ATI RN
ATI Mental Health 2023 II Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is taking citalopram. For which of the following adverse effects should the nurse monitor the client?
Correct Answer: B
Rationale: Decreased libido is a common SSRI (citalopram) effect. Jaundice, bruising, and retention are less typical.
Question 2 of 5
An older adult client is brought to the mental health clinic by her daughter. The daughter reports that her mother is not eating and seems uninterested in routine activities. The daughter states, 'I’m so worried that my mother is depressed.' Which of the following responses should the nurse make?
Correct Answer: D
Rationale: Open-ended question gathers info empathetically. Others minimize or generalize.
Extract:
Physical Examination
Day 1 0900:
A client who has a urinary tract infection is admitted for treatment with IV antibiotics. The client is alert and oriented x3. Respirations are equal and unlabored bilaterally. S1 and S2 heart tones noted upon auscultation. Client has hearing loss and wears glasses. Abdomen is soft with suprapubic pain on palpation rated as a 4 on a scale of 0 to 10. Client reports three episodes of urinary incontinence. Bowel sounds active in all four quadrants. Able to move all extremities.
Vital Signs
Day 1 0915:
Temperature 37.3° C (99.1° F)
Heart rate 90/min
Respiratory rate 15/min
Blood pressure 130/76 mm Hg
Oxygen saturation 97% on room air
Day 1 1900:
Temperature 37.3° C (99.1° F)
Heart rate 99/min
Respiratory rate 16/min
Blood pressure 136/88 mm Hg
Oxygen saturation 98% on room air
Nurses' Notes
Day 1 1900:
The client is alert and is oriented to person, with confusion about time and place. Client is unable to focus. The client exhibits agitation upon assessment. Client states they do not remember coming to the facility, and they are late for a provider's appointment. Reorientation to environment initiates anxiety and worsens the agitation.
Question 3 of 5
Upon assessment, the nurse should recognize that the client is at risk for developing ___ as evidenced by the client’s ___
Correct Answer: A,B
Rationale: UTI and disorientation (alert x3) increase delirium risk in older adults.
Extract:
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
Hospital day 5,0800:
• Temperature 36.1° C (97° F)
• Blood pressure 128/66 mm Hg
• Heart rate 74/min
• Respiratory rate 12/min
Nurses' Notes
Client 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."
Client has a history of alcohol use disorder for over 20 years.
Client attended 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.
Client is currently unemployed after being laid off.
Client's family member states, "Everything combined caused the drinking to start again." Family member estimates the client's last drink was 2 hr ago.
Day 2, 0800:
Client is in the bathroom vomiting. Assisted the client with oral feeding and he has a good appetite.
He resolves to limit his alcohol intake moving forward. He has currently accepted the news about his parents demise and is attending group therapy.
Question 4 of 5
A nurse is evaluating the client’s response to treatment. Select the 4 findings that indicate the client is progressing with their plan of care.
Correct Answer: A,B,D,E
Rationale: Appetite (
A), grief acceptance (
B), therapy (
D), and resolve (E) show progress. Cognition lacks evidence.
Extract:
Question 5 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: Working phase evaluates goal progress. Confidentiality, boundaries, and objectives occur earlier.