ATI RN MENTAL HEALTH A 2021 PROCTORED A

GUIDE

1. A nurse in an alcohol treatment facility is caring for a client who states, “My job is so stressful that

the only way I can cope is to drink.” The nurse should recognize that the client is displaying which of

the following defense mechanisms?

A. Introjection (Unconscious adoption of the ideas or attitudes of others)

B. Repression

C. Rationalization

D. Intellectualization

Repression

● Unconsciously putting unacceptable ideas, thoughts, and emotions out of awareness

● ADAPTIVE USE: A person preparing to give a speech unconsciously forgets about the time when

he was young and kids laughed at him while on stage.

● MALADAPTIVE USE: A person who has a fear of the dentist

Rationalization

● Creating reasonable and acceptable explanations for unacceptable behavior

● ADAPTIVE USE: An adolescent boy says, “she must already have a boyfriend” when rejected by a girl

● MALADAPTIVE USE: A young adult explains he had to drive home from a party after

drinking alcohol because he had to feed his dog

Intellectualization

● Separation of emotions and logical facts when analyzing or coping with a situation or event

● ADAPTIVE USE: A law enforcement officer blocks out the emotional aspect of a crime so he

can objectively focus on the investigation.

● MALADAPTIVE USE: A person who learns he has a terminal illness focuses on creating a will

and financial matters rather than acknowledging his grief.

2. A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for

 smoking cessation. Which of the following assessment findings in the client’s history should the nurse

report to the provider?

A. Knee arthroplasty 1 month ago

B. Hepatitis B infection

C. Recent head injury (Avoid administering to clients at risk for seizures, such as a client who has a head

injury)

D. Hypothyroidism

Bupropion = ATYPICAL ANTIDEPRESSANT, inhibits Dopamine uptake

○ Alternative to SSRIs for clients unable to tolerate sexual dysfunction side effects

○ Complications: Headache, dry mouth, GI distress, constipation, increased heart

rate, nausea, restlessness, insomnia

■ Suppression of appetite = weight loss, contraindicated for those who

have anorexia or bulimia

3. A nurse is assessing a client who has histrionic personality disorder. Which of the following

findings should the nurse expect?

A. Lack of remorse

B. Splitting of staff

C. Attention-seeking

D. Identity disturbance

Histrionic

● “ POK POK” - Characterized by emotional attention-seeking behavior, in which the person needs

to be the center of attention; often seductive and flirtatious.

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ATI RN MENTAL HEALTH A 2021 PROCTORED A

GUIDE

4. A nurse is providing teaching to the daughter of an older client who has obsessive-compulsive disorder.

Which of the following statements by the daughter indicates an understanding of the teaching?

A. “I will provide my mother with detailed instructions about how to perform self-care.” (Give

simple directions)

B. “I will limit my mother’s clothing choices when she is getting dressed.” (If client is indecisive,

limit the client's choices; if client still unable to make a decision, give client one outfit to wear)

C. “I will wake my mother up a couple of times in the night to check on her.”

D. “I will discourage my mother from talking about her physical complaints.”

OCD

● The client attempts to suppress persistent thoughts or urges that cause anxiety

through compulsive or obsessive behaviors, such as repetitive hand washing.

● Obsessions or compulsions are time-consuming and result in impaired social and

occupational functioning.

6. A nurse is providing crisis intervention for a client who was involved in a violent mass casualty

situation in the community. Which of the following actions should the nurse take during the initial session

with the client?

A. Identify the client’s usual coping style.

B. Encourage the client to display anger toward the cause of the crisis. (Reduce stressrelated manifestations, such as using techniques to alleviate a panic attack)

C. Tell the client that this life will soon return to normal (False assurance)

D. Help the client focus on a wide variety of topics regarding the crisis. (Reduce stress)

18. A charge nurse is orienting a newly licensed nurse and observes the newly licensed nurse imitating her

behaviors. The nurse should recognize this behavior as which of the following defense mechanisms?

A. Suppression (Voluntarily denying unpleasant thoughts and feelings)

B. Identification (Conscious or unconscious assumption of the characteristics of another individual

or group)

C. Compensation (Emphasizing strengths to make up for weaknesses)

D. Reaction formation (Overcompensating or demonstrating the opposite behavior of what is felt)

21. A nurse in an inpatient mental health facility is assessing a client who has schizophrenia and is taking

haloperidol. Which of the following clinical findings is the nurse’s priority?

A. Insomnia (Sedation)

B. Urinary frequency (Complication → ANTIcholinergic effects)

C. High fever (Complication → agranulocytosis)

D. Headache

Other complications: Acute dystonia, Pseudoparkinsonism, Akathisia, Tardive dyskinesia, Neuroendocrine

effects (Gynecomastia, Weight gain, Menstrual irregularities), NMS, Orthostatic Hypotension, Sedation, Sexual

dysfunction, Skin effects, Liver impairment

27. A nurse in a mental health facility is caring for a client. Which of the following actions should the

nurse take during the working phase of the nurse-client relationship?

A. Summarize goals and objectives.

B. Address confidentiality.

C. Promote problem-solving skills.

D. Establish a participation contract

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ATI RN MENTAL HEALTH A 2021 PROCTORED A

GUIDE

30. A nurse is providing behavioral therapy for a client who has OCD. The client repeatedly checks that the

doors are locked at night. Which of the following instructions should the nurse give the client when using

thought stopping technique?

A. “Keep a journal of how often you check the locks each night.”

B. “Ask a family member to check the locks for you at night.”

C. “Focus on abdominal breathing whenever you go to check the locks.”

D. “Snap a rubber band on your wrist when you think about checking the locks.”

Thought stopping: teach pt to say “stop” when negative thoughts/compulsive behaviors arise & substitute

positive thought - goal for pt use command silently over time

33. A nurse is assisting with obtaining informed consent for a client who has been legally incompetent.

Which of the following actions should the nurse take?

A. Explain implied consent to the client’s family.

B. Contact the facility social work to obtain the consent.

C. Request that the client’s guardian sign the consent

D. Ask the charge nurse to obtain informed consent.

Client who has been judged incompetent has a temporary or permanent guardian appointed by the court. The

guardian can sign the informed consent for the client.

46. A nurse is reviewing the laboratory report of a client who is taking carbamazepine for bipolar disorder.

Which of the following laboratory results should the nurse report to the provider?

A. Urine specific gravity 1.029

B. Platelets 90,000/mm

C. Urine pH 5.6

D. RBC 4.7/mm

Complications: CNS effects, Blood Dyscrasias, Teratogenesis, Hyperosmolality (ANTI-diuretic), Skin

Disorders

49. A nurse in a mental health facility is making plans for client’s discharge. Which of the following

interdisciplinary team members should the nurse contact to assist the client with housing placement?

A. Social worker

B. Occupational therapist

C. Clinical nurse specialist

D. Recreational therapist

50. A nurse is caring for a client who reports that he is angry with his partner because she thinks he is

trying to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to

leave. Which of the following defense mechanisms is the client demonstrating? (ATI p.21)

A. Rationalization

B. Compensation

C. Denial

D. Displacement

Displacement - shifting feelings r/t to an object, person or situation to another less threatening object,

person, or situation

59. A nurse is creating a plan of care for a client who has major depressive disorder. Which of the

following interventions should the nurse include in the plan?

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