ATI RN
ATI RN Mental Health 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has physical restraints applied. The nurse determines that the restraints should be removed when which of the following occurs?
Correct Answer: D
Rationale: The correct answer is D. When the client is able to follow commands, it indicates that they have regained control and are not a danger to themselves or others. This criterion ensures the safe removal of physical restraints.
Choice A is incorrect as orientation alone does not guarantee the client's safety.
Choice B is incorrect because medication refusal does not necessarily indicate safety.
Choice C is incorrect as the client's verbal threat of harm is not a reliable indicator of their actual intentions.
Question 2 of 5
A nurse is caring for a client who is scheduled for electroconvulsive treatment (ECT). The client states, 'I no longer want to have the treatment.' Which of the following statements would be an appropriate response from the nurse?
Correct Answer: C
Rationale:
Correct Answer: C
Rationale:
1. Respect for autonomy: Clients have the right to make decisions about their own treatment.
2. Advocacy: The nurse should communicate the client's decision to the provider.
3. Ethical principle: Upholding the client's right to refuse treatment is crucial in maintaining trust and promoting autonomy.
Summary:
A: Incorrect. Involuntary admission does not negate the client's right to refuse treatment.
B: Incorrect. Focusing on potential benefits disregards the client's autonomy.
D: Incorrect. Administering medication without addressing the client's refusal is unethical.
Question 3 of 5
A nurse is caring for a client who has a new diagnosis of metastatic lung cancer. The client states, 'I can't think about that until after my first grandchild is born next week.' The nurse should identify the client's statement as indicating the maladaptive use of which of the following defense mechanisms?
Correct Answer: A
Rationale: The correct answer is A: Suppression. Suppression involves consciously choosing to postpone dealing with thoughts, feelings, or impulses. In this scenario, the client is avoiding thoughts of their diagnosis by focusing on a future event. Compensation involves overemphasizing a trait to offset a perceived weakness. Regression involves reverting to an earlier stage of development. Sublimation involves channeling unacceptable impulses into constructive activities. In this case, the client's behavior aligns most closely with suppression, as they are consciously delaying thoughts about their diagnosis.
Question 4 of 5
A nurse is beginning a therapeutic relationship with a client. The nurse should plan to accomplish which of the following tasks during the working phase?
Correct Answer: B
Rationale: The correct answer is B: Evaluate progress toward predetermined goals. During the working phase of a therapeutic relationship, the nurse assesses the client's progress towards the goals set during the initial phase. This step is crucial in determining the effectiveness of the interventions and making adjustments as needed. Informing the client about confidentiality rights (choice
A) is important in the orientation phase. Establishing boundaries (choice
C) is relevant in the introductory phase. Setting short- and long-term objectives (choice
D) is typically done in the initial phase.
Question 5 of 5
A nurse is caring for a client who has been taking quetiapine for 1 week and reports dizziness. The client asks the nurse if the dizziness indicates an allergic reaction to the medication. Which of the following responses should the nurse make?
Correct Answer: D
Rationale: The correct answer is D: "Dizziness is a common adverse effect of the medication and is related to low blood pressure." Quetiapine, an antipsychotic medication, commonly causes dizziness as a side effect due to its potential to lower blood pressure. This response educates the client about a known side effect of the medication and provides a logical explanation for the dizziness.
Rationale for Incorrect
Choices:
A: Incorrect. Taking the medication with a meal may help reduce gastrointestinal side effects but is not directly related to dizziness.
B: Incorrect. Dizziness does not necessarily indicate an allergic response, and stopping the medication abruptly without consulting a healthcare provider can be dangerous.
C: Incorrect. The timing of medication administration does not directly affect the occurrence of dizziness associated with quetiapine.
By providing education on the common adverse effect of quetiapine and its relation to dizziness, the nurse empowers the client with knowledge and promotes safe medication management.