Download ATI Mental Health Proctored Exam 2026 Practice Questions & Rationales and more Exams Nursing in PDF only on Docsity!
ATI Mental Health Proctored Exam Practice Exam | Updated
2026 Complete Study Guide | Verified Questions with Detailed
Rationales on Therapeutic Communication & Nurse-Patient
Relationships, Psychiatric Disorders (Depression, Anxiety,
Schizophrenia, Bipolar Disorder, Personality Disorders), Crisis
Intervention & De-escalation Techniques,
Psychopharmacology (Antidepressants, Antipsychotics, Mood
Stabilizers, Anxiolytics), Substance Use & Withdrawal
Management, Patient Safety & Suicide Risk Assessment, Legal
& Ethical Issues, Behavioral Therapies, and Evidence-Based
Nursing Interventions for ATI Proctored Exam Success
Question 1: A client diagnosed with schizophrenia is experiencing auditory hallucinations and states, "The voices are telling me to hurt myself." What is the nurse's priority action? A. Administer a PRN antipsychotic medication B. Ask the client to describe the content of the voices C. Place the client on one-to-one suicide observation D. Document the client's report in the medical record CORRECT ANSWER: C. Place the client on one-to-one suicide observation RATIONALE: When a client reports command hallucinations to harm themselves, the nurse's priority is ensuring client safety. Placing the client on one-to-one observation prevents self-harm while further assessment and interventions occur. Administering medication, assessing content, and documenting are important but secondary to immediate safety. Question 2: Which statement by a client with major depressive disorder indicates the need for further teaching regarding sertraline? A. "I should take this medication in the morning to avoid insomnia." B. "It may take 2 to 4 weeks before I notice an improvement in my mood." C. "I can stop taking this medication once I feel better." D. "I should avoid drinking alcohol while taking this medication." CORRECT ANSWER: C. "I can stop taking this medication once I feel better." RATIONALE: Antidepressants like sertraline should never be abruptly discontinued, even when symptoms improve, due to risk of discontinuation syndrome and relapse. Clients must be taught to taper medications only under provider supervision. The other statements reflect accurate understanding of sertraline therapy. Question 3: A nurse is caring for a client experiencing a panic attack. Which intervention should the nurse implement first? A. Teach deep breathing exercises B. Administer a prescribed benzodiazepine
C. Stay with the client and speak in a calm, reassuring tone D. Encourage the client to identify triggers for the attack CORRECT ANSWER: C. Stay with the client and speak in a calm, reassuring tone RATIONALE: During a panic attack, the client experiences intense fear and loss of control. The nurse's priority is to provide a calming presence and reduce environmental stimuli. Staying with the client promotes safety and decreases anxiety. Teaching, medication administration, and trigger identification occur after the acute episode subsides. Question 4: A client with bipolar disorder is prescribed lithium carbonate. Which laboratory value requires immediate notification of the provider? A. Sodium 138 mEq/L B. Potassium 4.2 mEq/L C. Lithium level 1.8 mEq/L D. Creatinine 0.9 mg/dL CORRECT ANSWER: C. Lithium level 1.8 mEq/L RATIONALE: The therapeutic range for lithium is 0.6 to 1.2 mEq/L for maintenance and up to 1.5 mEq/L for acute mania. A level of 1.8 mEq/L indicates toxicity, which can cause tremors, confusion, ataxia, and seizures. Immediate intervention is required. The other values are within normal limits. Question 5: Which defense mechanism is demonstrated by a client who, after being denied a requested privilege, states, "I didn't want to go anyway; that activity is boring"? A. Projection B. Rationalization C. Reaction formation D. Sublimation CORRECT ANSWER: B. Rationalization RATIONALE: Rationalization involves creating logical explanations to justify unacceptable feelings or behaviors. The client minimizes disappointment by devaluing the privilege. Projection attributes one's feelings to others; reaction formation behaves opposite to true feelings; sublimation channels unacceptable impulses into socially acceptable activities. Question 6: A nurse is developing a care plan for a client with post-traumatic stress disorder (PTSD). Which intervention is most appropriate to include? A. Encourage the client to avoid discussing the traumatic event B. Teach grounding techniques to manage flashbacks C. Recommend the client sleep in a different room each night D. Limit the client's participation in group therapy sessions
