ATI RN
ATI Mental Health Exam 3 Questions
Question 1 of 5
A client with PTSD experiences exaggerated startle response. The client is paranoid and hypervigilant. Which nursing intervention is most appropriate?
Correct Answer: C
Rationale: The correct answer is C: Provide a structured environment with predictable routines and consistent staff. This intervention is most appropriate for a client with PTSD experiencing exaggerated startle response, paranoia, and hypervigilance. A structured environment creates a sense of safety and security, helping to reduce anxiety and paranoia. Predictable routines can help the client feel more in control and less overwhelmed by unexpected triggers. Consistent staff members build trust and familiarity, which can decrease hypervigilance and paranoia.
Other choices are incorrect because:
A: Referring the client to a support group may be beneficial, but it does not directly address the client's immediate needs related to exaggerated startle response, paranoia, and hypervigilance.
B: Mindfulness meditation may help with overall anxiety management but may not be as effective in addressing the specific symptoms mentioned.
D: Administering sedative medication as needed may provide temporary relief but does not address the underlying issues or promote long-term coping strategies
Question 2 of 5
A client is to receive enoxaparin 30 mg subcutaneously. Available is enoxaparin 40 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 0.8
Rationale:
To calculate the mL of enoxaparin needed, divide the desired dose (30 mg) by the concentration (40 mg/mL): 30 mg / 40 mg/mL = 0.75 mL. Since we need to round to the nearest tenth, 0.75 rounds up to 0.8 mL.
Therefore, the correct answer is 0.8 mL.
Summary:
A: 0.8 mL is the correct answer
B-G: Incorrect as they do not match the calculated dose.
Question 3 of 5
A charge nurse is teaching a group of nurses about the antagonist action of medications. The nurse should include in the teaching that which of the following antagonist medications is used for benzodiazepines?
Correct Answer: D
Rationale: The correct answer is D: Flumazenil. Flumazenil is a specific benzodiazepine receptor antagonist used to reverse the sedative effects of benzodiazepines. It competitively inhibits the binding of benzodiazepines to their receptors, effectively reversing their actions. Naloxone (
A) is an opioid receptor antagonist, Diphenhydramine (
B) is an antihistamine, and Protamine (
C) is used to reverse the effects of heparin. These medications are not used for benzodiazepines.
Question 4 of 5
A nurse at a walk-in mental health clinic is assessing a client experiencing severe anxiety. The nurse should recognize the client might exhibit which of the following manifestations?
Correct Answer: C
Rationale: The correct answer is C: Threatening behaviors. Severe anxiety can lead to aggressive or threatening behaviors as a result of feeling overwhelmed or unable to cope. This can be a manifestation of the fight-or-flight response triggered by intense anxiety. The other choices are incorrect because attention-seeking conduct (
A) is more commonly associated with personality disorders, mild fidgeting (
B) may indicate mild anxiety but not severe anxiety, and mild difficulty problem solving (
D) is a cognitive manifestation that is less likely to be prominent in cases of severe anxiety.
Question 5 of 5
A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client's compulsive behaviors?
Correct Answer: D
Rationale: The correct answer is D: Plan the client's schedule to allow time for rituals. This is the most appropriate action as it acknowledges the client's compulsive behaviors and allows for a structured approach in managing them without causing distress. Isolating the client (option
A) can worsen their condition. Setting strict limits (option
B) may lead to increased anxiety and resistance. Confronting the client (option
C) can be counterproductive as it may escalate their behaviors. Planning the client's schedule to accommodate rituals (option
D) supports the client's needs while maintaining a therapeutic environment.