnshenreq
uiresnemergencynsurgery.nThenclientnhasnanrespiratorynraten30/minnandnsays,n"Thisnisndiffic
ultntoncomprehend.nInfeelnshakynandnnervous."nThennursenshouldnidentifynthatnthenclientnisne
xperiencingnwhichnofnthenfollowingnlevelsnofnanxiety?
,A.nMild
B.nModerate
C.nSevere
D.nPanic
Annursenisncaringnfornanclientnwhonisnexperiencingnmoderatenanxiety.nWhichnofnthenfollowing
nactionsnshouldnthennursentakenwhenntryingntongivennecessaryninformationntonthenclient?n(S
electnallnthatnapply.)
A.nReassurenthenclientnthatneverythingnwillnbenokay.
B.nDiscussnpriornusenofncopingnmechanismsnwithnthenclient.
C.nIgnorenthenclient'snanxietynsonthatnshenwillnnotnbenembarrassed.
D.nDemonstratenancalmnmannernwhilenusingnsimplenandnclearndirections.
E.nGatherninformationnfromnthenclientnusingnclosed-endednquestions.
Annursenisntalkingnwithnanclientnwhonisnatnrisknfornsuicidenfollowingnthendeathnofnhisnspouse.n
Whichnofnthenfollowingnstatementsnshouldnthennursenmake?
A.n"Infeelnverynsorrynfornthenlonelinessnyounmustnbenexperiencing."
B.n"Suicidenisnnotnthenappropriatenwayntoncopenwithnloss."
C.n"Losingnsomeonenclosentonyounmustnbenverynupsetting."
D.n"Inknownhowndifficultnitnisntonlosenanlovednone."
Anchargennursenisndiscussingnthencharacteristicsnofnannurse-
clientnrelationshipnwithnannewlynlicensednnurse.nWhichnofnthenfollowingncharacteristicsnsho
uldnthennursenincludeninnthendiscussion?n(Selectnallnthatnapply)
A.nThenneedsnofnbothnparticipantsnarenmet.
B.nAnnemotionalncommitmentnexistsnbetweennthenparticipants.
C.nItnisngoal-directed.
D.nBehavioralnchangenisnencouraged.
E.nAnterminationndatenisnestablished.
Annursenisninnthenworkingnphasenofnantherapeuticnrelationshipnwithnanclientnwhonhasnmetha
mphetaminenusendisorder.nWhichnofnthenfollowingnactionsnindicatesntransferencenbehavior
?
A.nThenclientnasksnthennursenwhethernshenwillngonoutntondinnernwithnhim.
B.nThenclientnaccusesnthennursesnofntellingnhimnwhatntondonjustnlikenhisnex-girlfriend.
C.nThenclientnremindsnthennursenofnanfriendnwhondiednfromnansubstancenoverdose.
D.nThenclientnbecomesnangrynandnthreatensntonharmnhimself.
Annursenisnplanningncarenfornthenterminationnphasenofnannurse-
clientnrelationship.nWhichnofnthenfollowingnactionsnshouldnthennursenincludeninnthenplannofncare?
,A.nDiscussingnwaysntonusennewnbehaviors
B.nPracticingnnewnproblem-solvingnskills
C.nDevelopingngoals
D.nEstablishingnboundaries
Anchargennursenisndiscussingnmentalnstatusnexamsnwithnannewlynlicensednnurse.nWhichnofnt
henfollowingnstatementsnbynthennewlynlicensednnursenindicatesnannunderstandingnofnthente
aching?n(Selectnallnthatnapply)
A.n"Tonassessncognitivenability,nInshouldnasknthenclientntoncountnbackwardnbynsevens."
B.n"Tonassessnaffect,nInshouldnobserventhenclient'snfacialnexpression."
C.n"Tonassessnlanguagenability,nInshouldninstructnthenclientntonwritenansentence."
D.n"Tonassessnremotenmemory,nInshouldnhaventhenclientnrepeatnanlistnofnobjects."
E.n"Tonassessnthenclient'snabstractnthinking,nInshouldnasknthenclientntonidentifynournmostnrec
entnpresidents."
Annursenisnplanningncarenfornanclientnwhonhasnanmentalnhealthndisorder.nWhichnofnthenfollow
ingnactionsnshouldnthennursenincludenasnanpsychobiologicalnintervention?
A.nAssistnthenclientnwithnsystematicndesensitizationntherapy.
B.nTeachnthenclientnappropriatencopingnmechanisms.
C.nAssessnthenclientnforncomorbidnhealthnconditions.
D.nMonitornthenclientnfornadverseneffectsnofnthenmedications.
Annurseninnannoutpatientnmentalnhealthnclinicnisnpreparingntonconductnanninitialnclientnintervi
ew.nWhennconductingntheninterview,nwhichnofnthenfollowingnactionsnshouldnthennursenidentif
ynasnthenpriority?
