ATI RN
ATI RN Mental Health Asn Questions
Extract:
Question 1 of 5
A nurse is admitting a client who has experienced a weight loss of 11 kg (25 lb) in the past 3 months. The client weighs 40 kg (88 lb) and believes she is fat. Which of the following aspects of care should the nurse consider the first priority for this client?
Correct Answer: A
Rationale: The correct answer is A: Identify the client's nutritional status. The priority is to assess the client's nutritional status due to the significant weight loss. This will help determine if the client is at risk of malnutrition or other health issues. B, requesting a mental health consult, is not the first priority as addressing the client's physical health is crucial before addressing mental health concerns. Planning a therapeutic diet (
C) can come after assessing the nutritional status. Providing a structured environment (
D) may be important but not as critical as determining the client's nutritional status first.
Question 2 of 5
A nurse is caring for an older adult client who had a cerebrovascular accident and has right-sided paralysis and aphasia. The client's son tells the nurse it is his fault because he did not insist that his mother live with him. Which of the following responses should the nurse make?
Correct Answer: A
Rationale:
Correct
Answer: A
Rationale:
A is the correct response because it acknowledges the son's feelings without dismissing or invalidating them. It shows empathy and understanding towards his guilt, opening up a conversation for further exploration of his emotions. It reflects active listening and validates his concerns.
Summary of Incorrect
Choices:
B: This response minimizes the son's feelings and does not address his sense of guilt, which can further exacerbate his emotional distress.
C: While this response provides reassurance, it does not address the son's feelings of guilt and may come off as dismissive.
D: This response acknowledges the son's feelings but does not directly validate his sense of responsibility, missing an opportunity for therapeutic communication.
Question 3 of 5
A nurse is assessing a client who has illness anxiety disorder. Which of the following findings should the nurse expect?
Correct Answer: D
Rationale: The correct answer is D because individuals with illness anxiety disorder experience persistent and excessive worry about having a serious medical condition despite reassurance from healthcare providers. This constant preoccupation with the possibility of being sick is a key characteristic of the disorder. Option A is incorrect as surgeries do not directly relate to illness anxiety disorder. Option B describes body dysmorphic disorder, not illness anxiety disorder. Option C does not align with the typical presentation of illness anxiety disorder.
Question 4 of 5
A nurse is caring for a client who was admitted with delirium tremens five days ago. The client seeks permission from the nurse before performing activities of daily living. This behavior indicates which of the following findings?
Correct Answer: D
Rationale: The correct answer is D: The client is exhibiting dependency. This behavior indicates that the client is relying on the nurse for permission before performing activities of daily living, suggesting a level of dependency. This is common in clients with delirium tremens as they may have cognitive impairment and need guidance for decision-making.
A: The client seeking permission does not necessarily indicate readiness for discharge.
B: The client seeking permission does not necessarily indicate ability to function independently.
C: There is no indication of a recurrence of delirium tremens based on seeking permission.
Summary: The correct answer, D, is supported by the client's behavior of seeking permission, indicating dependency. Other choices are incorrect as they do not align with the behavior exhibited by the client in this scenario.
Question 5 of 5
A nurse is caring for a client who has schizophrenia and is experiencing a variety of hallucinations. Which of the following hallucinations is the priority for the nurse to address?
Correct Answer: C
Rationale: The correct answer is C: Command hallucination. This is the priority because command hallucinations can pose a direct threat to the client or others if the commands are harmful or dangerous. Addressing command hallucinations promptly is crucial to ensure the safety of the client and those around them. Visual hallucinations (
A) may not necessarily lead to immediate harm. Gustatory hallucinations (
B) involve taste sensations and are not typically associated with imminent danger. Tactile hallucinations (
D) involve false perceptions of touch and are also less likely to result in immediate harm compared to command hallucinations.