ATI RN
ATI RN Mental Health 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is assessing a client who has post-traumatic stress disorder (PTSD). Which of the following findings should the nurse expect? (Select all that apply)
Correct Answer: A,D,E
Rationale: The correct answers are A, D, and E. A client with PTSD often holds persistent negative beliefs about themselves (
A) due to the trauma experienced. Difficulty falling or staying asleep (
D) is a common symptom of PTSD, as the client may experience nightmares or intrusive thoughts. Difficulty concentrating on set tasks (E) is another common finding, as the client may be easily distracted by triggers or memories related to the trauma. Talks excessively (
B) and blames others for own mistakes (
C) are not typical symptoms of PTSD and are more indicative of other conditions or personality traits.
Question 2 of 5
A nurse is teaching a client who is about to start taking fluoxetine. The nurse should instruct the client that which of the following supplements interacts adversely with fluoxetine?
Correct Answer: A
Rationale: The correct answer is A: St. John's wort. St. John's wort is an herbal supplement that can interact adversely with fluoxetine, a selective serotonin reuptake inhibitor (SSRI), leading to serotonin syndrome. This occurs due to the combination of both substances increasing serotonin levels in the brain excessively, causing symptoms like confusion, agitation, rapid heart rate, and high blood pressure. Soy protein (
B), Echinacea (
C), and Ginkgo biloba (
D) do not have known significant interactions with fluoxetine.
Extract:
Medical History and Physical Examination
Neurological: The client is intoxicated, has slurred speech, and is unable to respond coherently to questions.
Cardiovascular: Normal sinus rhythm and pulses palpable. No history of heart disease.
Respiratory: Chest clear to auscultation and no shortness of breath noted. No history of respiratory disorders and the client states they quit smoking over 20 years ago.
Gastrointestinal: The client reports weight loss over the past 3 months and minimal appetite.
Genitourinary: The client reports no known problems.
Impression:
Relapse of alcohol use disorder.
Plan:
Admit for alcohol use disorder and observe for alcohol withdrawal.
Vital Signs
Admission, 1600:
Temperature: 36.1°C (97°F)
Blood pressure: 98/66 mm Hg
Heart rate: 76/min
Respiratory rate: 10/min
Pulse oximetry: 95% on room air
Day 2, 0800:
Temperature: 37.3°C (99.1°F)
Blood pressure: 198/86 mm Hg
Heart rate: 116/min
Respiratory rate: 22/min
Nurse’s Notes
The client was brought in by a family member who states that the client has been drinking ‘nonstop’ since the death of the client’s parents 3 months ago. The client has a history of alcohol use disorder for over 20 years. The client attended an inpatient rehabilitation program 5 years ago and remained sober until several months ago when both parents died. According to the client’s family member, the client has been unable to cope with the sudden death of their parents. The client is currently unemployed after being laid off. The client’s family member states, “Everything combined caused the drinking to start again.” The family member estimates the client’s last drink was 2 hours ago. On Day 2 at 0800, the client is in the bathroom vomiting. The nurse assisted the client with oral and facial hygiene. The client states, “I feel awful.” The client is oriented, lethargic, and weak with visible hand shaking. The client reports they were up most of the night.
Diagnostic Results
Blood alcohol level (BAC): 310 mg/dL (0 to 50 mg/dL)
Question 3 of 5
A nurse is caring for a client who is experiencing alcohol withdrawal.Exhibits A nurse is planning care for a client who has alcohol use disorder. For each potential provider's prescription, specify if the potential prescription is anticipated or contraindicated for the client.
| Options | Anticipated | Contraindicated |
|---|---|---|
| Methadone 40 mg PO daily (Contraindicated) | ||
| Nutritional consult (Anticipated) | ||
| Perform AUDIT (Contraindicated) | ||
| Complete blood count and basic metabolic profile (Anticipated) | ||
| Group therapy (Anticipated) | ||
| Schedule ECT (Contraindicated) | ||
| Diazepam 10 mg PO three times a day (Anticipated) |
Correct Answer:
Rationale:
Correct Answer:
Rationale:
- Methadone is contraindicated as it may worsen the client's condition due to its potential for respiratory depression.
- Nutritional consult is anticipated to address potential malnutrition and vitamin deficiencies common in alcohol use disorder.
- Performing AUDIT is contraindicated as it may not be appropriate during acute alcohol withdrawal.
- Complete blood count and basic metabolic profile are anticipated to assess for any alcohol-related complications.
- Group therapy is anticipated to provide social support and coping skills.
- Schedule ECT is contraindicated as it is not indicated for alcohol withdrawal.
- Diazepam is anticipated to manage alcohol withdrawal symptoms.
Extract:
Question 4 of 5
A nurse is leading a crisis intervention group for adolescents who witnessed the suicide of a classmate. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct answer is A: Identify prior coping skills. This should be the first action because understanding the adolescents' coping mechanisms will help tailor the crisis intervention effectively. By knowing their prior coping skills, the nurse can build on what has worked well for them in the past. This approach is client-centered and empowers the adolescents to utilize their strengths during this difficult time. Reviewing community resources (
B) can come later once the immediate needs are addressed. Discussing confidentiality (
C) is important but not the priority in a crisis situation. Initiating referrals (
D) may be necessary eventually but should follow understanding the adolescents' coping skills to ensure appropriate referrals are made.
Question 5 of 5
A nurse is preparing for an interprofessional meeting to discuss the plan of care for a client. Which of the following information should the nurse plan to communicate to a social worker?
Correct Answer: C
Rationale: The correct answer is C because informing the social worker that the client will be unable to return home after discharge is essential for coordinating appropriate post-discharge care, such as arranging alternative living arrangements or support services. This information is crucial for the social worker to address the client's social and environmental needs.
Choice A is incorrect because difficulty remembering food restrictions is more relevant to the healthcare team managing the client's medical needs, not specifically the social worker.
Choice B is incorrect as addressing frustration with finding an activity relates more to the client's emotional well-being and may be better suited for a counselor or occupational therapist.
Choice D is incorrect as discussing changes in spiritual beliefs is typically more appropriate for a chaplain or spiritual counselor.