ATI RN
ATI RN Mental Health 2023 III Questions
Extract:
Question 1 of 5
A nurse is caring for a client following a physical assault. The client states, I don't remember what happened to me. The nurse should recognize that the client is using which of the following defense mechanisms?
Correct Answer: B
Rationale: The correct answer is B: Repression. Repression is a defense mechanism where unpleasant or threatening thoughts or memories are pushed into the unconscious mind. In this scenario, the client's inability to remember the assault indicates that their mind is blocking out the traumatic event as a way to protect themselves from the emotional distress associated with it. Rationalization (
A) is when a person justifies their behavior, displacement (
C) is redirecting emotions to a substitute target, and denial (
D) is refusing to accept reality. In this case, repression is the most fitting defense mechanism as it aligns with the client's memory loss related to the assault.
Question 2 of 5
A nurse is interviewing a client who reports ongoing feelings of depression after the death of his sibling 9 months ago. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Explain to the client that the duration of grief is highly variable and can last for years. This is the most appropriate action because it acknowledges the client's feelings of depression and grief as valid and normal following the death of a loved one. By explaining the variability in the duration of grief, the nurse provides reassurance and validation to the client's experience. This approach helps in normalizing the client's emotions and promotes a sense of understanding and acceptance.
Choice A is incorrect because recommending solitary activities may worsen the client's depression by isolating them.
Choice C is incorrect as encouraging avoidance of discussing the death can hinder the client's grieving process.
Choice D is incorrect as cautioning against feeling angry can invalidate the client's emotions.
Question 3 of 5
A nurse in a mental health clinic is assessing a client who has borderline personality disorder. Which of the following findings should the nurse expect?
Correct Answer: D
Rationale: The correct answer is D: Intense efforts to avoid abandonment. Individuals with borderline personality disorder often exhibit a fear of abandonment, leading to frantic efforts to avoid real or imagined separation. This can manifest as clingy behavior, extreme emotional reactions to perceived rejection, and difficulty tolerating being alone. This finding is a hallmark of borderline personality disorder and is crucial for the nurse to assess and address in their care plan. The other options are incorrect because individuals with borderline personality disorder may actually have a strong desire for interpersonal relationships, may struggle with impulsivity and unstable sense of self rather than reluctance to discard objects, and may have difficulties with employment due to emotional dysregulation rather than inability to maintain employment.
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: C
Rationale: The correct answer is C: Failure to recognize familiar objects. In Alzheimer's disease, individuals often experience cognitive decline, including memory loss and difficulty recognizing familiar objects or people. This is due to the progressive deterioration of brain cells involved in memory and cognition. Altered level of consciousness (
A) is not typically a prominent feature of Alzheimer's disease, as individuals are usually awake and alert. Excessive motor activity (
B) is more commonly seen in conditions like mania or hyperactivity disorders, not specifically in Alzheimer's disease. Rapid mood swings (
D) may occur in some individuals with Alzheimer's, but failure to recognize familiar objects is a more characteristic feature.
Question 5 of 5
A nurse is caring for a client who has dementia and is experiencing anticipatory grief. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Encourage the client to express their feelings. This is crucial because allowing the client to talk about their emotions can help them process their grief and feel supported. Sharing personal stories (
B) may not be appropriate as it shifts the focus from the client. Providing a timeline (
C) for grieving is not effective as everyone grieves differently. Showing sympathy (
D) is important, but encouraging expression of feelings is more proactive in supporting the client.