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Ati Mental Health Exam

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Total Questions : 73

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Question 1:

A 25-year-old male with schizophrenia is brought to the emergency department by his family. He is exhibiting severe agitation, auditory hallucinations, and paranoid delusions. What are the nursing priorities for managing this patient in an acute situation?
(Select All that Apply.)

A. Administer prescribed antipsychotic medication as ordered. B. Ensure the patient is in a safe environment to prevent harm to himself or others. C. Monitor the patient for any side effects of medications. D. Leave the patient alone to calm down in a quiet room. E. Establish a relationship by using calm and clear communication. F. Encourage the patient to participate in group therapy immediately. G. Ignore the patient’s hallucinations and delusions to avoid reinforcing them. H. Provide the patient with detailed explanations of their condition and treatment plan.

Answer and Explanation

Choice A:

Administering prescribed antipsychotic medication is a priority in acute psychotic episodes to reduce agitation, control hallucinations, and stabilize thought processes. Prompt pharmacologic intervention can prevent escalation of symptoms and potential harm.

Choice B:

Ensuring a safe environment is essential because patients experiencing psychosis are at increased risk of self-harm or harming others due to delusions and impaired judgment. Safety is always the first priority in emergency psychiatric care.

Choice C:

Monitoring for side effects of medications is necessary because antipsychotics can cause acute adverse reactions such as dystonia, akathisia, or even neuroleptic malignant syndrome. Early recognition and intervention can prevent complications.

Choice D:

Leaving the patient alone while highly agitated is unsafe, as the patient may harm themselves or others. Continuous supervision and therapeutic presence are needed.

Choice E:

Using calm and clear communication builds trust, reduces paranoia, and helps orient the patient. Clear, simple language is effective when the patient’s cognitive processing is impaired.

Choice F:

Group therapy is inappropriate during acute agitation. The patient must first stabilize before being introduced to therapeutic group settings.

Choice G:

Ignoring hallucinations and delusions is not therapeutic. While the nurse should not reinforce false beliefs, acknowledging the patient’s feelings and providing reality orientation is best practice.

Choice H:

Providing detailed explanations about the condition and treatment during acute psychosis is ineffective. The patient is unlikely to process complex information until stabilized.

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Question 2:

A nurse is attending a group therapy session and listening to clients who have bipolar disorder discuss coping strategies. Which of the following statements by the clients indicate adaptive coping?
(Select All that Apply.)

A. "I get 7 hours of sleep at night by skipping afternoon naps." B. "I exercise aerobically three times a day for 30 minutes at a time." C. "I think about my favorite beach vacation when I get anxious." D. "I see the glass as half-full when it starts looking empty." E. "I tense and release my muscles, starting with my feet."

Answer and Explanation

Choice A:

Maintaining adequate and consistent sleep helps regulate mood and prevent manic or depressive episodes. Avoiding naps can improve nighttime sleep quality.

Choice B:

Excessive exercise multiple times a day may increase risk of exhaustion and even trigger mania in bipolar disorder. Moderation is key.

Choice C:

Using positive mental imagery, such as recalling a pleasant vacation, is a healthy cognitive coping strategy to manage anxiety.

Choice D:

A positive outlook (optimism) is a strong protective coping mechanism that enhances resilience and stress management in individuals with mood disorders.

Choice E:

Progressive muscle relaxation is an evidence-based relaxation technique that reduces anxiety, promotes calmness, and decreases tension.

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Question 3:

A school nurse is talking with a 13-year-old female at her annual health-screening visit. Which of the following comments made by the adolescent should be the nurse's priority to address?

A. "I haven't gotten my period yet and all my friends have theirs." B. "None of the kids at this school like me, and I don't like them either." C. "My parents treat me like a baby sometimes." D. "There's a big pimple on my face, and I worry that everyone will notice it."

Answer and Explanation

Choice A:

Delayed menarche at age 13 is within normal developmental variation. Although it may cause concern for the adolescent, it is not an immediate priority unless accompanied by other signs of delayed puberty.

Choice B:

Expressing social isolation and rejection is a priority because it may indicate depression or risk for self-harm. Adolescents who feel excluded and disliked are more vulnerable to mental health crises.

Choice C:

Perceiving parents as overprotective is common in adolescence as teenagers seek independence. This is not typically a clinical concern.

Choice D:

Concerns about acne and appearance are common during adolescence and usually reflect normal developmental self-consciousness rather than a safety issue.

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Question 4:

A nurse is assessing a client who has schizophrenia. Which of the following behaviors should the nurse anticipate?

A. Preoccupied with folding clothes. B. Periods of elation with unusual talkativeness. C. Recurrent thoughts of past trauma. D. Invents words that have no meaning.

Answer and Explanation

Choice A:

Being preoccupied with repetitive activities such as folding clothes can sometimes occur in individuals with obsessive-compulsive disorder or autism spectrum disorders, but it is not a defining feature of schizophrenia.

Choice B:

Elation and unusual talkativeness are hallmark features of mania in bipolar disorder, not schizophrenia.

Choice C:

Recurrent thoughts of past trauma are more characteristic of post-traumatic stress disorder (PTSD), not schizophrenia.

Choice D:

Creating words that have no meaning, also called neologisms, is a common positive symptom of schizophrenia and reflects disorganized thought processes.

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Question 5:

A patient is prescribed 300 mg of Risperidone divided into two doses daily. If Risperidone is available in 50 mg tablets, how many tablets should be administered per dose?