RATIONALE: For a suicidal client, creating a safe environment by removing potential means of self-harm is the priority. This includes sharp objects, belts, cords, and glass items. Privacy, while sometimes therapeutic, increases risk in actively suicidal clients. Environmental safety supersedes comfort measures. Question 10: Which statement by a client with anorexia nervosa indicates readiness for discharge? A. "I will try to eat more when I go home." B. "I understand that my weight must stay above 90% of ideal body weight." C. "My family says I look much better now." D. "I promise I won't exercise anymore." CORRECT ANSWER: B. "I understand that my weight must stay above 90% of ideal body weight." RATIONALE: This statement demonstrates cognitive understanding of a specific, measurable discharge criterion for anorexia nervosa. Vague promises, reliance on others' perceptions, or absolute statements like "won't exercise anymore" indicate incomplete insight. Recovery requires realistic, sustained behavioral changes. Question 11: A client with alcohol use disorder is experiencing withdrawal. Which medication should the nurse anticipate administering first? A. Disulfiram B. Naltrexone C. Chlordiazepoxide D. Acamprosate CORRECT ANSWER: C. Chlordiazepoxide RATIONALE: Benzodiazepines like chlordiazepoxide are first-line for alcohol withdrawal to prevent seizures and delirium tremens by reducing CNS hyperexcitability. Disulfiram, naltrexone, and acamprosate are used for relapse prevention in recovery, not acute withdrawal management. Question 12: A nurse is using therapeutic communication with a client who states, "I feel like everyone is against me." Which response is most therapeutic? A. "That's not true; your family loves you very much." B. "Can you give me an example of when you felt this way?" C. "You should focus on the people who support you." D. "I'm sure you're misunderstanding their intentions." CORRECT ANSWER: B. "Can you give me an example of when you felt this way?" RATIONALE: This response uses clarification and open-ended questioning to explore the client's perception without judgment. It encourages expression of feelings and gathers assessment data. The other options provide false reassurance, give advice, or minimize the client's experience, which blocks therapeutic communication.
Question 13: Which behavior indicates a client with obsessive-compulsive disorder is benefiting from exposure and response prevention therapy? A. The client performs rituals only in private B. The client reports decreased anxiety when resisting a compulsion C. The client asks family members to assist with rituals D. The client avoids situations that trigger obsessions CORRECT ANSWER: B. The client reports decreased anxiety when resisting a compulsion RATIONALE: Exposure and response prevention works by helping clients tolerate anxiety without performing compulsions, leading to habituation. Reporting decreased anxiety when resisting indicates therapeutic progress. Performing rituals privately, involving others, or avoiding triggers maintains the OCD cycle. Question 14: A client with schizophrenia is experiencing extrapyramidal symptoms from haloperidol. Which medication should the nurse anticipate administering? A. Lorazepam B. Benztropine C. Fluoxetine D. Lithium CORRECT ANSWER: B. Benztropine RATIONALE: Benztropine is an anticholinergic medication used to treat extrapyramidal symptoms (EPS) such as dystonia, akathisia, and parkinsonism caused by typical antipsychotics. Lorazepam may help akathisia but is not first-line for EPS. Fluoxetine and lithium treat mood disorders, not EPS. Question 15: Which finding is most characteristic of a client experiencing a manic episode? A. Psychomotor retardation B. Pressured speech C. Social withdrawal D. Flat affect CORRECT ANSWER: B. Pressured speech RATIONALE: Pressured speech—rapid, loud, difficult-to-interrupt talking—is a hallmark of mania. Psychomotor retardation, social withdrawal, and flat affect are characteristic of depressive episodes, not mania. Other manic symptoms include grandiosity, decreased need for sleep, and impulsivity. Question 16: A nurse is caring for a client who has just been admitted under involuntary commitment. What is the nurse's priority action?
