Week 1: ati hw & ati book ch 1, 2, & 6

Question 1

most common type of unintentional tort

Answer 1

Negligence

Question 2

to involuntarily admit a patient..

Answer 2

2 providers must assess client & confirm need

Question 3

3 complications from inadequate monitoring of restraints

Answer 3

1. positional asphyxia
2. food aspiration
3. cardiac arrest

Question 4

Affordable Care Act of 2010

Answer 4

mandates mental health parity

Question 5

incivility

Answer 5

act/behavior that shows lack of respect and lack of courtesy

*jokes at expense of others — repeated=bullying

Question 6

4 interventions for situations (least-most restrictive)

Answer 6

1. de-escalation
2. timeout
3. seclusion
4. restraint

Question 7

competency vs capacity

Answer 7

competency: capacity of a client DEEMED BY A JUDGE during a hearing

capacity: client’s ability to understand info.

Question 8

Milieu therapy

Answer 8

psychotherapuetic based treatment focused on modifying or controlling the immediate ENVIRONMENT to make safe and conducive to healing.

Question 9

nursing process

Answer 9

1. assessment
2. analysis
3. planning
4. implementation
5. evaluation

Question 10

B.I. R. P. is used for

Answer 10

a format for progress notes

B = behavior
I = intervention
R = response
P = pain

Question 11

a charge nurse is discussing mental status examinations with a newly licensed nurse. Which of the following statements indicates an understanding of the teaching? (sap)

a) “to assess cognitive ability , I should ask the client to count backward by 7.”

b) “to assess affect, I should observe the client’s facial expression.”

c) “to assess language ability, I should instruct the client to write a sentence

d) “to assess remote memory, I should have the client repeat a list of objects.”

e) “to assess the client’s abstract thinking, I should ask the client to identify our most recent presidents.”

Answer 11

a) “to assess cognitive ability , I should ask the client to count backward by 7.”

b) “to assess affect, I should observe the client’s facial expression.”

c) “to assess language ability, I should instruct the client to write a sentence

Question 12

a nurse is planning care for a client who has a mental health disorder. which of the following actions should the nurse include as a psychobiological intervention?

1) assist the client with systematic desensitization therapy.

2) teach the client appropriate coping mechanisms

3) assess the client for comorbid health conditions

4) monitor the client for adverse effects of medications

Answer 12

4) monitor the client for adverse effects of medications

Question 13

a nurse in an outpatient mental health clinic is preparing to conduct an initial client interview. when conducting the interview, which of the following actions should the nurse identify as the priority?

1) coordinate holistic care with social services

2) identify the client’s perception of their mental health status

3) Include the client’s family in the interview

4) teach the client about their current mental health disorder

Answer 13

2) identify the client’s perception of their mental health status

Question 14

a nurse is planning a peer group discussion about the DSM-5. Which of the following info. is appropriate to include in the discussion? sap

1) the DSM-5 includes client education handouts for mental health disorders

2) the DSM-5 establishes diagnostic criteria for individual mental health disorders

3) the DSM-5 indicates recommended pharmacological treatment for mental health disorders

4) the DSM-5 assists nurse’s in planning care for clients who have mental health disorders

5) the DSM-5 indicates expected assessment findings of mental health disorders

Answer 14

2) the DSM-5 establishes diagnostic criteria for individual mental health disorders

3) the DSM-5 indicates recommended pharmacological treatment for mental health disorders

5) the DSM-5 indicates expected assessment findings of mental health disorders

Question 15

standardized assessment tool the nurse should use to assess the older adult’s severity of depression

Answer 15

geriatric depression scale

Question 16

the nurse should identify that which of the following clients requires a temporary emergency admission?

1) a client who has schizophrenia with delusions of grandeur

2) a client who has manifestations of depression and attempted suicide a year ago

3) a client who has borderline personality disorder and assaulted a homeless man with a metal rod

4) a client who has bipolar disorder and paces quickly around the room while talking to themself.

Answer 16

3) a client who has borderline personality disorder and assaulted a homeless man with a metal rod

Question 17

a client tells a nurse, “don’t tell anyone but i hid a sharp knife under my mattress in order to protect myself from my roommate, who is always threatening me.” which of the following actions should the nurse take?

1) keep the client’s communication confidential, but talk to the client daily using therapeutic communication to convince them to admit to hiding the knife.

2) keep the client’s communication confidential, but watch the client and their roommate closely

3) tell the client that this must be reported to the healthcare team because it concerns the health and safety of the client and others

4) report the incident to the healthcare team, but do not inform the client of the intention to do so.