A.nCoordinatenholisticncarenwithnsocialnservices.
B.nIdentifynthenclient'snperceptionnofnhernmentalnhealthnstatus.
C.nIncludenthenclient'snfamilyninntheninterview.
D.nTeachnthenclientnaboutnherncurrentnmentalnhealthndisorder.
Annursenisntoldnduringnchangenofnshiftnreportnthatnanclientnisnstuporous.nWhennassessingnthe
nclient,nwhichnofnthenfollowingnfindingsnshouldnthennursenexpect?
A.nThenclientnarousesnbrieflyninnresponsentonansternalnrub.
B.nThenclientnhasnanglasgowncomanscalenscorenlessnthann7.
C.nThenclientnexhibitsndecorticatenrigidity.
D.nThenclientnisnalertnbutndisorientedntontimenandnplace.
, AnnursenisnplanningnanpeerngroupndiscussionnaboutnthenDSM-
5.nWhichnofnthenfollowingninformationnisnappropriatentonincludeninnthendiscussion?n(Selectnal
lnthatnapply)
A.nThenDSM-5nincludesnclientneducationnhandoutsnfornmentalnhealthndisorders.
B.nThenDSM-5nestablishesndiagnosticncriterianfornindividualnmentalnhealthndisorders.
C.nThenDSM-
5nindicatesnrecommendednpharmacologicalntreatmentnfornmentalnhealthndisorders.
D.nThenDSM-
5nassistsnnursesninnplanningncarenfornclient'snwhonhavenmentalnhealthndisorders.
E.nThenDSM-5nindicatesnexpectednassessmentnfindingsnofnmentalnhealthndisorders.
Annurseninnannemergencynmentalnhealthnfacilitynisncaringnfornangroupnofnclients.nThennursens
houldnidentifynthatnwhichnofnthenfollowingnclientsnrequiresnantemporarynemergencynadmissi
on?
A.nAnclientnwhonhasnschizophrenianwithndelusionsnofngrandeur
B.nAnclientnwhonhasnmanifestationsnofndepressionnandnattemptednsuicidenanyearnago
C.nAnclientnwhonhasnborderlinenpersonalityndisordernandnassaultednanhomelessnmannwithnan
metalnrod
D.nAnclientnwhonhasnbipolarndisordernandnpacesnquicklynaroundnthenroomnwhilentalkingntonhi
mself
n n n n n n n n n n n n n n n
A nurse decides to put a client who has a psychotic disorder in seclusion overnight becau
n n n n n
se the unit is very short-
n n n n n n n n n n n n n n
staffed, and the client frequently fights with other clients. The nurse's actions are an exam
n n n n n n
ple of which of the following torts?
n n n
A. Invasion of privacy
n n
B. False imprisonment
n
C. Assault
n
D. Battery
n n n n n n n n n n n n n n n n n n n
A client tells a nurse, "Don't tell anyone but I hid a sharp knife under my mattress in order
n n n n n n n n n n n n n n n
to protect myself from my roommate, who is always yelling at me and threatening me." W
n n n n n n n n
hich of the following actions should the nurse take?
n n n n n n n n n n n n n
A. Keep the client's communication confidential, but talk to the client daily, using therapeu
n n n n n n n n n n
tic communication to convince him to admit to hiding the knife.
n n n n n n n n n n n n n
B. Keep the client's communication confidential, but watch the client and his roommate cl
osely.
n n n n n n n n n n n n n n n n n
C. Tell the client that this must be reported to the health care team because it concerns th
n n n n n n n n
e health and safety of the client and others.
n n n n n n n n n n n n n n n n n n
D. Report the incident to the health care team, but do not inform the client of the intention
n n
to do so.
n n n
n n n n n n n n n n n n n n n n
A nurse is caring for a client who is in mechanical restraints. Which of the following state
n n n n n n n n n n n
ments should the nurse include in the documentation? (Select all that apply)
n n n n n n
A. "Client ate most of his breakfast."
n n n n n n n n n
B. "Client was offered 8 oz of water every hr."
n n n n n n
C. "Client shouted obscenities at assistive personnel."
n n n n n n n n n
D. "Client received chlorpromazine 15 mg by mouth at 1000."
n n n n n
E. "Client acted out after lunch."
Annursenhearsnannewlynlicensednnursendiscussingnanclient'snhallucinationsninnthenhallwaynwi
thnanothernnurse.nWhichnofnthenfollowingnactionsnshouldnthennursentakenfirst?
n n n n
A. Notify the nurse manager.
n n n n n n n n
B. Tell the nurse to stop discussing the behavior.
n n n n n n
C. Provide an in-service program about confidentiality.
n n n n
D. Complete an incident report.
n n n n n n n n n n n n n n n n
A nurse is caring for the parents of a child who has demonstrated changes in behavior an
n n n n n n n n n n n n n n n n
d mood. When the mother of the child asks the nurse for reassurance about her son's con
n n n n n n n n n
dition, which of the following responses should the nurse make?
