ATI RN
ATI RN Mental Health 2023 with NGN Questions
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 1 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: Denial of future violence (
A) worsens psychologically, social worker (
B) and safety plan (
D) improve, less pain (
C) improves physically, blaming self (E) worsens.
Extract:
Question 2 of 5
A nurse is caring for a client who has obsessive-compulsive personality disorder (OCPD). Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: Preoccupation with details is a hallmark of OCPD. Individuals with this disorder have an excessive concern with orderliness, perfectionism, and control over their environment and tasks. Lack of empathy, exploitative behavior, and excessive clinging are not typical OCPD traits. (Note: This is a repeat of Question 2 with an unrelated explanation about ACT, likely a document error; correct rationale applied.)
Question 3 of 5
A nurse is assessing a client who has been receiving electroconvulsive therapy (ECT). Which of the following findings indicates the treatment is effective?
Correct Answer: D
Rationale: ECT is most effective for severe depression, improving symptoms like mood and sleep. It’s not standard for BPD, phobias, or seizure reduction (it induces seizures).
Question 4 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: Guided imagery calms anxiety, aiding sleep. Forcing sleep increases frustration, heavy meals disrupt rest, and sleep restriction worsens anxiety.
Question 5 of 5
A nurse is providing teaching for a client who has an alcohol use disorder. Which of the following statements should the nurse make to help prevent relapse?
Correct Answer: A
Rationale: Listing negative effects reinforces motivation to stay sober by highlighting consequences. 'As needed' lacks structure, lorazepam risks dependence, and familiar places may trigger cravings.