Answer 17

3) tell the client that this must be reported to the healthcare team because it concerns the health and safety of the client and others

Question 18

a nurse is caring for a client who is in mechanical restraints. which of the following statements should the nurse include in the documentation? sap

1) client ate most of their breakfast

2) client was offered 8oz of water every hr

3) client shouted obscenities at assistive personnel

4) client received chlorpromazine 15mg by mouth at 1000

5) client acted out after lunch

Answer 18

2) client was offered 8oz of water every hr

3) client shouted obscenities at assistive personnel

4) client received chlorpromazine 15mg by mouth at 1000

Question 19

a nurse hears a newly liscensed nurse discussing a client’s hallucinations in the hallway with another nurse. which of the following actions should the nurse take first?

1) notify the nurse manager

2) tell the nurse to stop discussing the behavior

3) provide an in-service program about confidentiality

4) complete an incident report

Answer 19

2) tell the nurse to stop discussing the behavior

Question 20

with restraints..a nurse must check on patient every ___ hours according to age

Answer 20

every 4hrs (ages 18+)
every 2 hrs (ages 9 to 17)
every hours (8 and below)

Question 21

nurse must get written prescription for emergency restraints within? (ati)

Answer 21

15 to 30 minutes

Question 22

a nurse is planning care for several clients who are attending community based mental health programs. which of the following client’s should the nurse visit first?

1) a client who received a burn on the arm while using a hot iron at home

2) a client who requests a change of antipsychotic medication due to some new adverse effects

3) a client who reports a voice saying that life is not worth living anymore

4) a client who tells a nurse about experiencing manifestations of severe anxiety before and during a job interview

Answer 22

3) a client who reports a voice saying that life is not worth living anymore

Question 23

a nurse is working in a community mental health facility. which of the following services does this type of program provide? sap

1) educational groups
2) medication dispensing programs
3) individual counseling programs
4) detoxification programs
5) family therapy

Answer 23

1) educational groups

3) individual counseling programs

5) family therapy

Question 24

a nurse in an acute mental health facility is assisting with discharge planning for a client who has a sever mental illness and requires supervision. the client’s partner works all day but is home by late afternoon. Which of the following strategies should the nurse suggest for follow up care?

1) receiving daily care from a home health aide
2) having a weekly visit from a nurse case worker
3) attending a partial hospitalization program
4) visiting a community mental health center on a daily basis

Answer 24

3) attending a partial hospitalization program

Question 25

which of the following clients should a nurse consider for a referral to an assertive community treatment (act) group?

1) a client in an acute care mental health facility who has fallen several times while running down the hallway

2) a client who lives at home and keeps “forgetting” to come in for a scheduled monthly antipsychotic injection for schizophrenia

3) a client in a day treatment program who reports increasing anxiety during group therapy.

4) a client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months

Answer 25

2) a client who lives at home and keeps “forgetting” to come in for a scheduled monthly antipsychotic injection for schizophrenia

Question 26

5 A’s when applying evidence-based practice

Answer 26

1. Ask
2. Acquire
3. Appraise
4. Apply
5. Assess

Question 27

4 elements in the art of nursing

Answer 27

1. therapuetic use of self
   2.caring
2. attending
3. advocating

Question 28

1. In which scenario is it most urgent for the nurse to act as a patient advocate?

a. An adult cries and experiences anxiety after a near-miss automobile accident on the way to work.

b. A homeless adult diagnosed with schizophrenia lives in a community expecting a category 5 hurricane.

c. A 14-year-old girl’s grades decline because she consistently focuses on her appearance and social networking.

d. The parents allow the prescription to lapse for 1 day for their 8-year-old child’s medication for attention-deficit/hyperactivity disorder.

Answer 28

b. A homeless adult diagnosed with schizophrenia lives in a community expecting a category 5 hurricane.

Question 29

The nurse interacts with a veteran of World War II. The veteran says, “Veterans of modern wars whine and complain all the time. Back when I was in service, you kept your feelings to yourself.” Select the nurse’s best response.

a. “American society in the 1940s expected World War II soldiers to be strong.”

b. “World War II was fought in a traditional way, but the enemy is more difficult to identify in today’s wars.”

c. “We now have a better understanding of how trauma affects people and the importance of research-based, compassionate care.”

d. “Intermittent explosive devices (IEDs), which were not in use during World War II, produce traumatic brain injuries that must be treated.”

Answer 29

c. “We now have a better understanding of how trauma affects people and the importance of research-based, compassionate care.”