n n n n n n n n n n n
A. "I think your son is getting better. What have you noticed."
n n n n n n n n n n n n
B. "I'm sure everything will be okay. It just takes time to heal."
n n n n n n n n n n n n n
C. "I'm not sure whats wrong. Have you asked the doctor about your concerns?"
n n n n n n n n n n
D. "I understand you're concerned. Let's discuss what concerns you specifically."
Annursenisncaringnfornanclientnwhonsmokesnandnhasnlungncancer.nThenclientnreports,n"I'mnco
ughingnbecausenInhaventhatncoldnthatneveryonenhasnbeenngetting."nThennursenshouldnidenti
fynthatnthenclientnisnusingnwhichnofnthenfollowingndefensenmechanisms?
A.nReactionnformation
B.nDenial
C.nDisplacement
D.nSublimation
Annursenisnprovidingnpreoperativenteachingnfornanclientnwhonwasnjustninformednthatnshenreq
uiresnemergencynsurgery.nThenclientnhasnanrespiratorynraten30/minnandnsays,n"Thisnisndiffic
ultntoncomprehend.nInfeelnshakynandnnervous."nThennursenshouldnidentifynthatnthenclientnisne
xperiencingnwhichnofnthenfollowingnlevelsnofnanxiety?
,A.nMild
B.nModerate
C.nSevere
D.nPanic
Annursenisncaringnfornanclientnwhonisnexperiencingnmoderatenanxiety.nWhichnofnthenfollowing
nactionsnshouldnthennursentakenwhenntryingntongivennecessaryninformationntonthenclient?n(S
electnallnthatnapply.)
A.nReassurenthenclientnthatneverythingnwillnbenokay.
B.nDiscussnpriornusenofncopingnmechanismsnwithnthenclient.
C.nIgnorenthenclient'snanxietynsonthatnshenwillnnotnbenembarrassed.
D.nDemonstratenancalmnmannernwhilenusingnsimplenandnclearndirections.
E.nGatherninformationnfromnthenclientnusingnclosed-endednquestions.
Annursenisntalkingnwithnanclientnwhonisnatnrisknfornsuicidenfollowingnthendeathnofnhisnspouse.n
Whichnofnthenfollowingnstatementsnshouldnthennursenmake?
A.n"Infeelnverynsorrynfornthenlonelinessnyounmustnbenexperiencing."
B.n"Suicidenisnnotnthenappropriatenwayntoncopenwithnloss."
C.n"Losingnsomeonenclosentonyounmustnbenverynupsetting."
D.n"Inknownhowndifficultnitnisntonlosenanlovednone."
Anchargennursenisndiscussingnthencharacteristicsnofnannurse-
clientnrelationshipnwithnannewlynlicensednnurse.nWhichnofnthenfollowingncharacteristicsnsho
uldnthennursenincludeninnthendiscussion?n(Selectnallnthatnapply)
A.nThenneedsnofnbothnparticipantsnarenmet.
B.nAnnemotionalncommitmentnexistsnbetweennthenparticipants.
C.nItnisngoal-directed.
D.nBehavioralnchangenisnencouraged.
E.nAnterminationndatenisnestablished.
Annursenisninnthenworkingnphasenofnantherapeuticnrelationshipnwithnanclientnwhonhasnmetha
mphetaminenusendisorder.nWhichnofnthenfollowingnactionsnindicatesntransferencenbehavior
?
A.nThenclientnasksnthennursenwhethernshenwillngonoutntondinnernwithnhim.
B.nThenclientnaccusesnthennursesnofntellingnhimnwhatntondonjustnlikenhisnex-girlfriend.
C.nThenclientnremindsnthennursenofnanfriendnwhondiednfromnansubstancenoverdose.
D.nThenclientnbecomesnangrynandnthreatensntonharmnhimself.
Annursenisnplanningncarenfornthenterminationnphasenofnannurse-
clientnrelationship.nWhichnofnthenfollowingnactionsnshouldnthennursenincludeninnthenplannofncare?
,A.nDiscussingnwaysntonusennewnbehaviors
B.nPracticingnnewnproblem-solvingnskills
C.nDevelopingngoals
D.nEstablishingnboundaries
Anchargennursenisndiscussingnmentalnstatusnexamsnwithnannewlynlicensednnurse.nWhichnofnt
henfollowingnstatementsnbynthennewlynlicensednnursenindicatesnannunderstandingnofnthente
aching?n(Selectnallnthatnapply)
A.n"Tonassessncognitivenability,nInshouldnasknthenclientntoncountnbackwardnbynsevens."
B.n"Tonassessnaffect,nInshouldnobserventhenclient'snfacialnexpression."
