Questions 70

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ATI RN Mental health 2019 NGN II Questions

Extract:


Question 1 of 5

A nurse is caring for a client who has alcohol use disorder and is experiencing withdrawal. The nurse should monitor the client for which of the following manifestations?

Correct Answer: D

Rationale: Hyperthermia is a common withdrawal symptom due to sympathetic overactivity requiring close monitoring.

Question 2 of 5

A nurse is assessing a client who has delirium. Which of the following findings requires immediate intervention by the nurse?

Correct Answer: A

Rationale: Command hallucinations which may instruct harmful actions require immediate intervention to ensure client safety.

Question 3 of 5

A nurse in a long-term care facility is caring for a client. The nurse should identify that which of the following conditions places the client at an increased risk for developing delirium?

Correct Answer: C

Rationale: An elevated WBC count suggests infection or inflammation common delirium triggers requiring attention.

Question 4 of 5

A nurse is preparing for an interprofessional team meeting regarding a newly admitted client who has major depressive disorder. Which of the following findings obtained during the initial assessment is the priority to report to other disciplines?

Correct Answer: D

Rationale: Psychomotor retardation may indicate severe depression or suicide risk requiring urgent team attention.

Question 5 of 5

A nurse is caring for a client who has borderline personality disorder and has been engaging in self-mutilation. The nurse should encourage the client to participate in which of the following groups?

Correct Answer: A

Rationale: Dialectical behavior therapy is specifically designed to address self-harm and emotional dysregulation in borderline personality disorder.

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