Question 30

A patient reports sleeplessness, fatigue, and sadness to the primary care provider. In our current health care climate, what is the most likely treatment approach that will be offered to the patient?

a. Group therapy

b. Individual psychotherapy

c. Complementary therapy

d. Psychopharmacological treatment

Answer 30

d. Psychopharmacological treatment

Question 31

The nurse prepares outcomes to the plan of care for an adult diagnosed with mental illness. Which strategy recognizes the current focus of treatment services for this population?

a. The patient’s diagnoses are confirmed using advanced neuroimaging techniques.

b. The nurse confers with the treatment team to verify the patient’s most significant disability.

c. The nurse prioritizes the patient’s problems in accordance with Maslow’s hierarchy of needs.

d. The patient and family participate actively in establishing priorities and selecting interventions.

Answer 31

d. The patient and family participate actively in establishing priorities and selecting interventions.

Question 32

Which scenario best demonstrates empathic caring?

a. A nurse provides comfort to a colleague after an error of medication administration.

b. A nurse works a fourth extra shift in 1 week to maintain adequate unit staffing.

c. A nurse identifies a violation of confidentiality and makes a report to an agency’s privacy officer.

d. A nurse conscientiously reads current literature to stay aware of new evidence-based practices.

Answer 32

a. A nurse provides comfort to a colleague after an error of medication administration.

Question 33

resiliency

Answer 33

ability to recover from or adjust successfully to trauma or change

Question 34

prevalence rate for mental illness

Answer 34

1 in 5 adults **proportion of population with a mental disorder at any given time

Question 35

A mentally ill gunman opens fire in a crowded movie theater, killing six people and injuring others. Which comment about this event by a member of the community most clearly shows the stigma of mental illness?

a. “Gun control laws are inadequate in our country.”

b. “It’s frightening to feel that it is not safe to go to a movie theater.”

c. “All these people with mental illness are violent and should be locked up.”

d. “These events happen because American families no longer go to church together.”

Answer 35

c. “All these people with mental illness are violent and should be locked up.”

Question 36

The nurse presents a class about mental health and mental illness to a group of fourth graders. One student asks, “Why do people get mentally ill?” Select the nurse’s best response.

a. “There are many reasons why mental illness occurs.”

b. “The cause of mental illness is complicated and very hard to understand.”

c. “Sometimes a person’s brain does not work correctly because something bad happens or he or she inherits a brain problem.”

d. “Most mental illnesses result from genetically transmitted abnormalities in cerebral structure; however, some are a consequence of traumatic life experiences.”

Answer 36

c. “Sometimes a person’s brain does not work correctly because something bad happens or he or she inherits a brain problem.”

Question 37

An adult experienced a spinal cord injury resulting in quadriplegia 3 years ago and now lives permanently in a skilled care facility. Which comment by this person best demonstrates resiliency?

a. “I often pray for a miracle that will heal my paralysis so I will be whole again.”

b. “I don’t know what I did to deserve this fate or whether I am tough enough to endure it.”

c. “My accident was a twist of fate. I suppose there are worse things than being paralyzed.”

d. “Being paralyzed has taken things from me, but it hasn’t kept me from being mentally involved in life.”

Answer 37

d. “Being paralyzed has taken things from me, but it hasn’t kept me from being mentally involved in life.”

Question 38

A nursing assistant says to the nurse, “The schizophrenic in room 226 has been rambling all day.” When considering the nurse’s responsibility to manage the ancillary staff, which response should the nurse provide?

a. “It is more respectful to refer to the patient by name than by diagnosis.”

b. “Thank you for informing me about that. I will document the behavior.”

c. “It is not unusual for schizophrenics to do that. It’s just part of their illness.”

d. “You have a difficult job. I’m glad you are so accepting of our patients’ behaviors.”

Answer 38

a. “It is more respectful to refer to the patient by name than by diagnosis.”

Question 39

Which scenario meets the criteria for “normal” behavior?

a. An 8-year-old child’s only verbalization is “No, no, no.”

b. A 16-year-old girl usually sleeps for 3 or 4 hours per night.

c. A 43-year-old man cries privately for 1 month after the death of his wife.

d. A 64-year-old woman has difficulty remembering the names of her grandchildren.

Answer 39

c. A 43-year-old man cries privately for 1 month after the death of his wife.

Question 40

A patient diagnosed with major depressive disorder tells the community mental health nurse, “I usually spend all day watching television. If there’s nothing good to watch, I just sleep or think about my problems.” What is the nurse’s best action?

a. Refer the patient for counseling with a recreational therapist.

b. Ask the patient, “What kinds of program do you like to watch?”

c. Suggest to the patient, “Are there some friends you could call instead?”

d. Advise the patient, “Watching television and thinking about problems makes depression worse.”

Answer 40

a. Refer the patient for counseling with a recreational therapist.

