ATI RN
ATI RN Mental Health 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is caring for a client who just received lorazepam 1 mg IM for anxiety. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Initiate fall precautions for the client. Lorazepam is a benzodiazepine that can cause drowsiness, dizziness, and impaired coordination, increasing the risk of falls. Fall precautions, such as ensuring a safe environment, bed alarms, and assistance with ambulation, are essential to prevent injury. Instructing the client about ringing in the ears (choice
A) is not relevant to lorazepam administration. Placing the client in restraints (choice
B) is not necessary and can be considered a violation of the client's rights. Repeating the dose in 15 minutes (choice
D) is not recommended as it can lead to overdose.
Question 2 of 5
A nurse is visiting with the partner of a client who recently died. The partner expresses guilt that they did not do more for their partner. Which of the following responses should the nurse make?
Correct Answer: B
Rationale: The correct answer is B: 'It must be difficult for you to feel this way after losing your partner.' This response is empathetic and acknowledges the partner's feelings without invalidating them. It shows understanding and support without imposing judgment. Option A shares a personal experience, which may not be relevant or helpful to the partner. Option C is directive and may not be the partner's immediate need. Option D, though positive, may come across as dismissive of the partner's feelings.
Question 3 of 5
A nurse is caring for a client who has obsessive-compulsive personality disorder (OCPD). Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Preoccupation with details. Individuals with obsessive-compulsive personality disorder (OCP
D) often display an intense focus on perfectionism and rigid adherence to rules and details. This preoccupation can manifest in various aspects of their lives, such as work, relationships, and daily routines. This behavior is a key characteristic of OCPD and distinguishes it from other personality disorders.
Incorrect answers:
A: Lack of empathy - While individuals with OCPD may struggle with expressing emotions, the primary feature is not a lack of empathy.
C: Exploitative behavior - Exploitative behavior is not a typical feature of OCPD; it is more commonly associated with antisocial personality disorder.
D: Excessive clinging - Excessive clinging is not a characteristic of OCPD; it may be more indicative of dependent personality disorder.
Question 4 of 5
A nurse is caring for a client who has schizophrenia and is experiencing auditory hallucinations. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct answer is A: Ask the client what they are hearing. This is the first action the nurse should take to assess the nature and content of the auditory hallucinations. Understanding the hallucinations will help the nurse determine the level of distress the client is experiencing and develop an appropriate care plan.
Choice B: Focusing on reality-based topics may be helpful but should come after assessing the hallucinations to establish rapport and trust with the client.
Choice C: Taking the client for a walk outside may not address the immediate concern of the auditory hallucinations and may not be appropriate without first understanding the hallucinations.
Choice D: Encouraging the client to listen to music may not be helpful if the auditory hallucinations are distressing and could potentially exacerbate the symptoms.
Question 5 of 5
A nurse is caring for a client who has a depressive disorder. The client states, 'I don't always go to bed at night, so I get in trouble for falling asleep at work.' Which of the following interventions should the nurse recommend?
Correct Answer: C
Rationale: The correct answer is C: Keep a sleep diary to promote a consistent sleep schedule. This intervention is appropriate because it helps the client track their sleep patterns, identify any disruptions, and establish a routine for better sleep hygiene. By maintaining a sleep diary, the client and the nurse can pinpoint factors contributing to the sleep disturbances and work together to develop a plan to address them. This intervention focuses on addressing the underlying issue of inconsistent sleep patterns, which can be crucial in managing depressive symptoms.
Option A (Take a 1-hour nap every day) may not be the best choice as it could potentially further disrupt the client's sleep pattern and lead to difficulties falling asleep at night. Option B (Exercise late in the day, preferably before bedtime) may also not be ideal as exercising close to bedtime can actually stimulate the body and make it harder to fall asleep. Option D (Discontinue any medication until your sleep disruption is addressed) is inappropriate as abruptly stopping medication can have negative consequences and should only be done