VATI ATI Mental health test (60 Questions and Answers). 2020/2021 EXAM STUDY GUIDE GRADED A

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VATI ATI Mental health test (60 Questions and Answers) 1. A nurse is planning care for a client following a suicide attempt. Which of the following interventions should the nurse include in the plan? ... 2. A nurse is performing an admission assessment for a client who appears withdrawn and fearful. Which of the following actions should the nurse take first? 3. A nurse is caring for an adolescent client who has anorexia nervosa. The client states, "Have I done any permanent damage to my body?" Which of the following responses should the nurse make? "You should ask your provider that question." This response by the nurse does not address the client's question and can invalidate the client's concerns. "I wouldn't worry about any permanent damage you might have caused right now." This response by the nurse is giving false reassurance, which indicates to the client that there is no cause to worry and might cause the client to stop sharing feelings. "Why do you feel like you have damaged your body?" This response by the nurse is asking a "why" question, which implies criticism and often makes the client feel defensive. "You're afraid you have caused physical injury to yourself?" MY ANSWER This response by the nurse is repeating the main idea of what the client has said, which will allow for clarification of any misunderstanding on the part of the client or the nurse. 4. A nurse is caring for a client following a fire that destroyed her home and killed one of her children. The client is crying and does not make eye contact with the nurse. Which of the following questions should the nurse ask first? "How are you feeling at this time?" Although the nurse should assist the client by identifying her feelings, the nurse should ask another question first. "Is there someone I can call to be with you now?" Although the nurse should assist the client by asking about individuals who can provide emotional support, the nurse should ask another question first. "Can you tell me what you have done in the past when going through a difficult time?" Although the nurse should assist the client by identifying past coping mechanisms, the nurse should ask another question first. "Have you thought of harming yourself?" MY ANSWER The greatest risk to this client is self-harm due to the loss of her child and home; therefore, the first question the nurse should ask a client who is having a personal crisis is to determine if the client has suicidal ideation. If so, the nurse should take action to protect the client from self-harm. 5.A nurse is checking laboratory values for a hospitalized young adult client who has bipolar disorder and is taking lithium. Which of the following values is the priority for the nurse to report to the provider? Lithium level 0.8 mEq/L The client's lithium level is within the expected reference range of 0.4 to 1.3 mEq/L. Toxic effects occur at 1.5 mEq/L and higher. The nurse should report this level to the provider, because it is important for the provider to consider when prescribing lithium; however, another laboratory value is the priority to report. Serum creatinine 2.1 mg/dL MY ANSWER The client's serum creatinine level is above the expected reference ranges of 0.5 to 1 mg/dL for young adult females and 0.6 to 1.2 mg/dL for young adult males. The greatest risk to this client is decreased kidney function, which can cause an increase in the client's lithium level; therefore, this value is the priority for the nurse to report to the provider. The client's lithium dosage might need to be modified based on this laboratory value and the provider will need to determine the cause of the client's increased creatinine level. Causes of increased serum creatinine include dehydration as well as renal disorders. Lithium is contraindicated for clients who have severe renal disease, cardiac disease, or severe dehydration. Serum sodium 141 mEq/L The client's serum sodium level is within the expected reference range of 136 to 145 mEq/L. The nurse should report this level to the provider because decreased levels can lead to lithium toxicity; however, another laboratory value is the priority to report. T3 180 ng/dL The client's T3 level is within the expected reference range for adult clients of 70 to 205 ng/dL. Levels of T3, T4, and TSH should be checked annually while a client is taking lithium because lithium can cause thyroid gland enlargement and even hypothyroidism. The nurse should report this level to the provider; however, another laboratory value is the priority to report. 6. A nurse is providing information to a client who is seeking voluntary admission to a mental health facility. Which of the following information should the nurse include? "You cannot leave until your provider discharges you." A client who seeks voluntary admission can leave the facility whenever they decide they no longer want to receive treatment. If assessment of the client reveals that they are a threat to themselves or others, the provider can prevent them from leaving. "You will give up your right to refuse treatment upon admission." Whether a client is receiving treatment voluntarily or involuntarily, they retain the right to refuse any treatment they do not want to receive. A client who is receiving mental health treatment has the same rights as a client receiving any other kind of health care. "You will still need to give informed consent for treatments after admission." MY ANSWER A client who seeks voluntary admission to a mental health facility has the same rights as clients receiving any other kind of health care. The client will still need to give informed consent for treatments and therapies, such as electroconvulsive therapy. "Your provider will notify your employer of your admission." Whether a client is receiving treatment voluntarily or involuntarily, they retain the right to confidentiality. Informing an employer of an employee's admission without the client's permission is a breach of confidentiality. 