ATI RN
ATI RN Mental Health 2023 with NGN Questions
Question 1 of 5
A nurse is caring for a client who has borderline personality disorder. Which of the following outcomes should the nurse include in the treatment plan?
Correct Answer: C
Rationale: The correct answer is C: The client will attend to personal hygiene. This outcome is important in the treatment of borderline personality disorder as it can improve the client's self-esteem and overall well-being. Personal hygiene is a fundamental aspect of self-care and can help the client feel more in control and confident. It also promotes a sense of normalcy and routine, which can be beneficial in managing symptoms of the disorder.
The other choices are incorrect because:
A: Verbalizing an improved mood may not directly address the core issues of borderline personality disorder.
B: Decrease in hallucinations is more commonly associated with psychotic disorders, not borderline personality disorder.
D: Communicating needs is important, but attending to personal hygiene is more fundamental for daily functioning.
E, F, G: Not provided in the question.
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 2 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 3 of 5
A nurse is reviewing laboratory results of a client who has schizophrenia and is taking risperidone. For which of the following findings should the nurse notify the provider?
Correct Answer: A
Rationale: The correct answer is A: Blood glucose 256 mg/dL (74 to 106 mg/dL). This finding is concerning because risperidone, an antipsychotic medication, can cause metabolic side effects such as hyperglycemia. High blood glucose levels can lead to serious complications like diabetic ketoacidosis. The nurse should notify the provider for further evaluation and management.
The other choices (B, C,
D) fall within the normal reference ranges and do not indicate any immediate concerns related to the client's condition or medication.
Therefore, they do not require immediate notification to the provider.
Question 4 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.
Question 5 of 5
A nurse is receiving a change-of-shift report about a group of assigned clients at a mental health facility. Which of the following clients should the nurse assess for risks related to sensory impairments?
Correct Answer: D
Rationale: The correct answer is D because individuals with severe obsessive-compulsive disorder may experience sensory impairments due to their obsessive thoughts and compulsive behaviors. This can manifest as heightened sensitivity to certain stimuli or a distorted perception of reality. The nurse should assess this client for risks related to these sensory impairments to ensure their safety and well-being.
Choice A (conversion disorder) is incorrect as it is characterized by physical symptoms that are not explained by any underlying medical condition.
Choice B (mild anxiety disorder) is incorrect as sensory impairments are not typically associated with mild anxiety.
Choice C (narcissistic personality disorder) is incorrect as it is a personality disorder characterized by a pattern of grandiosity, need for admiration, and lack of empathy, not sensory impairments.