ATI LPN
ATI PN Mental Health 2023 Questions
Extract:
Question 1 of 5
A nurse in a mental health facility is collecting a blood specimen from a client. The client is hallucinating and states, 'That looks like a snake, and I won’t let it take all of my blood.' Which of the following responses should the nurse make?
Correct Answer: C
Rationale: This empathetic response validates the client’s fear without reinforcing the hallucination, building trust. A dismisses the client’s state, B risks escalation by invalidating perception, and D denies the experience, potentially increasing distrust.
Question 2 of 5
A nurse is collecting data from a client who is taking lithium. Which of the following findings should the nurse identify as early manifestations of lithium toxicity? (Select all that apply)
Correct Answer: A,B,D,E
Rationale: Early lithium toxicity includes confusion (
A), nausea (
B), polyuria (
D), and incoordination (E) due to its effects on the CNS, GI tract, kidneys, and neuromuscular system. Convulsions (
C) indicate severe toxicity, not an early sign.
Question 3 of 5
A nurse is assisting in the care of a client who has bipolar disorder and is experiencing mania. Which of the following actions should the nurse take to promote a therapeutic environment?
Correct Answer: C
Rationale: Specific explanations provide structure and reduce confusion in mania. Dayroom time (
A) may overstimulate, free choice (
B) risks poor decisions, and exercise (
D) needs control.
Extract:
Provider’s Note
0230:
Client diagnosis: delirium secondary to a urinary tract infection and dehydration.
Laboratory Results
0230:
Serum toxicology screen:
Alcohol: 60 mg/dL (80 to 200 mg/dL mild to moderate intoxication)
Vital Signs
0200:
Temperature 38.6°C (101.5°F)
Heart rate 104/min
Respiratory rate 18/min
Blood pressure 158/96 mm Hg
Oxygen saturation 98% on room air
Nurses’ Notes
0205:
Client brought to the ED by police after being found wandering on the street. Client able to provide identity to police but not able to identify place or time. Family notified.
Client confused and agitated. Appearance is disheveled. Mucous membranes dry. Lungs clear and equal, heart rhythm regular.
During data collection, client states, “Can you ask that person to leave my room?” Client is pointing to an empty chair.
0230:
Client’s adult child arrived to the ED and went to client’s room. Client identified family member. Client is pacing and agitated, and states, “I don’t understand why I am here.” Adult child asks nurse to talk outside of room and states, “I don’t know why they are so confused. They are not normally like this.” Adult child states client has past medical history of hypertension and alcohol-related cirrhosis. Upon returning to room, client voided 250 mL of dark yellow, cloudy urine.
Question 4 of 5
The nurse has reviewed the nurses’ notes, provider’s note, and laboratory results at 0230. Exhibits For each client finding, click to specify if the finding is consistent with delirium or Alzheimer’s disease. Each finding may support more than one disease process.
| Options | Delirium | Alzheimer’s Disease |
|---|---|---|
| Agitation | ||
| Current medical diagnosis | ||
| Sudden onset of confusion | ||
| Hallucinations |
Correct Answer:
Rationale: Agitation (
A) and hallucinations (
D) occur in both; diagnosis (
B) of delirium and sudden confusion (
C) are delirium-specific, unlike Alzheimer’s gradual onset.
Extract:
Question 5 of 5
A nurse is reinforcing teaching about a new prescription for haloperidol with a client who has schizophrenia. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: D
Rationale: Photosensitivity is a haloperidol side effect; this shows understanding. Tinnitus (
A), incontinence (
B), and metallic taste (
C) are not typical.