7. A nurse is developing a plan of care for an adolescent client who has conduct disorder. Which of the following interventions should the nurse include in the plan? Determine if the client has a history of command hallucinations. The nurse should determine the history of command hallucinations for clients who have schizophrenia. Clients who are having command hallucinations are experiencing a sensory disturbance that can lead to self-harm or harm to others. Command hallucinations are not a manifestation of conduct disorder. Instruct the client on thought-stopping techniques. The nurse should teach clients who have obsessive-compulsive disorder how to use thought-stopping techniques. These techniques can help clients control obsessive thoughts or actions by interrupting the undesirable action and substituting a more positive action. Obsessive thoughts are not a manifestation of conduct disorder. Initiate a behavioral contract with the client. MY ANSWER A client who has conduct disorder can demonstrate patterns of behavior that are aggressive, disrespectful of others' rights, and can lead to injury of others. The nurse should initiate a behavioral contract for a client who has conduct disorder. A behavioral contract helps to develop trust between the client and the nurse and emphasizes the client's responsibility to commit to work on changes in behavior. Monitor the client's neurologic status. The nurse should monitor the neurologic status of a client who has delirium. Clients who have delirium can show an acute onset of manifestations. The nurse should monitor for a change in the client's level of consciousness, decreased attention span, memory impairment, and poor judgment. Neurologic changes are not a manifestation of conduct disorder. 8. A hospice nurse is talking with the family of a client who recently died from cancer following a series of chemotherapy treatments. One of the adult children is angry with the provider and blames the provider for their father's death. Which of the following defense mechanisms is the family member using? Dissociation Family members can use dissociation as a defense mechanism to separate themselves from a situation they find uncomfortable. Rationalization Family members can use rationalization as a defense mechanism to justify unacceptable actions or behavior. Repression MY ANSWER Family members can use repression as a defense mechanism to unconsciously block unpleasant experiences. Displacement The family member is using the defense mechanism of displacement. When this family member uses displacement, they are transferring their feelings of anger to the provider so they do not have to cope with their own feelings of sadness and loss. 9. A nurse in an acute care facility is providing teaching for the adult child of an older adult client who is admitted with a urinary tract infection and delirium. The client has been living independently at home. Which of the following statements by the adult child demonstrates the teaching has been effective? "I should look into the possibility of long-term care for my father when he is discharged." Dementia is not reversible and is progressive, making the need for long-term care likely. Delirium can include severe confusion, agitation, and disorientation, but, when treated promptly, is reversible and does not progress. "I would like information about respite care for when my father is discharged." The family of a client who has dementia, rather than delirium, may need respite care due to the progressive, 24-hr care needed for a client who has dementia. Respite care is a service that provides relief for family members who must provide constant care for a client who has dementia or another chronic or a terminal illness. In respite care, a substitute caregiver provides care while the family member has some time off. Respite care can occur in the home but some communities offer short term respite services in over-night facilities. "I expect that my father will no longer be confused when he is discharged." MY ANSWER The client who has delirium is likely to return to normal functioning after the underlying cause of the delirium is discovered and treated. Common causes of delirium include metabolic disorders, medication effects, and systemic infections. Delirium has a sudden onset over hours or days and can have distressing manifestations of acute confusion, agitation, rapid mood swings and slurred speech. However, it can be completely reversed by treatment. Before discharge the client and family should receive teaching about ways to prevent urinary tract infection and other causes of delirium which are fairly common in older adults. "I will obtain a permanent identification bracelet for my father when he is discharged." A client who has dementia, rather than delirium, may require a permanent identification bracelet for safety after discharge if wandering is common. Other strategies for clients who have dementia and are at risk for wandering include putting locks at the tops of doors, or using bed and chair alarms that tell a caregiver when the client is walking about. 