C.n"Tonassessnlanguagenability,nInshouldninstructnthenclientntonwritenansentence."
D.n"Tonassessnremotenmemory,nInshouldnhaventhenclientnrepeatnanlistnofnobjects."
E.n"Tonassessnthenclient'snabstractnthinking,nInshouldnasknthenclientntonidentifynournmostnrec
entnpresidents."
Annursenisnplanningncarenfornanclientnwhonhasnanmentalnhealthndisorder.nWhichnofnthenfollow
ingnactionsnshouldnthennursenincludenasnanpsychobiologicalnintervention?
A.nAssistnthenclientnwithnsystematicndesensitizationntherapy.
B.nTeachnthenclientnappropriatencopingnmechanisms.
C.nAssessnthenclientnforncomorbidnhealthnconditions.
D.nMonitornthenclientnfornadverseneffectsnofnthenmedications.
Annurseninnannoutpatientnmentalnhealthnclinicnisnpreparingntonconductnanninitialnclientnintervi
ew.nWhennconductingntheninterview,nwhichnofnthenfollowingnactionsnshouldnthennursenidentif
ynasnthenpriority?
A.nCoordinatenholisticncarenwithnsocialnservices.
B.nIdentifynthenclient'snperceptionnofnhernmentalnhealthnstatus.
C.nIncludenthenclient'snfamilyninntheninterview.
D.nTeachnthenclientnaboutnherncurrentnmentalnhealthndisorder.
Annursenisntoldnduringnchangenofnshiftnreportnthatnanclientnisnstuporous.nWhennassessingnthe
nclient,nwhichnofnthenfollowingnfindingsnshouldnthennursenexpect?
A.nThenclientnarousesnbrieflyninnresponsentonansternalnrub.
B.nThenclientnhasnanglasgowncomanscalenscorenlessnthann7.
C.nThenclientnexhibitsndecorticatenrigidity.
D.nThenclientnisnalertnbutndisorientedntontimenandnplace.
, AnnursenisnplanningnanpeerngroupndiscussionnaboutnthenDSM-
5.nWhichnofnthenfollowingninformationnisnappropriatentonincludeninnthendiscussion?n(Selectnal
lnthatnapply)
A.nThenDSM-5nincludesnclientneducationnhandoutsnfornmentalnhealthndisorders.
B.nThenDSM-5nestablishesndiagnosticncriterianfornindividualnmentalnhealthndisorders.
C.nThenDSM-
5nindicatesnrecommendednpharmacologicalntreatmentnfornmentalnhealthndisorders.
D.nThenDSM-
5nassistsnnursesninnplanningncarenfornclient'snwhonhavenmentalnhealthndisorders.
E.nThenDSM-5nindicatesnexpectednassessmentnfindingsnofnmentalnhealthndisorders.
Annurseninnannemergencynmentalnhealthnfacilitynisncaringnfornangroupnofnclients.nThennursens
houldnidentifynthatnwhichnofnthenfollowingnclientsnrequiresnantemporarynemergencynadmissi
on?
A.nAnclientnwhonhasnschizophrenianwithndelusionsnofngrandeur
B.nAnclientnwhonhasnmanifestationsnofndepressionnandnattemptednsuicidenanyearnago
C.nAnclientnwhonhasnborderlinenpersonalityndisordernandnassaultednanhomelessnmannwithnan
metalnrod
D.nAnclientnwhonhasnbipolarndisordernandnpacesnquicklynaroundnthenroomnwhilentalkingntonhi
mself
n n n n n n n n n n n n n n n
A nurse decides to put a client who has a psychotic disorder in seclusion overnight becau
n n n n n
se the unit is very short-
n n n n n n n n n n n n n n
staffed, and the client frequently fights with other clients. The nurse's actions are an exam
n n n n n n
ple of which of the following torts?
n n n
A. Invasion of privacy
n n
B. False imprisonment
n
C. Assault
n
D. Battery
n n n n n n n n n n n n n n n n n n n
A client tells a nurse, "Don't tell anyone but I hid a sharp knife under my mattress in order
n n n n n n n n n n n n n n n
to protect myself from my roommate, who is always yelling at me and threatening me." W
n n n n n n n n
hich of the following actions should the nurse take?
n n n n n n n n n n n n n
A. Keep the client's communication confidential, but talk to the client daily, using therapeu
n n n n n n n n n n
tic communication to convince him to admit to hiding the knife.
n n n n n n n n n n n n n
B. Keep the client's communication confidential, but watch the client and his roommate cl
osely.
n n n n n n n n n n n n n n n n n
C. Tell the client that this must be reported to the health care team because it concerns th
n n n n n n n n
e health and safety of the client and others.
n n n n n n n n n n n n n n n n n n
D. Report the incident to the health care team, but do not inform the client of the intention
n n
to do so.
