ATI RN
ATI RN Mental Health 2023 Exam 2 Questions
Extract:
Provider Prescriptions
• Olanzapine 10 mg tablet PO daily
• Alprazolam 1 mg tablet PO three times daily PRN anxiety
Nurses’ Notes
Client reports hearing voices that are talking about race cars and race tracks. Client appears diaphoretic and pale. Client reports weight gain of 2.2 kg (4.9 lb) in the past week.
Graphic Record
• BP 128/82 mmHg
• Pulse rate 98/min
• Respiratory rate 20/min
• Temperature 39.4° C (103° F)
• SaO2 95%
Question 1 of 5
A nurse is assessing a client who has schizophrenia. Which of the following findings should the nurse report to the provider? (Click on the “Exhibit” button for additional information about the client. There are three tabs that contain separate categories of data.)
Correct Answer: A
Rationale: The correct answer is A: Temperature. The nurse should report temperature findings to the provider as it can indicate potential infection or other medical issues. Elevated temperature can be a sign of infection which could exacerbate the client's schizophrenia symptoms. Blood pressure (
B) and weight gain (
C) may be important but are not as urgent as temperature in this scenario. Hallucinations (
D) are a symptom of schizophrenia and should be addressed by the nurse but are not typically reported to the provider as they are expected in this client population.
Extract:
Question 2 of 5
A nurse is planning to lead a support group for clients who have alcohol use disorder. One of the group members is a client who speaks a different language than the nurse. The nurse should ask which of the following individuals to assist with communication?
Correct Answer: B
Rationale: The correct answer is B: A translator of the same gender as the client. This choice ensures effective communication while also considering the cultural and gender preferences of the client. The translator will facilitate accurate exchange of information, maintaining confidentiality.
Choice A, a unit secretary, may not have the necessary skills for translation.
Choice C, another client, may not be reliable or appropriate to maintain professional boundaries.
Choice D, a family member, may introduce bias or confidentiality concerns.
Question 3 of 5
A charge nurse is discussing the care of a client who has a substance use disorder with a staff nurse. Which of the following statements by the staff nurse should the charge nurse identify as countertransference?
Correct Answer: A
Rationale:
Correct Answer: A
Rationale: Statement A reflects countertransference as it indicates a personal connection between the nurse and the client based on the nurse's past experience with their brother. This can lead to biased care.
Summary:
- Statement B is focused on the client's responsibility.
- Statement C is about the client's behavior during therapy.
- Statement D is about the client's request for a date with the nurse, which is boundary crossing.
Question 4 of 5
A nurse is caring for a client who has Alzheimer's disease. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Failure to recognize familiar objects. In Alzheimer's disease, individuals experience cognitive decline, including memory loss and difficulty recognizing familiar objects or people. This is due to brain changes affecting memory and perception. Excessive motor activity (
A) is not typically a hallmark of Alzheimer's; rather, individuals may have decreased motor skills. Rapid mood swings (
C) are more commonly seen in mood disorders, not specific to Alzheimer's. Altered level of consciousness (
D) is not a primary feature of Alzheimer's; individuals may have periods of confusion but usually remain conscious.
Question 5 of 5
A nurse is caring for a client who begins yelling and pacing around the room. Which of the following actions should the nurse take? (Select all that apply.)
Correct Answer: A,B
Rationale:
Correct Answer: A, B
Rationale:
A: Identifying the client's stressors is important to understand the underlying cause of the behavior and helps in addressing the root issue.
B: Talking to the client using short, simple sentences can help in de-escalating the situation and ensuring effective communication.
C: Speaking to the client in a loud voice may escalate the situation further by increasing agitation and aggression.
D: Requesting security guards to restrain the client should be a last resort and may lead to physical harm and trauma.
E: Standing directly in front of the client can be perceived as confrontational and may escalate the situation further.