A. 3 tablets. B. 5 tablets. C. 6 tablets. D. 4 tablets.

Answer and Explanation

Choice A:

Each dose must equal 150 mg. With 50 mg tablets, that equals 3 tablets per dose. This is the accurate calculation.

Choice B:

Five tablets would equal 250 mg per dose, which is too high and exceeds the prescribed amount.

Choice C:

Six tablets equal 300 mg per dose, doubling the total daily prescription.

Choice D:

Four tablets equal 200 mg per dose, which is higher than prescribed.

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Question 6:

A patient is prescribed 150 mg/day of Lithium, divided into two equal doses. How much Lithium should be given per dose?

A. 150 mg. B. 75 mg. C. 50 mg. D. 100 mg.

Answer and Explanation

Choice A:

Giving 150 mg in one dose would mean the full daily dose is administered at once, not divided as ordered.

Choice B:

The total daily dose is 150 mg. Dividing this into two equal doses means 150 ÷ 2 = 75 mg per dose.

Choice C:

Fifty mg per dose would only total 100 mg per day, which is below the prescribed dose.

Choice D:

One hundred mg per dose would total 200 mg daily, which exceeds the prescribed 150 mg/day.

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Question 7:

A nurse is assessing a client who is receiving treatment with multiple antipsychotic medications and who suddenly became ill. Findings include blood pressure changes, hyperpyrexia, and diaphoresis. The nurse should recognize that which of the following adverse effects may be occurring?

A. Pseudoparkinsonism. B. Tardive dyskinesia. C. Neuroleptic malignant syndrome. D. Acute dystonia.

Answer and Explanation

Choice A:

Pseudoparkinsonism involves tremors, shuffling gait, rigidity, and bradykinesia, but it does not cause high fever, blood pressure instability, or diaphoresis.

Choice B:

Tardive dyskinesia involves involuntary movements such as lip smacking, tongue protrusion, or grimacing, and it develops gradually after long-term medication use. It does not cause acute systemic symptoms.

Choice C:

Neuroleptic malignant syndrome (NMS) is a rare but life-threatening reaction to antipsychotics. It presents with hyperpyrexia, autonomic instability (blood pressure changes, diaphoresis), muscle rigidity, and altered mental status. This fits the scenario.

Choice D:

Acute dystonia is characterized by sudden, severe muscle contractions (often of the neck, eyes, or jaw) but does not include fever or autonomic instability.

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Question 8:

A. Pseudoparkinsonism. B. Tardive dyskinesia. C. Neuroleptic malignant syndrome. D. Acute dystonia.

Answer and Explanation

Choice A:

Pseudoparkinsonism causes symptoms such as tremors, rigidity, bradykinesia, and shuffling gait. It is not associated with fever, blood pressure changes, or diaphoresis.

Choice B:

Tardive dyskinesia develops gradually after prolonged antipsychotic use and presents with involuntary movements like lip smacking, tongue protrusion, or grimacing. It does not cause acute systemic symptoms such as hyperpyrexia or autonomic instability.

Choice C:

Neuroleptic malignant syndrome (NMS) is a life-threatening emergency associated with antipsychotics. It manifests with hyperpyrexia, autonomic instability (blood pressure changes, diaphoresis), severe muscle rigidity, and altered mental status. The client’s presentation matches NMS.

Choice D:

Acute dystonia involves sudden muscle contractions affecting the face, neck, or back (e.g., torticollis, oculogyric crisis). It does not present with systemic symptoms like fever or blood pressure fluctuations.

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Question 9:

A nurse in an acute care mental health facility is sitting with a client who has schizophrenia. The client whispers to the nurse, "I'm being kept in this prison against my will. Please try to get me out." Which of the following responses should the nurse make?

A. "You feel that you don't belong here?" B. "We are here to help you and give you the care that you need right now." C. "Try to take some deep breaths and you will feel better." D. "Why do you feel that you need to leave?"

Answer and Explanation

Choice A:

Reflecting the patient’s feelings can be therapeutic in some cases, but here it could reinforce the delusion of being imprisoned rather than provide reassurance and grounding.

Choice B:

This response provides reality orientation, reassurance, and therapeutic communication. It acknowledges the client’s concern while reinforcing the purpose of hospitalization, which is treatment and safety.

Choice C:

Encouraging deep breathing addresses anxiety but does not respond to the client’s delusional thought. It avoids the core issue and may make the client feel dismissed.

Choice D:

Asking “why” questions can feel confrontational and may heighten paranoia or mistrust. It does not provide therapeutic reassurance.

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Question 10:

A. "You feel that you don't belong here?" B. "We are here to help you and give you the care that you need right now." C. "Try to take some deep breaths and I'm sure you'll feel better." D. "Why do you feel that you need to leave?"

Answer and Explanation

Choice A:

This response uses therapeutic communication by reflecting the client’s feelings, which encourages further expression and demonstrates empathy without judgment. It acknowledges the client’s concern while maintaining professional boundaries.

Choice B:

This response, although supportive, does not focus on the client’s expressed feelings. It dismisses the concern by shifting to the nurse’s perspective rather than validating the client’s emotions.

Choice C:

This is a dismissive and minimizing response. Suggesting deep breathing without addressing the underlying delusion fails to use therapeutic communication techniques in mental health care.

Choice D:

This response is confrontational and places the client in a defensive position. It may escalate agitation and is not consistent with therapeutic communication principles.

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Ati Mental Health Exam

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