Question 41

The nurse admits a patient experiencing hallucinations and delusional thinking to an inpatient mental health unit. The plan of care will require that which service occurs first?

a. Social history

b. Psychiatric history

c. Medical assessment

d. Psychological evaluation

Answer 41

c. Medical assessment

Question 42

A nurse working in an acute care unit for adolescents diagnosed with mental illness says, “Our patients have so much energy. We need some physical activities for them.” In recognition of needs for safety and exercise, which activity could the treatment team approve?

a. Badminton tournament

b. Competitive soccer matches

c. Intramural basketball games

d. Line dancing to popular music

Answer 42

d. Line dancing to popular music

Question 43

As Election Day nears, a psychiatric nurse studies the position statements of various candidates for federal offices. Which candidate’s commentary would the nurse interpret as supportive of services for persons diagnosed with mental illness?

a. Full-parity insurance coverage for mental illness

b. Coverage for biologically based mental illnesses

c. Reimbursement for initial treatment of addictions

d. Managed care oversight for mental illness services

Answer 43

a. Full-parity insurance coverage for mental illness

Question 44

An experienced nurse in a major medical center requests a transfer from a general medical unit to an acute care psychiatric unit. Which organizational feature would best support this nurse’s successful transition?

a. Assignment to medication administration for the first 6 months

b. Working with a seasoned mental health technician for the first month

c. Co-assignment with a knowledgeable psychiatric nurse for an extended orientation

d. Staff development activities focused on developing therapeutic communication skills

Answer 44

c. Co-assignment with a knowledgeable psychiatric nurse for an extended orientation

Question 45

A nurse’s sibling happily says, “I want to introduce you to my fiancé. We’re getting married in 6 months.” The nurse has encountered the fiancé in a clinical setting and is aware of the fiancé’s diagnosis of schizophrenia. What is the nurse’s best response?

a. In private, tell the sibling about the fiancé’s diagnosis.

b. Encourage the sibling to postpone the wedding for at least a year.

c. Ask the fiancé, “Have you told my sibling about your mental illness?”

d. Say to the sibling and fiancé, “I hope you will be very happy together.”

Answer 45

d. Say to the sibling and fiancé, “I hope you will be very happy together.”

Question 46

A patient has been disruptive to the therapeutic milieu for 2 days. A certified nursing assistant says to the nurse, “We need to seclude this patient because this behavior is upsetting everyone on the unit.” Considering patients’ rights, how should the nurse respond?

a. “Seclusion is not part of this patient’s plan of care.”

b. “Let’s think of some new ways to help this patient be less disruptive.”

c. “Thank you for that suggestion. I will discuss it with the health care provider.”

d. “Disruptive behavior is expected with mental illness. We must respond therapeutically.”

Answer 46

b. “Let’s think of some new ways to help this patient be less disruptive.”

Question 47

A day-shift nurse contacts a nurse scheduled for the night shift at home and says, “Our unit is full, and there are eight patients in the emergency department waiting for a bed.” The night-shift nurse replies, “Thanks for telling me. I am calling in sick.” Which type of problem is evident by the night-shift nurse’s reply?

a. Ethical problem of fidelity

b. Legal problem of negligence

c. Legal problem of an intentional tort

d. Violation of the patients’ right to treatment

Answer 47

a. Ethical problem of fidelity

Question 48

In a staff meeting at an inpatient mental health facility for individuals, the administrator announces that psychiatric technicians will now be supervised by the milieu director rather than by nurses. What is the nurse’s best action?

a. Confer with colleagues about their opinions regarding the proposed change.

b. Volunteer to participate on a committee charged with defining the job responsibilities of unlicensed assistive personnel.

c. Ask the administrator to delay implementation of this change until the decision can be reviewed by an interdisciplinary team.

d. Advise the administrator of regulations in the state nurse practice act regarding supervision of unlicensed assistive personnel.

Answer 48

d. Advise the administrator of regulations in the state nurse practice act regarding supervision of unlicensed assistive personnel.

Question 49

A colleague tells the nurse, “I have not been able to sleep for the past 3 days. I feel like a robot.” What is the nurse’s best action?

a. Direct the colleague to leave the facility immediately.

b. Observe the colleague closely for evidence of impaired practice.

c. Offer to administer medications to patients assigned to the colleague.

d. Confer with the supervisor about the nurse’s ability to safely deliver care.

Answer 49

d. Confer with the supervisor about the nurse’s ability to safely deliver care.

Question 50

writ of habeas corpus

Answer 50

a court order telling a public official to bring you to the court and show a legal reason for holding you

Question 51

Reize petition

Answer 51

capacity hearing – determines right to refuse medications

*psych medication only
**expires with hold

Question 52

5150
5250
5270

Answer 52

5150 = 72 hr hold
5250 = 14 day hold
5270 = 30 day hold