ATI RN
ATI RN Mental Health Asn Questions
Extract:
Question 1 of 5
A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.)
Correct Answer: B, D, E
Rationale: Tardive dyskinesia involves involuntary repetitive movements such as lip smacking, facial grimacing, and pelvic rocking.
Question 2 of 5
A nurse is caring for a client who has rheumatoid arthritis and tells the nurse that she wears a copper bracelet to help her feel better. Which of the following responses should the nurse make?
Correct Answer: A
Rationale: The correct response is A because it acknowledges and validates the client's feelings without dismissing her beliefs. It shows empathy and supports the therapeutic relationship.
Choice B could come off as confrontational and may lead to the client feeling defensive.
Choice C may make the client feel invalidated and dismissed.
Choice D may be seen as judgmental and could damage the trust between the nurse and client.
Therefore, choice A is the best response to maintain a positive and trusting relationship with the client.
Question 3 of 5
A nurse is caring for a client who has delusional behavior and states, "I can't go to group therapy today. I am expecting a high-level official to visit me." The nurse responds, "I understand, but it is time for group therapy, and we expect everyone to attend. Let's walk over together.” For which of the following reasons is the nurse's response considered therapeutic?
Correct Answer: A
Rationale: The correct answer is A because it clearly articulates what is expected of the client, promoting structure and consistency in the therapeutic environment. By stating the expectation for the client to attend group therapy, the nurse establishes boundaries and encourages the client to participate in the treatment plan. This approach helps the client understand the importance of group therapy and fosters accountability.
The other choices are incorrect:
B: Demonstrating empathy towards the delusion may validate the client's false beliefs and hinder therapeutic progress.
C: Setting limits on manipulative behavior may be necessary, but in this scenario, the focus is on setting clear expectations rather than addressing manipulation.
D: Using reflection is a valuable therapeutic technique, but it is not the primary reason why the nurse's response is considered therapeutic in this situation.
Question 4 of 5
A nurse observes that a client who has depression is sitting alone in the room crying. As the nurse approaches, the client states, "I'm feeling really down and don't want to talk to anyone right now." Which of the following responses should the nurse make?
Correct Answer: B
Rationale: Offering presence without pressuring the client to talk provides comfort and support.
Question 5 of 5
A nurse is admitting a client who has experienced a weight loss of 11 kg (25 lb) in the past 3 months. The client weighs 40 kg (88 lb) and believes she is fat. Which of the following aspects of care should the nurse consider the first priority for this client?
Correct Answer: A
Rationale: The client’s nutritional status must be assessed first as severe weight loss can lead to life-threatening complications.