ATI MENTAL HEALTH  Exam -1----(40 Q &  A) ATI MENTAL HEALTH  Exam -2----(40 Q &  A)

ATI Mental Health Exam 1. As a nurse approaches a client with schizophrenia, the client looks at the nurse and says, “Back off. Leave me alone.” The client appears tense and is pacing rapidly. Which of the following is an appropriate nursing response? a. “I can’t leave you alone when you are this upset. Sit down, and try to relax.” b. “Let’s go to your room, and you can tell me what is bothering you.” d. “I will leave you alone for a few minutes while you try to compose yourself.” The nurse’s first concern is to ensure safety. To avoid escalating the client’s behavior, the nurse should stay at the comfortable distance and remain calm while stressing the importance of maintaining control. Verbal intervention is the least restrictive form of action. If the client does not respond to verbal interventions, then more restrictive measures may have to be used. 2. A nurse ona mental health care unit is providing care for a client diagnosed with schizophrenia. The client is experiencing delusional thinking. Which of the following defense mechanisms is the client using when making delusional statements? b. Dissociation —a client detaches emotional or behavioral processes from usual conscious behavior patterns or identity. There is not indication that the client has amnesia problems c. Displacement —a client redirects an emotion from the original object to a more acceptable substitute. Displacement is not the defense mechanism used in delusional thinking d. Regression —a client attempts to reduce anxiety and conflict by returning to less mature behaviors that help the client better tolerate the anxiety. Regression is not the defense mechanism used in delusional thinking. In projection a client attributes unacceptable emotions and qualities to others. This is the defense mechanism that is operative in delusive thinking 3. A client diagnosed with schizophrenia says to the nurse, “They lied about me and are trying to poison my food.” Which of the following is a therapeutic nursing response? a. “Tell me who would do such things to you?” b. “You are mistaken. Nobody has told lies about you or tried to poison you. c.