ATI RN
Adult Behavioral Health Nursing Questions
Question 1 of 5
Nursing behaviors associated with the implementation phase of nursing process are concerned with:
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
The nurse asks a patient to list the days of the week in reverse order. The nurse is assessing which of the following?
Correct Answer: A
Rationale: The nurse assesses the client's ability to concentrate by asking the client to perform certain tasks such as repeating the days of the week backward. The nurse directly assesses memory, both recent and remote, by asking questions with verifiable answers. Orientation refers to the client's recognition of person, place, and time. Abstract thinking is to making associations or interpretations about a situation or comment.
Question 3 of 5
Which of the following would best assess a client's judgment?
Correct Answer: B
Rationale: The client's judgment can be elicited by asking the client to discuss hypothetical situations, which would indicate one's ability to interpret one's environment and situation correctly and to adapt one's behavior and decisions accordingly. Counting by serial sevens and spelling words backward would assess the client's ability to concentrate. Interpreting proverbs would assess the client's abstract thinking.
Question 4 of 5
In the space of 5 minutes, the client has been laughing and euphoric, then angry, and then crying for no reason that is apparent to the nurse. This behavior would be best described as
Correct Answer: C
Rationale: Moods that shift rapidly, displaying a range of emotions, are termed labile. Flight of ideas is manifested by excessive amount and rate of speech composed of fragmented or unrelated ideas. Lack of insight would be manifested by the lack of the ability to understand the true nature of one's situation and accept some personal responsibility for that situation. Tangential thinking would be manifested by wandering off the topic and never providing the information requested.
Question 5 of 5
Which of the following client situations most urgently requires the nurse to break confidentiality and warn a third party?
Correct Answer: D
Rationale: Mental health clinicians have a duty to warn identifiable third parties of threats made by clients, even if these threats were discussed during therapy sessions otherwise protected by privilege. The clinician must base his or her decision to warn others on the following: Is the client dangerous to others? Is the danger the result of serious mental illness? Is the danger serious? Are the means to carry out the threat available? Is the danger targeted at identifiable victims? Is the victim accessible?