CORRECT ANSWER: B. Ask the client if they plan to act on the commands RATIONALE: Assessing intent and plan regarding command hallucinations is critical for determining risk and implementing safety interventions. Arguing increases agitation; ignoring compromises safety; sedation without assessment is inappropriate. Direct, nonjudgmental inquiry guides appropriate care. Question 20: A nurse is teaching a client about cognitive behavioral therapy (CBT). Which statement by the client indicates understanding? A. "CBT will help me uncover repressed childhood memories." B. "I will learn to identify and change negative thought patterns." C. "The therapist will analyze my dreams to find hidden meanings." D. "I need to focus on expressing my emotions freely without filtering." CORRECT ANSWER: B. "I will learn to identify and change negative thought patterns." RATIONALE: CBT is based on the concept that thoughts, feelings, and behaviors are interconnected. Clients learn to recognize and modify distorted thinking to improve emotional regulation and behavior. Uncovering repressed memories relates to psychoanalysis; dream analysis is psychodynamic; unrestricted emotional expression is not a CBT focus. Question 21: Which assessment finding is most indicative of neuroleptic malignant syndrome (NMS) in a client taking antipsychotics? A. Temperature 99.1°F (37.3°C), mild tremor B. Temperature 102.6°F (39.2°C), muscle rigidity, altered mental status C. Temperature 98.6°F (37°C), reports of restlessness D. Temperature 100.4°F (38°C), dry mouth, constipation CORRECT ANSWER: B. Temperature 102.6°F (39.2°C), muscle rigidity, altered mental status RATIONALE: NMS is a life-threatening reaction to antipsychotics characterized by the classic tetrad: fever, muscle rigidity, altered mental status, and autonomic instability. Mild symptoms or isolated side effects do not meet criteria. Immediate discontinuation of the antipsychotic and intensive care are required. Question 22: A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching? A. "I should take this medication exactly as prescribed." B. "It may take several weeks to feel the full effect." C. "I can drink alcohol in moderation while taking this." D. "I won't become dependent on this medication." CORRECT ANSWER: C. "I can drink alcohol in moderation while taking this."
RATIONALE: Alcohol should be avoided with buspirone as it can increase CNS depression and dizziness. The other statements are accurate: buspirone requires consistent dosing, has a delayed onset (2-4 weeks), and has low abuse potential compared to benzodiazepines. Question 23: Which behavior is most consistent with a client in the manic phase of bipolar disorder? A. Spending sprees and reckless driving B. Excessive sleeping and fatigue C. Social isolation and tearfulness D. Ritualistic hand washing CORRECT ANSWER: A. Spending sprees and reckless driving RATIONALE: Impulsivity, poor judgment, and engagement in high-risk activities like spending sprees or reckless driving are hallmark behaviors of mania. Excessive sleeping, isolation, and tearfulness suggest depression; ritualistic behaviors indicate OCD. Question 24: A nurse is caring for a client with dementia who is experiencing sundowning. Which intervention should be included in the care plan? A. Increase environmental stimulation in the evening B. Schedule demanding activities for late afternoon C. Maintain a consistent daily routine with calming evening activities D. Encourage daytime napping to reduce evening agitation CORRECT ANSWER: C. Maintain a consistent daily routine with calming evening activities RATIONALE: Sundowning—increased confusion and agitation in late afternoon/evening—is managed by reducing stimuli, maintaining routines, and providing calming activities. Increasing stimulation, scheduling demanding tasks, or encouraging naps can worsen confusion and disrupt sleep-wake cycles. Question 25: Which statement by a client with schizophrenia demonstrates insight into their illness? A. "The voices aren't real; they're part of my illness." B. "I only hear voices when people are actually whispering." C. "The government is testing new technology on me through the voices." D. "If I ignore the voices, they will eventually go away forever." CORRECT ANSWER: A. "The voices aren't real; they're part of my illness." RATIONALE: Insight involves recognizing that symptoms like hallucinations are manifestations of illness rather than external reality. Option A demonstrates this awareness. Options B, C, and D reflect delusional thinking or unrealistic expectations about symptom management.
