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ATI Mental Health Proctored Exam 2019
1. In an emergency mental health facility, a nurse is caring for a group of clients. The nurse should identify that which of the following clients requires a temporary emergency admission?
- A. A client with schizophrenia who has delusions of grandeur
- B. A client with manifestations of depression who attempted suicide a year ago
- C. A client with borderline personality disorder who assaulted a homeless man with a metal rod
- D. A client with bipolar disorder who paces quickly around the room while talking to themselves
Correct answer: C
Rationale: The correct answer is C. A client with borderline personality disorder who has committed an assault poses a risk to others and themselves, necessitating temporary emergency admission for safety and further assessment. Choices A, B, and D do not indicate an immediate risk to self or others that would require temporary emergency admission.
2. Which therapeutic communication technique involves restating the patient's message to ensure understanding?
- A. Clarification
- B. Reflection
- C. Summarization
- D. Paraphrasing
Correct answer: D
Rationale: Paraphrasing is the correct therapeutic communication technique where the nurse restates the patient's message in their own words to confirm understanding. This technique helps in validating the patient's feelings and ensuring that both parties are in agreement, leading to effective communication and rapport building. Choice A, 'Clarification,' involves seeking further information to enhance understanding rather than restating the message. Choice B, 'Reflection,' involves echoing the patient's feelings to show empathy rather than restating the message. Choice C, 'Summarization,' involves condensing the main points of a conversation rather than restating a specific message.
3. A patient with obsessive-compulsive disorder (OCD) frequently washes their hands. Which nursing intervention is most appropriate?
- A. Allow the patient to wash their hands, then gradually limit the time spent on this behavior.
- B. Discourage the patient from discussing their obsessions.
- C. Encourage the patient to suppress their compulsive behaviors.
- D. Avoid setting limits on the patient's compulsive behaviors.
Correct answer: A
Rationale: In managing a patient with OCD who frequently washes their hands, it is important to understand that compulsive behaviors provide temporary relief from anxiety. Allowing the patient to engage in their rituals initially and then gradually setting limits on the time spent can help them gain control over their compulsions. This approach supports the patient without causing undue distress, ultimately assisting in managing OCD symptoms effectively. Choice B is incorrect as discouraging the patient from discussing their obsessions can hinder therapeutic communication and understanding of their condition. Choice C is wrong because encouraging the patient to suppress their compulsive behaviors may increase their anxiety and lead to worsening symptoms. Choice D is also incorrect as avoiding setting limits on the patient's compulsive behaviors does not help the patient in gaining control over their OCD symptoms.
4. Which assessment question will provide information regarding the effects of a woman’s circadian rhythms on her quality of life?
- A. How much sleep do you usually get each night?
- B. Does your heart ever seem to skip a beat?
- C. When was the last time you had a fever?
- D. Do you have problems urinating?
Correct answer: A
Rationale: The correct answer is A: 'How much sleep do you usually get each night?' Asking about sleep patterns is essential to understand the impact of circadian rhythms on an individual's quality of life. Adequate sleep is closely linked to circadian rhythms, and disturbances in sleep patterns can significantly affect a person's well-being and daily functioning. Choices B, C, and D are not directly related to circadian rhythms and would not provide information specifically about how circadian rhythms affect quality of life.
5. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, ‘I don’t need to come see you anymore. I have found a therapy app on my phone that I love.’ How should Carolina respond to this news?
- A. That sounds exciting; would you be willing to visit and show me the app?
- B. At this time, there is no real evidence that the app can replace our therapy.
- C. I am not sure that is a good idea right now; we are so close to progress.
- D. Why would you think that is a better option than meeting with me?
Correct answer: A
Rationale: Carolina should respond with openness and curiosity to maintain a positive therapeutic relationship. By showing interest in the patient's new therapy method and inviting them to share the app, Carolina demonstrates a willingness to explore alternative approaches while also ensuring the patient feels heard and valued in their decision-making process. Choice B is incorrect because it dismisses the patient's choice without exploring it further. Choice C focuses more on Carolina's concerns rather than engaging with the patient's decision. Choice D comes off as defensive and may make the patient feel misunderstood or judged.
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