ATI RN
ATI Mental Health 2023 II Questions
Extract:
Question 1 of 5
A nurse in an emergency department is assessing a client who reports recently using cocaine. Which of the following clinical manifestations should the nurse expect?
Correct Answer: B
Rationale: Cocaine, a stimulant, increases blood pressure via sympathetic activation. It causes tachycardia (not bradycardia), alertness (not lethargy), and hyperthermia (not hypothermia).
Question 2 of 5
A nurse is assessing a client who has post-traumatic stress disorder. Which of the following findings should the nurse expect? (Select all that apply.)
Correct Answer: A,C,E
Rationale: Sleep issues (
A), negative self-beliefs (
C), and concentration difficulty (E) are PTSD symptoms. Excessive talk (
B) and blaming (
D) are not typical.
Question 3 of 5
A nurse is planning care for a client who has borderline personality disorder. Which of the following interventions should the nurse plan to include to assist the client with impaired social interactions with others?
Correct Answer: B
Rationale: Exploring abandonment addresses BPD’s core issue, aiding social skills. Dependency reinforces issues, avoiding discussion stalls progress, same staff risks attachment.
Question 4 of 5
A nurse in an emergency department is assessing a client who reports recently using cocaine. Which of the following clinical manifestations should the nurse expect?
Correct Answer: B
Rationale: Cocaine, a stimulant, increases blood pressure via sympathetic activation. It causes tachycardia (not bradycardia), alertness (not lethargy), and hyperthermia (not hypothermia).
Extract:
Physical Examination
Day 1 0900:
A client who has a urinary tract infection is admitted for treatment with IV antibiotics. The client is alert and oriented x3. Respirations are equal and unlabored bilaterally. S1 and S2 heart tones noted upon auscultation. Client has hearing loss and wears glasses. Abdomen is soft with suprapubic pain on palpation rated as a 4 on a scale of 0 to 10. Client reports three episodes of urinary incontinence. Bowel sounds active in all four quadrants. Able to move all extremities.
Vital Signs
Day 1 0915:
Temperature 37.3° C (99.1° F)
Heart rate 90/min
Respiratory rate 15/min
Blood pressure 130/76 mm Hg
Oxygen saturation 97% on room air
Day 1 1900:
Temperature 37.3° C (99.1° F)
Heart rate 99/min
Respiratory rate 16/min
Blood pressure 136/88 mm Hg
Oxygen saturation 98% on room air
Nurses' Notes
Day 1 1900:
The client is alert and is oriented to person, with confusion about time and place. Client is unable to focus. The client exhibits agitation upon assessment. Client states they do not remember coming to the facility, and they are late for a provider's appointment. Reorientation to environment initiates anxiety and worsens the agitation.
Question 5 of 5
Upon assessment, the nurse should recognize that the client is at risk for developing ___ as evidenced by the client’s ___
Correct Answer: A,B
Rationale: UTI and disorientation (alert x3) increase delirium risk in older adults.