ATI RN
ATI Mental Health Proctored Exam Questions
Extract:
Question 1 of 5
A nurse is assessing a client who has generalized anxiety disorder. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Restlessness. In generalized anxiety disorder, restlessness is a common symptom due to excessive worry and fear. The individual may have difficulty sitting still and may appear agitated. Increased energy (
A) is not typically associated with generalized anxiety disorder, as individuals often feel fatigued due to constant worry. Depersonalization (
C) is a dissociative symptom where one feels detached from oneself, not a common feature of generalized anxiety disorder. Euphoric mood (
D) is more characteristic of conditions like bipolar disorder, not generalized anxiety disorder.
Question 2 of 5
A nurse is assessing a client who is experiencing alcohol withdrawal. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Visual hallucinations. During alcohol withdrawal, the client may experience hallucinations due to central nervous system hyperactivity. This is a common symptom known as alcohol withdrawal hallucinosis. Bradycardia (
A) and hypotension (
C) are unlikely as withdrawal typically leads to increased heart rate and blood pressure. Hyperactivity (
D) is less common and usually occurs in the early stages of withdrawal, not when hallucinations start. Visual hallucinations are a key sign of alcohol withdrawal and can range from mild distortions to vivid and frightening images.
Question 3 of 5
A nurse is developing a plan of care for a client who has borderline personality disorder and exhibits manipulative behavior. Which of the following interventions should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Implement consistent limit-setting. For clients with borderline personality disorder and manipulative behavior, consistent limit-setting is essential to establish boundaries and promote a structured environment. By enforcing consistent limits, the nurse helps the client understand acceptable behaviors and consequences, fostering a sense of security and predictability. Encouraging flexibility with unit rules (
A) may enable manipulation by blurring boundaries. Allowing negotiation of consequences (
C) can reinforce manipulative behavior by giving the client power to avoid accountability. Avoiding addressing manipulative behavior (
D) fails to address the issue and can perpetuate maladaptive behaviors.
Question 4 of 5
A nurse in a mental facility is assessing a client for suicide risk factors using the SAD PERSONS scale. Which of the following findings indicates a risk for suicide?
Correct Answer: C
Rationale: The correct answer is C: The client is 50 years of age. This indicates a risk for suicide because being in the age group of 45-54 years is a significant risk factor according to the SAD PERSONS scale. This age group has a higher likelihood of experiencing life stressors and psychiatric disorders, increasing their vulnerability to suicidal thoughts and behaviors.
Option A (The client is married) does not directly correlate with suicide risk according to the SAD PERSONS scale. Option B (The client is female) is a general demographic factor and not specific to suicide risk assessment. Option D (The client has diabetes mellitus) is a medical condition that may contribute to overall health but is not a direct risk factor for suicide according to the scale.
Question 5 of 5
A school nurse is caring for an adolescent client whose teacher reports changes in school performance and withdrawal from interaction with classmates. Which of the following interventions is the nurse’s priority at this time?
Correct Answer: C
Rationale: The correct answer is C: Ask the adolescent if he is considering hurting himself. This is the priority intervention because it addresses the immediate safety and well-being of the adolescent. By directly asking about self-harm or suicide ideation, the nurse can assess the level of risk and intervene appropriately if necessary. Contacting the parents (
A) can be important but not the priority in ensuring the adolescent’s immediate safety. Joining support groups (
B) may be beneficial in the long term but does not address the current risk. Determining when the behavior change began (
D) is relevant but not as urgent as assessing for suicidal ideation.