ATI MENTAL HEALTH PROCTORED FINAL EXAM 2022-2023 FINAL MENTAL HEALTH PROCTORED EXAM QUESTIONS AND DETAILED ANSWERS|ALREADY GRADED A+

ATI MENTAL HEALTH PROCTORED FINAL EXAM 2022-2023 FINAL

MENTAL HEALTH PROCTORED EXAM QUESTIONS AND

DETAILED ANSWERS|ALREADY GRADED A+

The nurse formulates a nursing diagnosis of Impaired verbal communication for a client

with schizotypal personality disorder. Based on this nursing diagnosis, which nursing

intervention is most appropriate?

A) Helping the client to participate in social interactions

B) Establishing a one-on-one relationship with the client

C) Establishing alternative forms of communication

D) Allowing the client to decide when he wants to participate in verbal communication

with the nurse

RATIONALE: By establishing a one-on-one relationship, the nurse helps the client learn how to

interact with people innew situations. The other options are appropriate but should take place only

after the nurse-client relationship is established.

Since admission 4 days ago, a client has refused to take a shower, stating, "There are

poison crystals hidden in the showerhead. They'll kill me if I take a shower." Which

nursing action is most appropriate?

A) Dismantling the showerhead and showing the client that there is nothing in it

B) Explaining that other clients are complaining about the client's body odor

C) Asking a security officer to assist in giving the client a shower

D) Accepting these fears and allowing the client to take a sponge bath

RATIONALE: By acknowledging the client's fears, the nurse can arrange to meet the client's

hygiene needs inanother way. Because these fears are real to the client, providing a

demonstration of reality (as in option A) wouldn't be effective at this time. Options B and C would

violate the client's rights byshaming or embarrassing the client.

Drug therapy with thioridazine (Mellaril) shouldn't exceed a daily dose of 800 mg to prevent which

adverse reaction?

A) Hypertension

B) Respiratory arrest

C) Tourette Syndrome

D) Retinal pigmentation

RATIONALE: Retinal pigmentation may occur if the thioridazine dosage exceeds 800 mg per day. The

other optionsdon't occur as a result of exceeding this dose.

A client with paranoid personality disorder is admitted to a psychiatric facility. Which

remark by the nurse would best establish rapport and encourage the client to confide in

the nurse?

A) "I get upset once in a while, too."

B) "I know just how you feel. I'd feel the same way in your situation."

C) "I worry, too, when I think people are talking about me."

D) "At times, it's normal not to trust anyone."

RATIONALE: Sharing a benign, nonthreatening, personal fact or feeling helps the nurse

establish rapport and encourages the client to confide in the nurse. The nurse can't know how

the client feels. Telling the client otherwise, as in option B, would justify the suspicions of a

paranoid client; furthermore,the client relies on the nurse to interpret reality. Option C is

incorrect because it focuses on the nurse's feelings, not the client's. Option D wouldn't help

establish rapport or encourage the clientto confide in the nurse.

How soon after chlorpromazine (Thorazine) administration should the nurse expect to see a client's

delusional thoughts and hallucinations eliminated?

A) Several minutes

B) Several hours

C) Several days

D) Several weeks

RATIONALE: Although most phenothiazines produce some effects within minutesto hours, their

antipsychotic effectsmay take several weeks to appear.

A client is about to be discharged with a prescription for the antipsychotic agent

haloperidol (Haldol), 10 mg by mouth twice per day. During a discharge teaching session,

the nurse should provide which instruction to the client?

A) Take the medication 1 hour before a meal.

B) Decrease the dosage if signs of illness decrease

C)Apply a sunscreen before being exposed to the sun.

D) Increase the dosage up to 50 mg twice per day if signs of illness don't decrease.

RATIONALE: Because haloperidol can cause photosensitivity and precipitate severe sunburn,

the nurse should instruct the client to apply a sunscreen before exposure to the sun. The nurse

also should teach the client to take haloperidol with meals — not 1 hour before — and should

instructthe client not to decrease or increase the dosage unless the physician orders it.

A client with paranoid schizophrenia repeatedly uses profanity during an activity therapy

session. Which response by the nurse would be most appropriate?

A) "Your behavior won't be tolerated. Go to your room immediately."

B) "You're just doing this to get back at me for making you come to therapy."

C) "Your cursing is interrupting the activity. Take time out in your room for 10 minutes."

D) "I'm disappointed in you. You can't control yourself even for a few minutes."

RATIONALE: The nurse should set limits on client behavior to ensure a comfortable

environment for all clients. The nurse should accept hostile or quarrelsome client outbursts

within limits without becoming personally offended, as in option A. Option B is incorrect because

it implies that theclient's actions reflect feelings toward the staff instead of the client's own

misery. Judgmental remarks, such as option D, may decrease the client's self-esteem.

Which of the following is one of the advantages of the newer antipsychotic medication risperidone

(Risperdal)?

A) The absence of anticholinergic effects

B) A lower incidence of extrapyramidal effects

C) Photosensitivity and sedation

D) No incidence of neuroleptic malignantsyndrome

RATIONALE: Risperdal has a lower incidence of extrapyramidal effects than the typical

antipsychotics. Risperdal does produce anticholinergic effects and neuroleptic malignant syndrome can

occur. Photosensitivity isn't an advantage.

The etiology ofschizophrenia is best described by:

A) genetics due to a faulty dopamine receptor.

B) environmental factors and poor parenting.

C) structural and neurobiological factors.

D) a combination of biological, psychological, and environmental factors.

RATIONALE: A reliable genetic marker hasn't been determined for schizophrenia. However,

studies of twinsand adopted siblings have strongly implicated a genetic predisposition. Since

the mid-19th century, excessive dopamine activity in the brain has also been suggested as a

causal factor.Communication and the family system have been studied as contributing factors

in the development of schizophrenia. Therefore, a combination of biological, psychological,

and environmental factors are thought to cause schizophrenia.

A client with schizophrenia who receives fluphenazine (Prolixin) develops pseudoparkinsonism and

akinesia. What drug would the nurse administer to minimize extrapyramidal symptoms?

A) benztropine (Cogentin)

B) dantrolene (Dantrium)

C) clonazepam (Klonopin)

D) diazepam (Valium)

RATIONALE: Benztropine is an anticholinergic drug administered to reduce extrapyramidal

adverse effects in the client taking antipsychotic drugs. It works by restoring the equilibrium

between the neurotransmitters acetylcholine and dopamine in the central nervous system

(CNS). Dantrolene,a hydantoin drug that reduces the catabolic processes, is administered to

alleviate the symptoms of neuroleptic malignant syndrome, a potentially fatal adverse effect of

antipsychotic drugs. Clonazepam, a benzodiazepine drug that depresses the CNS, is

administered to control seizure activity. Diazepam, a benzodiazepine drug, is administered to

reduce anxiety.

A client with a diagnosis of paranoid schizophrenia comments to the nurse, "How do I

know what is really in those pills?" Which of the following is the best response?

A) Say, "You know it's your medicine."

B) Allow him to open the individual wrappers of the medication.

C) Say, "Don't worry about what is in the pills. It's what is ordered."

D) Ignore the comment because it's probably a joke.

RATIONALE: Option B is correct because allowing a paranoid client to open his medication

can help reducesuspiciousness. Option A is incorrect because the client doesn't know that it's

his medication and he's obviously suspicious. Telling the client not to worry or ignoring the

comment isn't supportive and doesn't offer reassurance.