ATI RN
ATI RN Mental Health 2023 Exam 2 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who states, 'I am too embarrassed to tell anyone what I did last night.' Which of the following responses should the nurse make?
Correct Answer: A
Rationale: The correct answer is A: Let's discuss what you feel embarrassed about. This response demonstrates active listening and empathy, encouraging the client to open up about their feelings without judgment. It shows support and willingness to help address the underlying issue.
Choice B is incorrect as it may pressure the client to disclose information prematurely.
Choice C is dismissive and does not validate the client's feelings.
Choice D generalizes and does not address the client's specific situation.
Extract:
Provider’s Note
0230:
Client diagnosis: Delirium secondary to a urinary tract infection and dehydration.
Vital Signs
0200:
Temperature 38.6° C (101.5° F)
Heart rate 104/min
Respiratory rate 18/min
Blood pressure 158/96 mm Hg
Oxygen saturation 98% on room air
Nurses’ Notes
0205:
Client brought to the ED by police after being found wandering on the street. Client able to provide identity to police, but not able to identify place or time. Family notified.
Client confused and agitated. Appearance is disheveled. Mucous membranes dry. Lungs clear and equal, heart rhythm regular.
During assessment, client states, “Can you ask that person to leave my room?” Client is pointing to an empty chair.
0230:
Client’s adult child arrived to the ED and went to client’s room. Client identified family member. Client is pacing and agitated, and states, “I don’t understand why I am here.” Adult child asks nurse to talk outside of room and states, “I don’t know why they are so confused. They are not normally like this.” Adult child states client has past medical history of hypertension and alcohol-related cirrhosis. Upon returning to their room, client voided 250 mL of dark yellow, cloudy urine.
Laboratory Results
0230:
Serum toxicology screen:
Alcohol 60 mg/dL (80 to 200 mg/dL mild to moderate intoxication)
Question 2 of 5
The nurse has reviewed the nurses’ notes, provider’s note, and laboratory results at 0230.Exhibits:For each client’s finding, specify if the finding is consistent with delirium or Alzheimer’s disease. Each finding may support more than one disease process or none at all. There must be at least one selection in every column. There does not need to be a selection in every row.
| Options | Delirium | Alzheimer’s Disease |
|---|---|---|
| Sudden onset of confusion | ||
| Hallucinations | ||
| Agitation | ||
| Current medical diagnosis |
Correct Answer:
Rationale:
Correct Answer:
Rationale:
- Sudden onset of confusion is more indicative of delirium due to its acute and fluctuating nature.
- Hallucinations can be seen in both delirium and Alzheimer's but are more common in delirium.
- Agitation is a common symptom in delirium and can also occur in Alzheimer's.
- Current medical diagnosis should also be checked to understand the overall clinical picture.
-
Therefore, the correct answer selects all options as each finding can potentially support either delirium or Alzheimer's disease.
Extract:
Question 3 of 5
A nurse is caring for a client who is seeking help to quit smoking. Which of the following prescriptions should the nurse expect the provider to prescribe?
Correct Answer: C
Rationale: The correct answer is C: Varenicline. This is because Varenicline is a medication specifically indicated for smoking cessation. It works by reducing the pleasurable effects of nicotine and decreasing cravings. Naltrexone (
A) is used for alcohol and opioid dependence, not smoking cessation. Donepezil (
B) is used to treat Alzheimer's disease. Disulfiram (
D) is used to deter alcohol consumption by causing unpleasant effects when alcohol is ingested. Hence, the nurse should expect the provider to prescribe Varenicline to help the client quit smoking effectively.
Question 4 of 5
A nurse is caring for a client who has bipolar disorder and is refusing to take prescribed medications. Which of the following ethical principles is the nurse displaying when he supports the client's refusal of medications?
Correct Answer: A
Rationale: The correct answer is A: Autonomy. Autonomy refers to the individual's right to make decisions about their own health care. By supporting the client's refusal of medications, the nurse is respecting the client's autonomy and right to make decisions about their own treatment. This empowers the client to have control over their own care.
Choice B: Justice, is incorrect as it pertains to fairness and equal treatment, which is not directly related to the client's refusal of medications.
Choice C: Veracity, is incorrect as it relates to honesty and truthfulness, which is not the main ethical principle demonstrated in this scenario.
Choice D: Beneficence, is incorrect as it refers to the obligation to do good and act in the best interest of the client, which would typically involve encouraging the client to take prescribed medications for their well-being.
Question 5 of 5
A nurse is planning overall strategies to address problems for a client who has borderline personality disorder. Which of the following strategies is the priority for the nurse to incorporate in the plan of care?
Correct Answer: C
Rationale: The correct answer is C: Implement measures to prevent intentional self-inflicted injury. This is the priority because individuals with borderline personality disorder are at a high risk of self-harm or suicide. By focusing on preventing self-inflicted harm, the nurse ensures the client's safety and addresses the most immediate threat. Encouraging support group attendance (
A) and discussing assertive behavior (
B) are important but not as critical as safety. Assisting the client in maintaining awareness of thoughts and feelings (
D) is valuable for therapy but does not address the immediate risk of harm.