ATI RN
ATI Capstone Mental Health Questions
Question 1 of 9
A client with a history of alcohol abuse is participating in a 12-step Alcoholics Anonymous (AA) program. The nurse determines that the client is at step two when he states which of the following?
Correct Answer: B
Rationale: Step-by-step rationale: 1. Step 2 in AA involves believing in a higher power's ability to help overcome alcoholism. 2. The client stating "I realize that there is a higher power that can help me" aligns with step 2. 3. This step acknowledges the need for external support beyond oneself in the recovery process. 4. Choice A refers to step 9, making amends. Choice C refers to step 1, admitting powerlessness. Choice D refers to step 8, making amends.
Question 2 of 9
A patient fearfully runs from chair to chair crying, "They're coming! They're coming!" The patient does not follow the staff's directions or respond to verbal interventions. Which nursing diagnosis has the highest priority?
Correct Answer: B
Rationale: The correct answer is B: Risk for injury. This diagnosis takes priority because the patient's behavior poses an immediate threat to their safety. Running and not responding to staff instructions increases the risk of falls and accidents. Addressing this risk is crucial to ensure the patient's physical well-being. Choice A (Fear) is important but not as urgent as addressing the immediate risk of injury. Choice C (Self-care deficit) and D (Disturbed thought processes) are not the priority in this scenario as the patient's safety is the primary concern.
Question 3 of 9
The nurse is planning care for a newly admitted adolescent who has bacterial meningitis. Which of the following instructions is appropriate for the nurse to include in the plan of care?
Correct Answer: A
Rationale: The correct answer is A: Initiate droplet precautions for the client. This is appropriate because bacterial meningitis is transmitted through droplets, so implementing droplet precautions helps prevent the spread of infection to others. Option B (Assist the client to a supine position) is incorrect as it can worsen intracranial pressure. Option C (Perform the Glasgow coma scale every 24 hours) is not directly related to preventing transmission of infection. Option D (Recommend prophylactic acyclovir for the client's family) is incorrect as acyclovir is used for herpes simplex virus, not bacterial meningitis.
Question 4 of 9
A nurse is preparing to reinforce the use of cognitive behavior therapy with a patient. When interacting with the patient, which of the following would be appropriate?
Correct Answer: C
Rationale: The correct answer is C: Using a future-oriented goal focus. In cognitive behavior therapy, focusing on future-oriented goals helps the patient set achievable objectives and work towards positive outcomes. This approach encourages the patient to look forward and make changes that align with their desired future. Establishing the agenda (A) can be helpful but may not be as effective as focusing on goal setting. Focusing primarily on behavior (B) is too narrow and may not address the underlying thoughts and emotions. Identifying the problem from the nurse's perspective (D) is not client-centered and may not promote active participation in the therapy process.
Question 5 of 9
Guadalupe is the matriarch of a large family. She is terminally ill and none of her family members know her end-of-life wishes. The best action for the nurse is to:
Correct Answer: B
Rationale: The correct answer is B because organizing a family meeting with Guadalupe's permission allows for open communication about her end-of-life wishes. This approach respects her autonomy and ensures her preferences are known. Discussing durable power of attorney (A) may be premature without knowing Guadalupe's wishes. Having a family meeting without her (C) disregards her right to be involved in decision-making. Asking the doctor to inform Guadalupe about her terminal illness (D) should be done by a healthcare provider, not a nurse, and may cause distress without addressing her specific wishes.
Question 6 of 9
To establish rapport with a 10-year-old child who is hospitalized in a psychiatric setting, which statement by the nurse would be most appropriate?
Correct Answer: D
Rationale: The correct answer is D: "Would you like to play a game of checkers with me?" This choice is most appropriate as it focuses on building a therapeutic relationship through a non-threatening and engaging activity. Playing a game of checkers can help establish rapport, foster trust, and create a sense of normalcy for the child in a psychiatric setting. It allows for social interaction, provides a distraction, and can help the child feel more comfortable and open up to the nurse. Explanation of why the other choices are incorrect: A: Comparing the child's situation to Cinderella's in a fairy tale may not be relatable or relevant to the child's experiences, potentially minimizing their feelings and concerns. B: Using a tool to measure self-control and initiative may come off as clinical and impersonal, possibly making the child feel like they are being evaluated rather than supported. C: Asking the child to draw a picture of themselves may be intimidating or invasive, as it delves into personal expression without
Question 7 of 9
The desired outcome for a patient experiencing insomnia is, "Patient will sleep for a minimum of 5 hours nightly within 7 days." At the end of 7 days, review of sleep data shows the patient sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap. The nurse will document the outcome as
Correct Answer: D
Rationale: The correct answer is D: never demonstrate. The rationale is that the desired outcome was for the patient to sleep for a minimum of 5 hours nightly within 7 days. However, the patient only sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap, which does not meet the desired outcome. Therefore, the nurse would document that the patient has never demonstrated the desired outcome of sleeping for a minimum of 5 hours nightly within 7 days. Choices A, B, and C are incorrect because the patient did not consistently, often, or sometimes demonstrate meeting the desired outcome.
Question 8 of 9
A family has a long history of conflicted relationships among the members. Which family member's comment best reflects a mentally healthy perspective?
Correct Answer: C
Rationale: The correct answer is C because it shows a mentally healthy perspective of taking responsibility and being proactive in making positive changes for the benefit of the family. By acknowledging the need for personal growth and willingness to change behavior, this family member demonstrates self-awareness and a commitment to improving relationships. Choice A is incorrect as it deflects responsibility by comparing oneself to others. Choice B reminisces about the past without addressing current issues or solutions. Choice D is not a healthy approach as it suggests avoidance rather than addressing and working through familial conflicts.
Question 9 of 9
A female patient was admitted to the hospital with pneumonia, and in the course of her treatment, it was determined that she was experiencing alcohol dependence because she began experiencing alcohol withdrawal while she was in the hospital. When the psychiatrist who was called in as a consultant documented the patient's mental disorder, he identified her alcohol dependence on which axis?
Correct Answer: A
Rationale: The correct answer is A: Axis I. In the DSM-IV-TR, mental disorders, including substance-related disorders like alcohol dependence, are classified under Axis I. This axis is for clinical disorders and other conditions that may be a focus of clinical attention. Alcohol dependence is a primary psychiatric disorder that affects the patient's mental and behavioral functioning, which is why it is categorized under Axis I. Choice B: Axis II is incorrect because Axis II is for personality disorders and mental retardation, not for substance-related disorders like alcohol dependence. Choice C: Axis III is incorrect because Axis III is for general medical conditions that may be relevant to the individual's mental health, not for mental disorders like alcohol dependence. Choice D: Axis IV is incorrect because Axis IV is for psychosocial and environmental problems that may influence the diagnosis, treatment, and prognosis of mental disorders, not for the mental disorders themselves.