10. A nurse is caring for a client who is experiencing a manic episode. Which of the following actions should the nurse take first? Provide supervised physical activities. The nurse should encourage the client to participate in physical activities to help the client release tension and expel energy. However, there is another action the nurse should take first. Maintain a calm attitude with the client. The nurse should maintain a calm attitude when interacting with the client in order to limit the risk of increasing the client's anxiety. However, there is another action the nurse should take first. Decrease environmental stimuli. MY ANSWER The nurse should decrease environmental stimuli to minimize the client's agitation and anxiety. However, there is another action the nurse should take first. Encourage the client to rest each hour. The greatest risk to this client is injury from exhaustion due to the manic phase; therefore, the priority action the nurse should take is to encourage the client to rest for 3 to 5 min every hour. 11. A nurse is leading a medication education group for several clients. A client who is sometimes violent becomes angry and begins yelling at others in the group. Which of the following actions should the nurse take? (Select all that apply.) Speak to the client in an aggressive tone of voice. Move others away from the client. Offer the client a PRN dose of lorazepam. Stand directly in front of the client. Ask the client open-ended questions about the behavior. MY ANSWER Speak to the client in an aggressive tone of voice is incorrect. The nurse should speak clearly and assertively but not aggressively to the client who is angry. Speaking in an aggressive tone can escalate the situation into one of violence. The nurse should maintain a calm demeanor and use short sentences while talking to the client slowly. Move others away from the client is correct. A large personal space should be maintained around the client who is angry. If the client's behavior continues to escalate, the nurse should move others away from the client for their safety. Offer the client a PRN dose of lorazepam is correct. Antianxiety medication can be used in conjunction with de-escalation techniques to prevent a violent episode. Stand directly in front of the client is incorrect. The nurse should stand to the side of the client and encourage the client to sit down. Standing in front of the client can be perceived as confrontational to the client. Ask the client open-ended questions about the behavior is correct. This communication technique is nonthreatening and encourages the client to express their feelings. 12. A charge nurse is planning an in-service for a group of newly licensed nurses about the use of restraints. Which of the following information should the nurse include? Record the client's behavior every 15 min while in restraints. MY ANSWER The nurse should complete a written record of the client's behavior every 15 min in the client's medical record while in restraints. The client should be considered for reintegration when they are able to follow commands and exhibit self-control of behavior. Secure the restraint to the client's bed rail using a slip knot. The nurse should secure the restraint to the removeable portion of the bed frame using a half-bow or quick-release knot. Raising all four bedrails to keep a client in bed is not considered a restraint. A restraint is any chemical or physical device that is used to limit the movement of a client's arms, legs, head or body. Raising all four bedrails with the intent to prevent a client from getting out of bed is considered a restraint. Additionally, raising all four bedrails increases a client's risk for a fall. The nurse should assess a restrained client once every 2 hr. The nurse should closely monitor the client's vital signs and physiological needs frequently while in restraints. The nurse should offer food, fluids, and toileting and monitor the client for pain. These interventions should occur every 15 to 30 min while the client is restrained, or more often if it is facility policy. The nurse should document these interventions in the client's medical record. 13. A nurse is assessing a client who has bulimia nervosa. Which of the following findings should the nurse expect? Yellow skin A client who has anorexia nervosa can have yellow skin due to carotenemia. Dental caries MY ANSWER A client who has bulimia nervosa can have dental caries and tooth erosion due to excessive exposure to stomach acid from frequent vomiting. Cold extremities A client who has anorexia nervosa can have cold extremities because of low body weight and starvation. Amenorrhea A client who has anorexia nervosa can have amenorrhea from low body weight and starvation. 