CORRECT ANSWER: B. Hyperthermia, clonus, agitation RATIONALE: Serotonin syndrome results from excessive serotonergic activity, often due to medication interactions. Classic symptoms include the triad of mental status changes, autonomic hyperactivity (hyperthermia, tachycardia), and neuromuscular abnormalities (clonus, hyperreflexia). Options A, C, and D describe findings inconsistent with this syndrome. Question 30: A client with postpartum depression states, "I'm a terrible mother; my baby would be better off without me." What is the nurse's priority concern? A. Impaired parent-infant bonding B. Risk for suicide C. Inability to perform self-care D. Social isolation CORRECT ANSWER: B. Risk for suicide RATIONALE: Statements suggesting the baby would be "better off without me" indicate suicidal ideation with potential for harm to self or infant. Safety assessment is the priority. While bonding, self-care, and isolation are concerns, they are secondary to imminent risk of harm. Question 31: Which intervention is most effective for managing aggression in a client with intermittent explosive disorder? A. Restraint at the first sign of anger B. Teaching anger management and coping skills C. Isolating the client during angry episodes D. Administering PRN antipsychotics prophylactically CORRECT ANSWER: B. Teaching anger management and coping skills RATIONALE: Intermittent explosive disorder involves recurrent impulsive aggression. Long-term management focuses on cognitive-behavioral strategies to recognize triggers and develop alternative responses. Restraint and isolation are last resorts for imminent danger; prophylactic medication is not standard first-line treatment. Question 32: A client with anorexia nervosa has a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements. Which goal is most appropriate? A. Client will verbalize understanding of calorie needs within 24 hours B. Client will gain 1-2 pounds per week until goal weight is achieved C. Client will attend all group meals without leaving the table D. Client will identify three triggers for restrictive eating CORRECT ANSWER: B. Client will gain 1-2 pounds per week until goal weight is achieved
RATIONALE: For Imbalanced Nutrition, the priority outcome is physiological stabilization through weight restoration. A measurable, time-bound weight gain goal addresses the immediate health risk. Verbalizing understanding, attending meals, and identifying triggers are important but secondary to nutritional rehabilitation. Question 33: Which statement by a client with substance use disorder indicates they are in the contemplation stage of change? A. "I don't have a problem; everyone drinks this much." B. "I know I should cut down, but I'm not ready to quit yet." C. "I've been sober for 6 months and attending meetings weekly." D. "I'm going to stop using starting tomorrow." CORRECT ANSWER: B. "I know I should cut down, but I'm not ready to quit yet." RATIONALE: The contemplation stage involves recognizing a problem and considering change but not yet committing to action. Precontemplation denies problems; preparation involves planning immediate change; maintenance reflects sustained behavior change. Question 34: A nurse is caring for a client experiencing delirium. Which finding is most characteristic? A. Gradual onset of memory loss over months B. Fluctuating level of consciousness and disorientation C. Stable mood with persistent delusions D. Intact attention with impaired judgment CORRECT ANSWER: B. Fluctuating level of consciousness and disorientation RATIONALE: Delirium is an acute, fluctuating disturbance in attention, awareness, and cognition, often due to medical illness or medication. Gradual memory loss suggests dementia; stable mood with delusions may indicate schizophrenia; intact attention contradicts delirium criteria. Question 35: Which intervention should the nurse implement first for a client in acute mania? A. Provide high-calorie finger foods B. Set firm, consistent limits on behavior C. Administer prescribed mood stabilizer D. Reduce environmental stimuli CORRECT ANSWER: D. Reduce environmental stimuli RATIONALE: Clients in acute mania are easily overstimulated, which can escalate agitation and impulsivity. Reducing noise, bright lights, and crowd exposure helps decrease sensory overload. Nutrition, limit-setting, and medication are important but follow environmental modification to promote safety and cooperation.
