ATI RN
ATI RN Mental Health 2023 Exam 3 Questions
Extract:
Nurses’ Notes
1100: Client is alert and oriented x 4. The client exhibits positive self-esteem. No negativity noted during conversation. Preparing client for discharge to partial-hospitalization program.
1230: Client requests a smoked turkey club sandwich for lunch. Education regarding medications provided.
Medical History
Client has a history of major depressive disorder.
Medication Administration Record
Selegiline 5 mg PO twice daily
Question 1 of 5
A nurse is caring for a client on an acute care mental health unit. Exhibits:The nurse is providing discharge education to the client about their medication. Drag 1 condition and 1 client finding to fill in each blank in the following sentence.When educating the client about their medication, the nurse should teach the client that there is a risk for ___ due to ___.
Correct Answer: A,B
Rationale: Selegiline (MAOI) risks hypertensive crisis with tyramine-rich foods (e.g., smoked meats), causing dangerous BP spikes.
Extract:
History & Physical
Neurological: Client is intoxicated, has slurred speech, and is unable to coherently respond 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 client states they quit smoking over 20 years ago.
Gastrointestinal: Client reports weight loss over the past 3 months and minimal appetite.
Genitourinary: Client reports no known problems.
Impression:
Relapse of alcohol use disorder.
Plan:
Admit for alcohol use disorder and observe for alcohol withdrawal.
Diagnostic Results
Blood alcohol level (BAC) 310 mg/dL (0 to 50 mg/dL)
Provider Prescriptions
Perform Alcohol Use Disorders Identification Test (AUDIT)
Complete blood count
Basic metabolic profile
Nutrition consultation
Consult counselor for grief therapy
Substance use group therapy
Diazepam 10 mg PO three times a day
Propranolol 40 mg PO twice a day
Metoclopramide 10 mg IM every 6 hr PRN nausea and/or vomiting
Nurses’ Notes
Client 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.’
Client has a history of alcohol use disorder for over 20 years.
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.
Client is currently unemployed after being laid off.
Client’s family member states, 'Everything combined caused the drinking to start again.’
Family members estimate the client’s last drink was 2 hours ago.
Vital Signs
Admission, 1600:
•
o Temperature: 36.1°C (97°F)
o Blood pressure: 98/66 mm Hg
o Heart rate: 76/min
o Respiratory rate: 10/min
o Pulse oximetry: 95% on room air
Day 2, 0800:
•
o Temperature: 37.3°C (99.1°F)
o Blood pressure: 198/86 mm Hg
o Heart rate: 116/min
o Respiratory rate: 22/min
Hospital day 5, 0800:
•
o Temperature: 36.1°C (97°F)
o Blood pressure: 128/66 mm Hg
o Heart rate: 74/min
o Respiratory rate: 12/min
o Pulse oximetry: 96% on room air
Question 2 of 5
A nurse is reviewing the day 5 vital signs and nurse’s notes.A nurse is evaluating the client’s response to treatment. Select the 4 findings that indicate the client is progressing with their plan of care.
Correct Answer: B,C,D,E
Rationale: Group therapy (
B), improved appetite (
C), cognition (
D), and stable vitals (E) show progress in alcohol use disorder treatment. Self-reported alcohol reduction (
A) is unreliable, and grief stages (F) are subjective.
Extract:
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
Diagnostic Results
Blood alcohol level (BAC): 310 mg/dL (0 to 50 mg/dL)
History & Physical
Neurological: Client is intoxicated, has slurred speech, and is unable to coherently respond 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 client states they quit smoking over 20 years ago.
Gastrointestinal: Client reports weight loss over the past 3 months and minimal appetite.
Genitourinary: Client reports no known problems.
Impression: Relapse of alcohol use disorder.
Plan: Admit for alcohol use disorder and observe for alcohol withdrawal.
Nurses’ Notes
Client 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.”
Client has a history of alcohol use disorder for over 20 years.
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.
Client is currently unemployed after being laid off.
Client’s family member states, “Everything combined caused the drinking to start again.”
Family member estimates the client’s last drink was 2 hours ago.
Question 3 of 5
A nurse in a mental health facility is admitting a client.Exhibits:Complete the following sentence by using the lists of options. The client is at risk for developing ___ as evidenced by the client's ___.
Correct Answer: A,B
Rationale: The client’s history of heavy alcohol use increases withdrawal risk when intake stops, evidenced by prior consumption patterns.
Extract:
Question 4 of 5
A nurse is providing discharge teaching about the manifestations of relapse to the family of a client who has schizophrenia. Which of the following information should the nurse include in the teaching?
Correct Answer: A
Rationale: Excessive sleep or a significant change in sleep patterns can be an indicator of a relapse in schizophrenia. Schizophrenia can disrupt the regular sleep-wake cycle, leading to either insomnia or hypersomnia. When a client begins sleeping more than usual, it may suggest a worsening of symptoms or an impending relapse. This is a critical sign for the family to monitor, as opposed to concentration issues (which are common but less specific), an inflated sense of self (more tied to mania or grandiose delusions not typical of schizophrenia relapse), or increased social activity (which is generally positive and not a relapse sign).
Question 5 of 5
A nurse observes the caregiver of a client who has Alzheimer's disease throwing magazines on the floor and crying. Which of the following actions should the case manager take first?
Correct Answer: D
Rationale: Offering to talk with the caregiver about their feelings is the most immediate and direct way to provide support. It addresses the caregiver’s current emotional distress by providing an outlet through active listening and empathy, which can alleviate immediate stress. This step precedes teaching relaxation techniques (preventive rather than immediate), referrals to support groups (long-term support), or consulting social services (a follow-up action), making it the priority in this acute emotional crisis.