ATI RN
ATI RN Mental Health 2023 with NGN Questions
Question 1 of 5
A nurse is caring for a client who has bipolar disorder and is refusing to take prescribed medications. Which of the following ethical principles is the nurse displaying when supporting the client's refusal of medications?
Correct Answer: A
Rationale: The correct answer is A: Autonomy. Autonomy refers to respecting the client's right to make their own decisions about their treatment. By supporting the client's refusal of medications, the nurse is upholding the principle of autonomy and acknowledging the client's right to choose what happens to their own body. This empowers the client and promotes self-determination.
Other choices are incorrect because:
B: Beneficence focuses on doing good for the client, which would involve ensuring the client receives necessary treatment.
C: Veracity relates to truth-telling, not the client's right to refuse treatment.
D: Justice is about fairness and equal treatment, not specifically related to respecting the client's autonomy.
Question 2 of 5
A nurse is caring for a client who has social anxiety disorder. The client reports experiencing feelings of anxiousness that disrupt their sleep. Which of the following recommendations should the nurse make?
Correct Answer: A
Rationale: The correct recommendation is A: Try guided imagery before bedtime. Guided imagery is a relaxation technique that can help reduce anxiety and promote better sleep. By engaging in guided imagery, the client can focus on positive mental images, calming their mind and body, leading to improved sleep. This technique is evidence-based and has been shown to be effective in managing anxiety and improving sleep quality.
Other choices are incorrect:
B: Lie in bed and try to make yourself fall asleep - This can increase anxiety and worsen sleep disturbances.
C: Eat something substantial before getting ready for bed - Eating a large meal before bed can disrupt sleep and exacerbate anxiety.
D: Restrict the amount of sleep you are getting - Restricting sleep can worsen anxiety symptoms and lead to further sleep disturbances.
Extract:
Nurses' Notes
2200:
According to the police officer's report, the client was found sleeping near railroad tracks. Refused to give name, and no identification found. Client states they were, "Just doing what they were told to do. Didn't know it would take so long for the train to come." Client appears disheveled with poor hygiene. Client does not follow simple commands, refuses to answer questions, and will not make eye contact.
2230:
Client refusing to follow prescribed treatment plan. States they believe someone is trying to poison them. Noted to occasionally be mumbling as if talking to unseen others.
Provider Prescriptions
2200:
Clozapine 200 mg PO twice per day
Risperidone 4 mg PO twice per day
Question 3 of 5
A nurse in a mental health facility is admitting a client who was brought in by the police department. Exhibits:Complete the diagram by selecting from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
Correct Answer: A, A,C, B,D
Rationale: Action to Take: A, A; Potential Condition: C; Parameter to Monitor: B, D.
Rationale: The client is likely experiencing schizophrenia based on brought in by the police, so actions to take include providing a safe environment (placing client in a room near the nurses' station) and administering antipsychotic medications to address the condition. Potential condition of seizures (
C) should be monitored closely. Parameters to monitor include behavior changes (
B) and medication efficacy (
D) to assess progress and ensure safety. Other choices are incorrect as they do not align with the client's likely condition or best practices in mental health care.
Extract:
2045
• X-ray of left wrist
• Hydrocodone 2.5 mg/acetaminophen 325 mg, 2 tablets PO now
2345:
• Discharge to home.
• Follow-up with orthopedist, their office will call tomorrow.
• Keep left arm elevated with splint on.
• Ice left wrist per written instructions provided.
• Ibuprofen 800 mg PO every 8 hr PRN pain
Medical History
• Premenstrual dysphoric disorder
• No known allergies
Physical Examination 2030
• Left wrist injury and edema
• Finger-shaped bruises on the left forearm
• Reports pain with movement of left wrist and hand as 8 on a 0 to 10 pain scale, and pain as 6 at rest. Grimacing and tearfulness noted with movement. Fingers warm with capillary refill less than 2 seconds.
2145:
• Reports left wrist pain as 6 with movement and as 4 at rest on a 0 to 10 pain scale.
Nurses’ Notes 2030
• Client presents for evaluation of left wrist injury reportedly following an incident of partner violence. The client states their partner had been drinking heavily prior to the physical altercation. The client reports the partner roughly grabbed their left arm while yelling loudly in their face. The client was able to free their arm and was walking to their car to leave when the partner aggressively pushed the client from behind. The client fell forward, using both arms to brace their fall. The client states the partner saw their wrist injury and began crying and apologizing, promising to never drink again. The client states, “I’ve heard that promise so many times, but they’ve never cried before, so I think it is sincere this time.”
• Left arm elevated on 2 pillows. Ice pack applied to left wrist.
2045:
• Provider in to see client. Prescriptions received.
2145:
• Client returned to room from radiology department via wheelchair. Left arm elevated and ice pack reapplied. A law enforcement officer in to talk with client after receiving a 911 call from the client’s neighbor who witnessed the physical altercation.
2330:
• Client declines to press charges against partner, per report of law enforcement officer. The client agreed to a social services referral, appointment scheduled for tomorrow. Discussed safety plan with client and the client reports having an envelope of important papers already hidden at home. Also provided the client with the phone numbers for the local crisis hotline and safe house. The client is receptive to information but states, “I need to work on my relationship a while longer. I really think things will get better this time.”
Question 4 of 5
A nurse in an emergency department is caring for a client who recently experienced partner violence.Exhibits:The nurse is reviewing the client’s medical record at discharge. For each finding, specify whether the finding indicates a potential improvement in or a worsening of the client’s physical or psychological status.
| Options | Indicates potential improvement | Indicates potential worsening |
|---|---|---|
| Client states that the partner will not be violent in the future. | ||
| Client agrees to an appointment with a social worker. | ||
| Client's reported pain level of the left wrist. | ||
| Client requests help developing a safety plan. | ||
| Client claims responsibility for the physical altercation. |
Correct Answer:
Rationale: [1, 0, 0]
Correct
Answer: A: Client states that the partner will not be violent in the future.
Rationale: This indicates a potential improvement in the client's physical and psychological status as it suggests a commitment to a non-violent future.
Summary: B: Client agrees to an appointment with a social worker - While beneficial, it does not directly address future violence. C: Client's reported pain level of the left wrist - Focuses only on physical aspect. D: Client requests help developing a safety plan - Indicates awareness of potential danger but not future behavior. E: Client claims responsibility for the physical altercation - May not indicate a change in future violence.
Extract:
Question 5 of 5
A nurse is providing teaching to the partner of a client who has Alzheimer's disease and a new prescription for donepezil. Which of the following pieces of information should the nurse include?
Correct Answer: A
Rationale: The correct answer is A: "You should administer the medication immediately before bedtime." Donepezil is typically recommended to be taken at bedtime to reduce the risk of side effects such as nausea and insomnia. Administering it at this time also helps with adherence to the medication schedule.
Choice B is incorrect because donepezil does not cure Alzheimer's disease, so the dose is not decreased as the disease improves.
Choice C is incorrect because while donepezil may help with symptoms, it does not stop the progression of the disease.
Choice D is incorrect because donepezil does not decrease the risk of falls; in fact, it may cause side effects that increase the risk of falls.