C. Tremors and shuffling gait D. Fever and autonomic instability CORRECT ANSWER: B. Involuntary muscle spasms of the neck and eyes RATIONALE: Acute dystonia is an extrapyramidal side effect of antipsychotics characterized by sudden, painful muscle spasms, often involving the neck (torticollis), eyes (oculogyric crisis), or face. Akathisia presents as restlessness; parkinsonism includes tremors and rigidity; NMS includes fever and autonomic changes. Question 40: A client with schizophrenia is being discharged on risperidone. Which statement by the client indicates understanding of discharge teaching? A. "I will stop taking this if I feel dizzy." B. "I should avoid standing up quickly to prevent dizziness." C. "I can drink grapefruit juice with my morning dose." D. "This medication will cure my schizophrenia in 2 weeks." CORRECT ANSWER: B. "I should avoid standing up quickly to prevent dizziness." RATIONALE: Risperidone can cause orthostatic hypotension; teaching clients to rise slowly prevents falls. Stopping medication abruptly risks relapse; grapefruit juice can interact with many psychotropics; antipsychotics manage but do not cure schizophrenia. Option B reflects accurate understanding of safety precautions. Question 41: Which therapeutic approach is most appropriate for a client with specific phobia? A. Psychoanalysis to explore unconscious conflicts B. Systematic desensitization with gradual exposure C. Electroconvulsive therapy for rapid symptom relief D. Long-term hospitalization for intensive monitoring CORRECT ANSWER: B. Systematic desensitization with gradual exposure RATIONALE: Systematic desensitization, a behavioral therapy involving gradual, controlled exposure to the feared object/situation paired with relaxation, is first-line treatment for specific phobias. Psychoanalysis is not evidence-based for phobias; ECT is for severe depression; hospitalization is unnecessary for uncomplicated phobias. Question 42: A nurse is caring for a client with catatonic schizophrenia. Which intervention is priority? A. Encourage participation in group activities B. Provide for physical needs and prevent complications C. Challenge delusional beliefs directly D. Administer PRN sedatives for agitation CORRECT ANSWER: B. Provide for physical needs and prevent complications
RATIONALE: Catatonia can involve stupor, mutism, rigidity, or posturing, placing clients at risk for dehydration, malnutrition, pressure injuries, and contractures. Meeting basic physiological needs and preventing complications take precedence. Group participation may be impossible; challenging delusions increases agitation; sedatives may worsen catatonia. Question 43: Which statement by a client with depression indicates improvement after starting antidepressant therapy? A. "I sleep 12 hours every night now." B. "I've started walking around the block each morning." C. "I no longer feel angry at my family." D. "I think the medication is working because I feel numb." CORRECT ANSWER: B. "I've started walking around the block each morning." RATIONALE: Behavioral activation, such as initiating light exercise, is a positive sign of antidepressant response and improved energy/motivation. Excessive sleep may indicate residual depression or sedation; absence of anger is nonspecific; feeling "numb" may reflect emotional blunting, not therapeutic benefit. Question 44: A client with opioid use disorder is prescribed methadone. Which statement requires nurse intervention? A. "I take my dose at the same time every day." B. "I understand I cannot stop this medication suddenly." C. "I can drink alcohol occasionally while on methadone." D. "I will keep all appointments for dose monitoring." CORRECT ANSWER: C. "I can drink alcohol occasionally while on methadone." RATIONALE: Alcohol and other CNS depressants should be avoided with methadone due to risk of additive respiratory depression and overdose. The other statements reflect accurate understanding of methadone maintenance therapy: consistent timing, avoiding abrupt discontinuation, and adhering to monitoring. Question 45: Which defense mechanism is demonstrated by a client who channels aggressive impulses into competitive sports? A. Displacement B. Sublimation C. Projection D. Regression CORRECT ANSWER: B. Sublimation RATIONALE: Sublimation is a mature defense mechanism where unacceptable impulses are redirected into socially acceptable or productive activities. Channeling aggression into sports is a classic example. Displacement redirects feelings to a safer
