ATI RN
ATI RN Mental Health 2023 Exam 2 Questions
Extract:
Question 1 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.
Question 2 of 5
A nurse is obtaining a history from a client who has been taking olanzapine to treat schizophrenia. Which of the following questions should the nurse ask the client?
Correct Answer: C
Rationale: The correct answer is C: "Have you noticed an increase in thirst?" This question is relevant because olanzapine, an antipsychotic medication, can cause side effects like increased thirst due to its impact on the body's regulation of water balance. By asking this question, the nurse can assess for potential side effects of the medication and monitor for dehydration.
Choices A, B, and D are less relevant as they do not directly relate to common side effects of olanzapine.
Choice A about decreased taste is not a common side effect of olanzapine.
Choice B about ringing in the ears is more likely related to ototoxic medications.
Choice D about unintentional weight loss is not a common side effect of olanzapine, which is more commonly associated with weight gain.
Question 3 of 5
A nurse is assessing a client who has been receiving electroconvulsive therapy. Which of the following findings indicates the treatment is effective?
Correct Answer: D
Rationale: The correct answer is D: Improvement in manifestations of depression. Electroconvulsive therapy is primarily used to treat severe depression. Improvement in depressive symptoms indicates the treatment is effective. Decreased fear of heights (
A) is not a typical outcome of ECT. ECT is not used to treat seizures (
B). ECT may not directly target symptoms of borderline personality disorder (
C).
Question 4 of 5
A nurse is assessing a client who has a recent diagnosis of dissociative identity disorder. The client tells the nurse, 'I think my blackouts are actually caused by low blood sugar.' The nurse should recognize the client is using which of the following defense mechanisms?
Correct Answer: D
Rationale: The correct answer is D: Rationalization. The client is using rationalization by attributing their blackouts to low blood sugar instead of acknowledging the possibility of dissociative identity disorder. Rationalization is a defense mechanism where individuals justify their behaviors or feelings with logical explanations to avoid facing uncomfortable truths. In this scenario, the client is rationalizing their blackouts as a result of low blood sugar, which is a more socially acceptable reason compared to accepting the diagnosis of dissociative identity disorder.
Suppression (
A) involves consciously pushing unwanted thoughts or feelings out of awareness. Sublimation (
B) is redirecting unacceptable impulses into socially acceptable activities. Projection (
C) is attributing one's own thoughts or feelings onto others. In this case, the client is not using these defense mechanisms.
Question 5 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. The nurse should explain to the client that the duration of grief is highly variable and can last for years. This is important because grief is a complex and individual process that can take a significant amount of time to work through. By providing this information, the nurse can help the client understand that feeling depressed after 9 months is not uncommon and that it is okay to take the time needed to heal.
Choice A is incorrect because recommending more solitary activities may further isolate the client, exacerbating feelings of depression.
Choice C is incorrect as avoiding discussing the events surrounding the sibling's death may hinder the client's ability to process their grief.
Choice D is incorrect as cautioning the client against feeling angry at the sibling may invalidate the client's emotions.