ATI RN
ATI RN Mental Health Asn Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has delusional behavior and states, "I can't go to group therapy today. I am expecting a high-level official to visit me." The nurse responds, "I understand, but it is time for group therapy, and we expect everyone to attend. Let's walk over together.” For which of the following reasons is the nurse's response considered therapeutic?
Correct Answer: A
Rationale: The correct answer is A because it clearly articulates what is expected of the client, promoting structure and consistency in the therapeutic environment. By stating the expectation for the client to attend group therapy, the nurse establishes boundaries and encourages the client to participate in the treatment plan. This approach helps the client understand the importance of group therapy and fosters accountability.
The other choices are incorrect:
B: Demonstrating empathy towards the delusion may validate the client's false beliefs and hinder therapeutic progress.
C: Setting limits on manipulative behavior may be necessary, but in this scenario, the focus is on setting clear expectations rather than addressing manipulation.
D: Using reflection is a valuable therapeutic technique, but it is not the primary reason why the nurse's response is considered therapeutic in this situation.
Question 2 of 5
A nurse is caring for a client who reports bilateral knee pain after hiking this past weekend in the mountains on rough ground. He says he is concerned because his cousin died from bone cancer recently. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The nurse should provide reassurance while ensuring proper medical evaluation.
Question 3 of 5
A nurse is caring for a client who has a history of alcohol use disorder and has been hospitalized for detoxification. The nurse enters the room and finds the client shouting in a terrified voice, "Get these bugs off of me!” Which of the following responses by the nurse is appropriate?
Correct Answer: C
Rationale:
Correct Answer: C - "I don't see any bugs, but you seem very frightened."
Rationale: This response acknowledges the client's feelings without confirming the presence of bugs, which could worsen the delusion. It shows empathy and validates the client's emotions, promoting trust and therapeutic communication.
Summary of Incorrect
Choices:
A: Invalidates the client's experience and may increase anxiety.
B: Encourages the client to elaborate on the delusion, potentially reinforcing it.
D: Denies the client's perception and can lead to mistrust or agitation.
Question 4 of 5
A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client's compulsive behaviors?
Correct Answer: C
Rationale: The correct answer is C: Plan the client's schedule to allow time for rituals. This is the most appropriate action because accommodating the client's compulsive behaviors by incorporating time for rituals into their schedule can help reduce anxiety and maintain a sense of control for the client. Isolating the client (
A) can worsen their symptoms and is not therapeutic. Confronting the client (
B) about the senseless nature of their behaviors may increase their anxiety and resistance to treatment. Setting strict limits on behaviors (
D) can lead to increased distress and potential escalation of symptoms.
Question 5 of 5
A nurse in a mental health clinic is attempting to develop a therapeutic relationship with a client. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Set limits for the relationship. Setting limits in a therapeutic relationship helps establish boundaries, maintain professionalism, and create a safe space for the client. Limits provide structure and clarity, helping the client understand expectations and fostering trust. Promoting transference (choice
B) can be harmful as it can distort the client's perception of the nurse. Instructing the client on behavior (choice
C) may feel authoritarian and hinder the development of a collaborative relationship. Engaging in friendly interactions (choice
D) can blur professional boundaries and compromise the therapeutic dynamic.