Question 49: Which intervention is most appropriate for a client experiencing depersonalization? A. Encourage the client to focus on external sensory stimuli B. Ask the client to describe the content of their dissociative episodes C. Administer a PRN antipsychotic medication D. Isolate the client to reduce environmental triggers CORRECT ANSWER: A. Encourage the client to focus on external sensory stimuli RATIONALE: Grounding techniques, such as focusing on sensory input (e.g., "name five things you see"), help clients reconnect with reality during depersonalization or derealization. Exploring content may increase distress; antipsychotics are not first-line for dissociation; isolation can worsen feelings of detachment. Question 50: A nurse is teaching a client about electroconvulsive therapy (ECT). Which statement indicates understanding? A. "I will be awake during the procedure." B. "I may experience temporary memory loss after treatments." C. "ECT is a last resort only for treatment-resistant schizophrenia." D. "I can drive myself home after each session." CORRECT ANSWER: B. "I may experience temporary memory loss after treatments." RATIONALE: Temporary retrograde and anterograde amnesia, particularly around the treatment period, is a common and expected side effect of ECT. Clients are under general anesthesia during the procedure; ECT is primarily used for severe depression, not just schizophrenia; and clients cannot drive post-ECT due to anesthesia effects. Question 51: Which assessment finding is most indicative of bulimia nervosa? A. Body mass index of 16 kg/m² B. Calluses on the dorsum of the hand C. Absence of menstruation for 3 months D. Refusal to eat in public settings CORRECT ANSWER: B. Calluses on the dorsum of the hand RATIONALE: Russell's sign—calluses or scars on the knuckles from self-induced vomiting—is a physical indicator of bulimia nervosa. Low BMI and amenorrhea are more characteristic of anorexia nervosa; avoiding public eating occurs in both disorders but is not specific to bulimia. Question 52: A client with schizophrenia states, "The TV is sending me secret messages about my mission." What type of symptom is this? A. Hallucination B. Delusion of reference
C. Idea of reference D. Loose association CORRECT ANSWER: B. Delusion of reference RATIONALE: A delusion of reference involves the fixed, false belief that neutral environmental events (e.g., TV, radio, newspapers) have personal significance or are directed at the individual. Hallucinations are sensory perceptions without stimuli; ideas of reference are less fixed beliefs; loose associations involve disorganized speech. Question 53: Which medication is contraindicated in a client with narrow-angle glaucoma? A. Sertraline B. Amitriptyline C. Risperidone D. Lithium CORRECT ANSWER: B. Amitriptyline RATIONALE: Tricyclic antidepressants like amitriptyline have strong anticholinergic properties that can increase intraocular pressure and precipitate acute angle-closure glaucoma in susceptible individuals. SSRIs, antipsychotics, and mood stabilizers have lower anticholinergic burden and are generally safer, though monitoring is still advised. Question 54: A nurse is caring for a client who is experiencing akathisia. Which intervention should be implemented? A. Administer prescribed benztropine B. Encourage the client to walk to release energy C. Apply restraints to prevent injury from restlessness D. Increase the dose of the antipsychotic medication CORRECT ANSWER: A. Administer prescribed benztropine RATIONALE: Akathisia, a subjective sense of inner restlessness and inability to remain still, is an extrapyramidal side effect of antipsychotics. Anticholinergics like benztropine or beta-blockers are first-line treatments. Encouraging walking may temporarily help but does not treat the underlying cause; restraints are inappropriate; increasing the antipsychotic would worsen symptoms. Question 55: Which statement by a client with borderline personality disorder indicates progress in dialectical behavior therapy (DBT)? A. "I cut myself last night because I felt empty." B. "I used the TIPP skill when I felt overwhelmed yesterday." C. "My family still doesn't understand me." D. "I wish I could just stop feeling so much." CORRECT ANSWER: B. "I used the TIPP skill when I felt overwhelmed yesterday."
