ATI RN
ATI Mental Health Proctored Exam 2019 Questions
Question 1 of 5
A client has been diagnosed with depersonalization/derealization disorder. Which of the following behaviors should the nurse expect?
Correct Answer: A
Rationale: Depersonalization/derealization disorder is characterized by feelings of detachment from one's body or surroundings. Individuals with this disorder may feel like they are observing themselves from outside their body or that the world around them is unreal. Therefore, the nurse should expect behaviors such as feelings of detachment from one's body (A). Fear of gaining weight (B) is more indicative of an eating disorder, paralysis of a limb (C) could be related to neurological issues, and episodes of hypomania (D) are associated with mood disorders like bipolar disorder, but not specifically with depersonalization/derealization disorder.
Question 2 of 5
After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, 'You are incompetent!' Which is the nurse's best response?
Correct Answer: B
Rationale: In this scenario, the most appropriate response for the nurse is option B. By acknowledging the client's feelings and setting a boundary regarding inappropriate behavior, the nurse addresses the situation with empathy. This response demonstrates understanding of the client's emotions while also maintaining a professional standard by expressing discomfort with swearing. Option A could come off as defensive and may escalate the situation. Option C may be perceived as condescending and not immediately address the client's behavior. Option D, although offering space, does not directly address the inappropriate behavior and misses an opportunity to set a professional boundary.
Question 3 of 5
A client diagnosed with paranoid schizophrenia states, 'The FBI is watching me. I see their agents everywhere.' Which is the nurse's most appropriate response?
Correct Answer: B
Rationale: The most appropriate response is **B: "I don't see any FBI agents, but it sounds like you're feeling frightened."** **Rationale for Correct Answer (B):** This response validates the patient's emotional experience without reinforcing the delusion, which is crucial in therapeutic communication for paranoid schizophrenia. By acknowledging the patient’s fear ("it sounds like you're feeling frightened"), the nurse demonstrates empathy and builds trust. Simultaneously, the nurse avoids reinforcing the delusion by stating, "I don’t see any FBI agents," which gently introduces reality without confrontation. This approach aligns with evidence-based psychiatric nursing practices, which emphasize reducing distress while avoiding arguments that could escalate paranoia or damage rapport. **Rationale for Incorrect Answers:** **A: "You shouldn't worry about that. It's not real."** This response dismisses the patient's experience, which can increase distress and reinforce feelings of isolation. Telling a delusional patient that their beliefs "aren’t real" is counterproductive—it doesn’t address the underlying fear and may provoke defensiveness. Effective psychiatric care focuses on managing distress, not challenging delusions outright. **C: "Let's talk about something else to take your mind off of it."** While distraction can sometimes be useful, this response avoids addressing the patient’s immediate emotional state. Ignoring the delusion may leave the patient feeling unheard, worsening their anxiety. Therapeutic communication requires engagement with the patient’s concerns, even if the content of the delusion isn’t validated. **D: "Why do you think the FBI is watching you?"** Asking for justification of a delusion can reinforce paranoid ideation by encouraging the patient to elaborate on false beliefs. Probing questions may also increase agitation, as the patient might perceive the nurse as doubting or investigating them. This approach risks deepening the delusion rather than alleviating distress. The correct response (B) balances empathy with gentle reality orientation, which is essential in managing paranoid schizophrenia. The incorrect choices either dismiss emotions, avoid the issue, or inadvertently worsen delusional thinking. Understanding these distinctions is critical for effective mental health nursing interventions.
Question 4 of 5
A client with depression is experiencing anhedonia. Which statement by the client reflects this symptom?
Correct Answer: B
Rationale: Anhedonia is the inability to experience pleasure from activities usually found enjoyable. The statement 'I don't enjoy the things I used to love' directly reflects this symptom as the client is expressing a lack of pleasure from previously enjoyable activities. Choices A, C, and D do not specifically relate to anhedonia but rather indicate symptoms of anxiety, concentration difficulties, and sleep disturbances, respectively.
Question 5 of 5
A client experiencing a manic episode is talking rapidly and jumping from one topic to another. Which term describes this symptom?
Correct Answer: B
Rationale: In a manic episode, 'Flight of ideas' is characterized by rapid speech, where the individual moves quickly between topics without a clear connection. This symptom reflects the racing thoughts and impulsivity often seen in manic episodes. Circumstantiality refers to unnecessary detail and delay in getting to the point, tangentiality involves going off on a tangent or unrelated topics, and perseveration is the persistent repetition of a response or behavior. Therefore, 'Flight of ideas' best describes the symptom of rapidly changing topics during a manic episode.