14. A nurse is providing teaching to a client who has bipolar disorder and has been taking lithium for 4 months. The client's serum lithium levels are within the therapeutic range. Which of the following instructions should the nurse include to promote the maintenance of the therapeutic lithium level? "Limit outdoor exercise during hot weather." MY ANSWER Spending time outdoors during hot weather, especially if exercising, promotes dehydration and sodium loss through diuresis, which can increase lithium levels. Whenever the client exercises, develops diarrhea, vomits, or has any circumstance that can cause dehydration, fluids and electrolytes must be replaced promptly. "Reduce dietary intake of sodium by avoiding salty foods." A decreased sodium intake increases lithium levels, putting the client at risk for toxicity. The client's diet should contain adequate dietary sodium in addition to at least 2 to 3 L of fluid per day. "Double your next lithium dose if a dose is skipped or forgotten." If the client forgets to take a dose, they can take it within 2 hr of the scheduled time. Otherwise, they should skip the missed dose and take the next dose at the scheduled time. The client should not double the dose of lithium because doing so increases the risk of toxicity. "Take a daily diuretic if ankle swelling occurs." Sodium loss, which increases the risk for lithium toxicity, can occur when taking diuretics. The nurse should instruct the client to avoid taking diuretics while taking lithium. 15. A nurse on a mental health unit is conducting a one-on-one session with a client who suddenly becomes silent. Which of the following responses should the nurse make? 16. A nurse is caring for a client who appears extremely agitated and believes that pacing the floor a specific number of times is necessary or "something terrible" will happen. Which of the following responses should the nurse make? "Nothing terrible is going to happen to you. You must stop this behavior." 17. A nurse is discussing therapeutic communication with a group of newly licensed nurses. Which of the following phrases should the nurse use as an example of offering general leads? 19. A nurse is caring for an adult client who was involuntarily admitted following a suicide attempt. The nurse receives a call from the client's spouse asking for a status report. Which of the following responses should the nurse make? A nurse is planning to teach a group of clients about techniques to change unwanted behaviors. Which of the following techniques is the nurse using when she acts out different scenarios and has clients respond by practicing new behaviors? 21. A home health nurse is caring for a new client who has hoarding disorder that involves food. Which of the following actions should the nurse take first? . 22. A nurse is caring for a client who is experiencing mania and is placed in seclusion due to escalating behavior. Which of the following actions should the nurse take? Request that the provider assess the client within 8 hr. 23. A nurse is assisting in obtaining informed consent from a client who is scheduled for vagus nerve stimulation. Which of the following actions should the nurse take to act as a client advocate? 24. A nurse is caring for a client who has a depressive disorder and recently started taking a selective serotonin reuptake inhibitor. For which of the following findings should the nurse monitor to identify serotonin syndrome? 25. A nurse is assessing a group of clients in a community health clinic. In which of the following situations should the nurse identify a requirement to report child or vulnerable adult maltreatment to an appropriate agency? (Select all that apply.) A 7-year-old child has a variety of old and new bruises on his back and posterior thighs A 2-year-old child has a spiral fracture of his arm, which the parent states happened when he fell from a swing A 10-year-old child has a swollen, bruised ankle, which she reports occurred during basketball practice at school An 80-year-old client who has dementia and lives in a group home has bruises in the perineal area A 25-year-old woman has newly diagnosed hypertension and states that she is stressed because she and her partner have been arguing about money 26. A nurse is providing dietary teaching to a client who has a prescription for tranylcypromine. The nurse should instruct the client to avoid which of the following foods while taking this medication? 27. A nurse is planning care for a client who is taking benztropine to reduce extrapyramidal manifestations developed secondary to taking an antipsychotic medication. For which of the following adverse effects of benztropine should the nurse monitor? 28. A nurse in a mental health clinic is assessing a client who has dependent personality disorder. Which of the following findings should the nurse expect? 29. A nurse is planning care for a client who is withdrawing from alcohol. Which of the following medications should the nurse plan to administer during the acute phase of alcohol withdrawal? 30. A charge nurse is conducting an in-service for a group of newly licensed nurses about risk factors for child maltreatment. Which of the following examples should the nurse include in the teaching? 31. A nurse in an acute care mental health facility is caring for a client who has generalized anxiety disorder and suddenly begins pacing, wringing her hands, and reporting numbness and tingling in her fingers. Which of the following actions should the nurse take? 32. A nurse is caring for a client who has schizophrenia and is exhibiting violent behavior. After staff members place the client in restraints, which of the following actions should the nurse take? 33. A nurse in a mental health facility is caring for a client who has frequent episodes of aggressive and violent behavior. The nurse should identify which of the following findings as indications that the client is at risk for imminent violence? (Select all that apply.) 