empowers the client. Direct advice, personal anecdotes, and fear-based warnings are confrontational and less effective in this client-centered approach. Question 59: Which finding suggests a client is experiencing withdrawal from benzodiazepines? A. Hypotension, bradycardia, sedation B. Anxiety, tremors, insomnia, seizures C. Euphoria, increased energy, dilated pupils D. Appetite increase, weight gain, hypersomnia CORRECT ANSWER: B. Anxiety, tremors, insomnia, seizures RATIONALE: Benzodiazepine withdrawal causes CNS hyperexcitability due to GABA receptor downregulation, manifesting as anxiety, tremors, insomnia, and potentially life-threatening seizures. Hypotension and sedation suggest ongoing intoxication; euphoria and dilated pupils indicate stimulant use; appetite increase and hypersomnia are not typical withdrawal symptoms. Question 60: A client with schizophrenia is prescribed a long-acting injectable antipsychotic. Which statement by the client indicates understanding? A. "I will need to come to the clinic every week for this shot." B. "This medication will work immediately after the injection." C. "I still need to take my oral pills every day with the shot." D. "This can help me stay consistent with my medication." CORRECT ANSWER: D. "This can help me stay consistent with my medication." RATIONALE: Long-acting injectable antipsychotics improve adherence by reducing the need for daily dosing, which is beneficial for clients with insight or adherence challenges. Dosing frequency varies by medication (e.g., every 2-4 weeks, not weekly); onset is not immediate; and oral supplementation is typically only needed initially or during dose transitions. Question 61: Which intervention is most therapeutic for a client experiencing grief after a significant loss? A. Encourage the client to "stay busy" to avoid painful feelings B. Validate the client's feelings and provide a safe space to express grief C. Suggest the client should be "over it" by now D. Redirect the conversation to positive topics immediately CORRECT ANSWER: B. Validate the client's feelings and provide a safe space to express grief RATIONALE: Therapeutic grief support involves acknowledging the loss, validating emotions, and allowing the client to process feelings at their own pace. Avoidance, minimizing, or premature redirection can inhibit healthy mourning and lead to complicated grief.
Question 62: A client with post-traumatic stress disorder (PTSD) is prescribed prazosin. What is the intended therapeutic effect? A. Reduce flashbacks during waking hours B. Decrease nightmares and improve sleep C. Eliminate hypervigilance in public settings D. Prevent panic attacks in crowded places CORRECT ANSWER: B. Decrease nightmares and improve sleep RATIONALE: Prazosin, an alpha-1 adrenergic blocker, is used off-label in PTSD to reduce trauma-related nightmares and improve sleep quality by blocking norepinephrine effects in the brain. It does not directly treat daytime flashbacks, hypervigilance, or panic attacks, though improved sleep may indirectly help overall symptom management. Question 63: Which statement by a nurse demonstrates understanding of the least restrictive alternative principle? A. "I'll use restraints first to ensure the client doesn't harm others." B. "I should try de-escalation techniques before considering seclusion." C. "Medication should be given PRN to avoid behavioral interventions." D. "Family members should leave if the client becomes agitated." CORRECT ANSWER: B. "I should try de-escalation techniques before considering seclusion." RATIONALE: The least restrictive alternative principle requires using the least intrusive intervention necessary to ensure safety. De-escalation, verbal interventions, and environmental modifications should precede seclusion or restraints. Restraints are never first-line; PRN medication should complement, not replace, behavioral strategies; family presence may be calming. Question 64: A client with bipolar disorder is in a depressive episode. Which symptom is most characteristic? A. Decreased need for sleep B. Psychomotor agitation C. Feelings of worthlessness D. Pressured speech CORRECT ANSWER: C. Feelings of worthlessness RATIONALE: Feelings of worthlessness, guilt, and hopelessness are core symptoms of depressive episodes in bipolar disorder. Decreased need for sleep, psychomotor agitation (though agitation can occur in depression), and pressured speech are characteristic of manic episodes. Differentiating mood polarity guides appropriate treatment. Question 65: Which assessment finding is most urgent in a client taking lithium?
