ATI LPN
LPN Custom Mental Health Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has bipolar disorder and states that his latest computer project is 'revolutionizing the industry.' Which of the following behaviors is the client exhibiting?
Correct Answer: A
Rationale: Grandiosity. Grandiosity is a symptom commonly seen in the manic phase of bipolar disorder. It involves an inflated sense of self-importance, unrealistic beliefs in one's abilities, and a perception of being involved in activities that are revolutionary or of great significance. In this scenario, the client's statement about revolutionizing the industry reflects grandiosity. Clang associations involve the association of words based on sound rather than meaning and are often seen in individuals with thought disorders. Flight of ideas refers to a rapid flow of thoughts, often manifested by speech that is difficult to interrupt, with topics changing rapidly. Confabulation is the creation of false or distorted memories without the intention to deceive. It is not a characteristic behavior of mania in bipolar disorder.
Question 2 of 5
A nurse observes a client sitting alone in her room crying. As the nurse approaches her, the client states, 'I'm feeling sad. I don't want to talk now.' Which of the following responses should the nurse make?
Correct Answer: C
Rationale: It will help you feel better if you talk about it.' While talking can be therapeutic, pushing the client to talk when they're not ready may be counterproductive and increase their distress. 'Come on out and get involved with the game the other clients are playing.' Encouraging the client to engage in activities may not be suitable when she is expressing a need for solitude and is not ready to participate. 'I'll stay with you for a few minutes.' This response reflects the nurse's willingness to provide support without pressuring the client to talk. It acknowledges the client's feelings and offers a comforting and nonintrusive presence. It respects the client's desire for solitude while still showing empathy and availability. 'I'll come back when you feel like talking.' This response leaves the client alone, which may be appropriate if that's what the client prefers. However, offering to stay for a few minutes communicates immediate support without pressure.
Question 3 of 5
A nurse is collecting data from a client admitted to an inpatient mental health unit and has a new prescription for disulfiram (Antabuse). Which of the following information is most important for the nurse to obtain before administering this medication?
Correct Answer: D
Rationale: History of kidney disease is not as critical for disulfiram administration. The primary concern is related to hepatic metabolism. When the client last drank alcohol is relevant information, but it is not the most critical factor to consider before administering disulfiram. The primary mechanism of disulfiram is to inhibit the breakdown of acetaldehyde, leading to an unpleasant reaction if alcohol is consumed, regardless of when the client last drank. Whether the client has taken disulfiram before is important information, but it does not take precedence over the assessment of liver function. The history of liver disease is more directly related to the potential risks and adverse effects associated with disulfiram use. History of liver disease is crucial to assess before administering disulfiram because disulfiram is metabolized in the liver. Patients with a history of liver disease may have impaired liver function, and the medication may not be well-tolerated or could exacerbate existing liver issues.
Question 4 of 5
A nurse is collecting data from a newly-admitted client who has bipolar disorder and is displaying manic behavior. Which of the following findings should the nurse expect? (Select all that apply.)
Correct Answer: A,B,D,E
Rationale: A. Exhibiting clang associations: Correct. Clang associations involve the repetition of words or phrases based on sound rather than meaning and are often seen in manic states. B. Interacting with others in a flirtatious way: Correct. Manic individuals may exhibit increased social and sexual behaviors, including being flirtatious. C. Reports sleeping for long periods of time: Incorrect. Manic episodes are typically associated with decreased need for sleep rather than increased. Reports of sleeping for long periods would be more indicative of a depressive episode in bipolar disorder. D. Talking in rapid continuous speech: Correct. Rapid and continuous speech is a common characteristic of manic episodes in bipolar disorder. E. Reports spending large sums of money: Correct. Excessive spending is a common manifestation of manic behavior, often without consideration of the consequences.
Question 5 of 5
A nurse in a mental health facility is caring for a client who becomes upset and breaks a chair when a visitor does not arrive. The client remains agitated following initial verbal attempts to calm him down. Which of the following interventions should the nurse implement first?
Correct Answer: C
Rationale: Planning with the client for how he can better handle frustration (option
A) is a valuable intervention, but it may not be immediately effective in the midst of heightened agitation. It is better suited for a calmer, more reflective time. Placing the client in a monitored seclusion room until he is calm (option
B) is an option for managing extreme agitation, but it should be used cautiously and as a last resort. Offering medication and attempting verbal de-escalation are generally preferable initial steps. Offer the client an antianxiety medication. When dealing with a client who is agitated and potentially escalating to a more volatile state, offering an antianxiety medication can be a helpful and immediate intervention to manage acute distress. It can aid in calming the client down and create an environment where other therapeutic interventions can be more effectively implemented. Restraining the client to prevent injury to himself or others (option
D) is a highly invasive intervention and should only be considered when there is an imminent risk of harm to the client or others. It is generally not the first choice in managing agitation due to its potential negative impact on the therapeutic relationship and the client's well-being.