ATI RN
ATI RN Mental Health 2023 Exam 3 Questions
Extract:
Medical History and Physical Examination
Neurological: The client is intoxicated, has slurred speech, and is unable to respond coherently 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 the client states they quit smoking over 20 years ago.
Gastrointestinal: The client reports weight loss over the past 3 months and minimal appetite.
Genitourinary: The client reports no known problems.
Impression:
Relapse of alcohol use disorder.
Plan:
Admit for alcohol use disorder and observe for alcohol withdrawal.
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
Day 2, 0800:
Temperature: 37.3°C (99.1°F)
Blood pressure: 198/86 mm Hg
Heart rate: 116/min
Respiratory rate: 22/min
Nurse’s Notes
The client was 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. The client has a history of alcohol use disorder for over 20 years. The 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. The client is currently unemployed after being laid off. The client’s family member states, “Everything combined caused the drinking to start again.” The family member estimates the client’s last drink was 2 hours ago. On Day 2 at 0800, the client is in the bathroom vomiting. The nurse assisted the client with oral and facial hygiene. The client states, “I feel awful.” The client is oriented, lethargic, and weak with visible hand shaking. The client reports they were up most of the night.
Diagnostic Results
Blood alcohol level (BAC): 310 mg/dL (0 to 50 mg/dL)
Question 1 of 5
A nurse is caring for a client who is experiencing alcohol withdrawal.Exhibits A nurse is planning care for a client who has alcohol use disorder. For each potential provider's prescription, specify if the potential prescription is anticipated or contraindicated for the client.
| Options | Anticipated | Contraindicated |
|---|---|---|
| Methadone 40 mg PO daily (Contraindicated) | ||
| Nutritional consult (Anticipated) | ||
| Perform AUDIT (Contraindicated) | ||
| Complete blood count and basic metabolic profile (Anticipated) | ||
| Group therapy (Anticipated) | ||
| Schedule ECT (Contraindicated) | ||
| Diazepam 10 mg PO three times a day (Anticipated) |
Correct Answer:
Rationale: Methadone (opioid), AUDIT (screening), ECT (depression), and propranolol (not first-line) are contraindicated. Nutritional consult, labs, group therapy, and diazepam (withdrawal management) are anticipated.
Extract:
Question 2 of 5
For which of the following adverse effects should a nurse monitor a client taking citalopram?
Correct Answer: B
Rationale: Decreased libido is a known adverse effect of citalopram, an SSRI. SSRIs can affect sexual function due to increased serotonin levels, leading to decreased libido, difficulty achieving orgasm, or erectile dysfunction. Urinary retention is not commonly linked to citalopram; bruising may occur rarely with bleeding risks but isn’t typical; and jaundice, indicating liver issues, is rare and not routine to monitor unless other risk factors are present.
Question 3 of 5
A nurse is caring for a client who has an anxiety disorder and is scheduled for a procedure. The client informs the nurse that they do not want to have the procedure. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Informing the client of their legal right to refuse treatment respects autonomy and empowers informed decision-making, addressing anxiety-related concerns. Encouragement may feel coercive, family consent is inappropriate unless the client is incompetent, and another nurse’s review doesn’t override refusal rights.
Question 4 of 5
A nurse is providing teaching to the caregiver of an older adult client who has Alzheimer's disease and is being cared for at home. The client wanders at night and has a history of previous falls. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
Correct Answer: B,C,E
Rationale: Sensors (
B), floor mattress (
C), and high locks (E) enhance safety against wandering and falls. A chair (
A) is impractical, and late activity (
D) may disrupt sleep.
Extract:
Medical History and Physical Examination
Neurological: The client is intoxicated, has slurred speech, and is unable to respond coherently 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 the client states they quit smoking over 20 years ago.
Gastrointestinal: The client reports weight loss over the past 3 months and minimal appetite.
Genitourinary: The client reports no known problems.
Impression:
Relapse of alcohol use disorder.
Plan:
Admit for alcohol use disorder and observe for alcohol withdrawal.
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
Day 2, 0800:
Temperature: 37.3°C (99.1°F)
Blood pressure: 198/86 mm Hg
Heart rate: 116/min
Respiratory rate: 22/min
Nurse’s Notes
The client was 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. The client has a history of alcohol use disorder for over 20 years. The 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. The client is currently unemployed after being laid off. The client’s family member states, “Everything combined caused the drinking to start again.” The family member estimates the client’s last drink was 2 hours ago. On Day 2 at 0800, the client is in the bathroom vomiting. The nurse assisted the client with oral and facial hygiene. The client states, “I feel awful.” The client is oriented, lethargic, and weak with visible hand shaking. The client reports they were up most of the night.
Diagnostic Results
Blood alcohol level (BAC): 310 mg/dL (0 to 50 mg/dL)
Question 5 of 5
A nurse is caring for a client who is experiencing alcohol withdrawal.Exhibits A nurse is planning care for a client who has alcohol use disorder. For each potential provider's prescription, specify if the potential prescription is anticipated or contraindicated for the client.
| Options | Anticipated | Contraindicated |
|---|---|---|
| Methadone 40 mg PO daily (Contraindicated) | ||
| Nutritional consult (Anticipated) | ||
| Perform AUDIT (Contraindicated) | ||
| Complete blood count and basic metabolic profile (Anticipated) | ||
| Group therapy (Anticipated) | ||
| Schedule ECT (Contraindicated) | ||
| Diazepam 10 mg PO three times a day (Anticipated) |
Correct Answer:
Rationale: Methadone (opioid), AUDIT (screening), ECT (depression), and propranolol (not first-line) are contraindicated. Nutritional consult, labs, group therapy, and diazepam (withdrawal management) are anticipated.