34. A nurse is assigning tasks to a licensed practical nurse and an assistive personnel (AP). Which of the following tasks should the nurse delegate to the AP? 35. A nurse is preparing to administer methylphenidate 30 mg PO to a school-age child who has ADHD. Available is methylphenidate oral solution 10 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 36. A nurse in an emergency department is preparing to discharge a client who has severe hypertension and requires detoxification for alcohol use disorder. The nurse should recommend a referral to which of the following resources? 37. A nurse in an outpatient mental health facility is assessing a family unit that consists of grandparents, parents, and several children. Which of the following tools should the nurse plan to use to assist in assessing this group of clients? 38 A nurse is caring for a client who has generalized anxiety disorder and is taking buspirone. The nurse should identify that which of the following outcomes is an advantage of buspirone? 39. A nurse is creating a plan of care for a client who has posttraumatic stress disorder (PTSD). Which of the following interventions should the nurse include in the plan? 40. A nurse in a mental health clinic receives a phone call from a client who has a mental health disorder and lives at home. The client reports they cannot afford to refill their prescription for an antipsychotic medication and requests assistance. Which of the following members of the client's health care team should the nurse notify? 41. A nurse is reviewing a laboratory report of a client who is taking olanzapine. Which of the following laboratory values should the nurse report to the provider? 42. A charge nurse on a mental health unit is discussing legal issues with a newly licensed nurse. Which of the following statements should the charge nurse include? 43. A nurse in an acute care mental health facility is preparing a client for discharge. Which of the following tasks should the nurse include in the termination phase of the nurse-client relationship? 44. A home health nurse is providing education for the family of a client who has dementia. Which of the following interventions should the nurse recommend? 45. A nurse is assessing a client who has bipolar disorder and is experiencing mania. Which of the following findings is the priority for the nurse to report to the provider? 46. A nurse is caring for a client who has bipolar disorder and is taking carbamazepine. The nurse should monitor the client for which of the following adverse effects? 47. A nurse in an emergency department is caring for a school-age child who has lacerations and bruises inflicted by his mother. The client's father states, "My wife was fired today and came home really angry. I don't think this will ever happen again." Which of the following responses should the nurse make? 48. A nurse is counseling a client who has alcohol use disorder and has chosen to enter a treatment program. The client states, "I need to find a program that won't interfere with my job." The nurse should identify which of the following community resources as being the least restrictive? 49. A nurse is providing morning care for a client who has Alzheimer's disease and has frequent outbursts of aggression. Which of the following actions should the nurse take? A nurse is caring for a client who has schizophrenia and is experiencing frequent delusions. Which of the following strategies should the nurse use when caring for the client? 51. A nurse is caring for a client whose partner died 3 years ago. The client has withdrawn socially and has not participated in regular activities since the funeral. The nurse should identify that the client is experiencing which of the following types of grief? . 52. A nurse is planning care to assist a client with smoking cessation. Which of the following medications should the nurse expect the provider to prescribe? 53. A nurse is discussing resources with the case manager of a client who has schizophrenia and heart failure. Which of the following resources should the nurse recommend to address the client's behavioral health and medical needs? 54. A nurse in an acute mental health facility is assessing a newly admitted client who has schizophrenia. Which of the following findings should the nurse identify as the priority to assess further? 55.Derealization is the perception that the client's usual surroundings are changing in some way, such as appearing visually distorted or looking larger than usual; however, another 56. A nurse is assessing a client who is experiencing mild anxiety. Which of the following findings should the nurse expect? 57. A nurse is performing a mental status examination of a client. Which of the following questions should the nurse ask the client to assess their cognition? 58. A nurse is creating a plan of care for a newly admitted client who has anorexia nervosa. Which of the following interventions should the nurse include? 59. A nurse is assessing a client for a substance use disorder. The client exhibits yawning, pupillary dilation, rhinorrhea, and reports muscle cramps. The nurse should suspect that the client is withdrawing from which of the following substances? 60. A nurse in an emergency department is assessing an older adult client who was brought in by a family member. The family member reports that the client has had a change in behavior over the past 2 days. The nurse should identify that which of the following findings is an indication that the client has delirium? (Select all that apply.) Show Less [Show More]

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