ATI RN
ATI RN Mental Health 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is beginning a therapeutic relationship with a client. The nurse should plan to accomplish which of the following tasks during the working phase?
Correct Answer: B
Rationale: During the working phase, the nurse’s primary task is to evaluate progress toward predetermined goals. This phase focuses on active problem-solving and assessing intervention effectiveness, crucial for addressing the client’s issues. Confidentiality and boundaries are set in the orientation phase, while objectives may be adjusted but are primarily established earlier.
Question 2 of 5
A nurse is caring for a client who has right-sided hemiplegia following a recent stroke. Which of the following questions should the nurse ask to determine the client's ability to cope?
Correct Answer: D
Rationale: How has this impacted your life?' is open-ended, allowing the client to express feelings and coping strategies, providing insight into their emotional adaptation. 'Why' may induce guilt, 'Are you okay' is insensitive, and hygiene support assesses practical needs, not coping.
Extract:
Nurse’s Notes
2000:
Client presents to the triage desk accompanied by a friend. The client states, “I need help. I was raped about an hour ago.” The client’s friend states, “I think they may have been drugged.” Allergies: penicillin, doxycycline Physical exam: General: exhibits anxiety Respiratory: breath sounds clear Cardiovascular: S1, S2, no murmur Abdomen: soft, mildly tender Skin: bruising to upper arms bilaterally, broken fingernails
Diagnostic Results
2030:
Urine drug screen: GHB (gamma-hydroxybutyric acid): positive
Vital signs
2015:
Blood pressure: 128/88 mm Hg
Heart rate: 80/min
Respiratory rate: 16/min
Temperature: 37°C (98.6°F)
Weight: 67.1 kg (147.9 lbs.)
Question 3 of 5
The nurse is continuing to care for the patient in the emergency department.Which findings should the nurse identify as potential complications of the client’s diagnostic results? Select all that apply.
Correct Answer: A,B,E,F
Rationale: GHB, suspected here, causes nausea/vomiting (
A), confusion (
B), amnesia (E), and respiratory depression (F) due to CNS depression. Tachycardia (
C) isn’t typical (bradycardia is), and hypothermia (
D) isn’t linked.
Extract:
Question 4 of 5
A nurse in a mental health facility is caring for a group of clients. After assessing the clients, which of the following clients requires an update to their plan of care to ensure client safety?
Correct Answer: C
Rationale: A client with bipolar disorder exhibiting poor impulse control presents an immediate safety concern. Poor impulse control can lead to risky behaviors, self-harm, or harm to others, necessitating an urgent update to the care plan with safety measures like close supervision or medication adjustments. Anorexia-related fear of weight gain requires monitoring but not immediate safety updates; tangential speech in schizophrenia is a symptom managed through ongoing care; and memory issues in Alzheimer’s, while distressing, don’t typically pose an immediate safety risk.
Extract:
Physical Examination
• Height: 152.4 cm (60 in)
• Weight: 36.7 kg (81 lb)
• BMI: 15.8
• Lanugo
• Decreased skin turgor
• Cold extremities
• Russell’s sign
• Hair loss
• Erosion of teeth enamel
• Client report of constipation
Vital Signs
• Heart rate: 44/min
• Respiratory rate: 20/min
• BP: 86/50 mm Hg
• Temperature: 36.2° C (97.2° F)
Medical History
The client is 18 years old and is being admitted into the inpatient eating disorder clinic. The client has had a history of anorexia nervosa since age 16. BMI has fluctuated from 15 to 19 over the past 3 years. The client reports restricting caloric intake to 400 cal/day, fasting, and dieting. The client also reports frequent episodes of binge eating, self-induced vomiting, frequent laxative use, and exercising three times per day, every day. The client states, “I am so fat. No matter what I do, I can’t get skinny or lose enough weight.” The client’s guardian reports that the client is a perfectionist and has obsessive thoughts related to food and diet.
Question 5 of 5
A nurse is initiating the plan of care for a client who has anorexia nervosa.Exhibits:Complete the following sentence by using the lists of options. The nurse should first address the client's ___ followed by the client's ___.
Correct Answer: A,B
Rationale: Bradycardia (44/min) is life-threatening in anorexia due to malnutrition, requiring immediate attention, followed by dehydration (skin turgor) to stabilize.