ATI RN
ATI RN Mental Health 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is planning care for a client who has complicated grieving following the death of their child. Which of the following interventions should the nurse identify as the priority?
Correct Answer: A
Rationale: The correct answer is A: Identify the client's current stage of grief. This is the priority because understanding the client's stage of grieving will guide the nurse in providing appropriate interventions and support. By identifying the stage, the nurse can tailor the care plan to address specific needs and challenges the client may be facing. Understanding where the client is in the grieving process will also help in assessing the client's coping mechanisms and potential risks. Encouraging physical activities (
B) may be beneficial but not as crucial as understanding the client's current stage of grief. Discussing the use of a spiritual grief counselor (
C) or informing the client about expected feelings of anger (
D) are important interventions but should come after identifying the client's stage of grief.
Extract:
Medical History
The client was diagnosed with obsessive-compulsive disorder 4 years ago.
Nurses’ Notes
Day 1 of admission at 1300:
The client is withdrawn, exhibits a flat affect, and makes limited eye contact with others. The client’s clothing is dirty and body odor is noted. The client reports sleeping 2 to 3 hours per night and losing 5.4 kg (12 lb) in the last month. The client also reports handwashing for several minutes multiple times per day. The client’s hands are noted to be red, but the skin is intact. The client is constantly folding and unfolding a small piece of paper during conversation. The client refuses to leave the room or eat lunch and declines the offer to watch a movie in the day room with peers. The client also declines the offer to take a shower at this time.
Day 3 of admission at 1835:
The client showered this morning without prompting. The client ate 75% of lunch and dinner in the day room with peers. The client’s hands remain reddened with a 1 cm x 1 cm area of peeling skin noted on the center of the right palm. The client’s affect rapidly changed throughout the afternoon and early evening; the client is now talkative and appears content. The client was overheard speaking to their sibling on the phone a few minutes ago, telling their sibling they could have the client’s car.
Provider Prescriptions
Day 1 of admission: Fluvoxamine 100 mg PO at bedtime Buspirone 10 mg PO twice daily Paroxetine 20 mg PO daily
Question 2 of 5
A nurse on an inpatient mental health unit is caring for a client.Exhibits:The nurse is discussing the assessment findings on day 3 of admission during the 1900 change of-shift report. For each finding, specify whether the finding indicates potential improvement in or worsening of the client’s condition.
| Options | Indicates potential improvement | Indicates potential worsening |
|---|---|---|
| Giving away car | ||
| Hygiene | ||
| Food intake | ||
| Condition of skin on right hand | ||
| Rapid change in mood |
Correct Answer:
Rationale:
Correct Answer:
Rationale:
- Giving away car (1): Potential worsening, as it may indicate a lack of attachment or impulsivity.
- Hygiene (0): No indication provided regarding improvement or worsening based on hygiene.
- Food intake (1): Potential improvement if the client is eating well and maintaining nutrition.
- Condition of skin on right hand (1): Potential worsening if there are signs of self-harm or neglect.
- Rapid change in mood (0): Not listed in the provided options for assessment findings.
Summary:
- A, C, D are the correct answers as they provide indications of potential improvement or worsening in the client's condition.
- B and E are not relevant to the assessment findings provided in the question.
Extract:
Question 3 of 5
A charge nurse is discussing the care of a client who has a substance use disorder with a staff nurse. Which of the following statements by the staff nurse should the charge nurse identify as countertransference?
Correct Answer: B
Rationale: The correct answer is B. Countertransference occurs when a healthcare professional projects their own personal feelings or experiences onto a client. In this scenario, the staff nurse comparing the client to their brother who overcame addiction demonstrates a personal connection that could affect their judgment and care for the client. This statement reflects the staff nurse's unresolved emotions or biases, which can interfere with providing objective and effective care.
Choices A, C, and D focus on the client's behavior or treatment without indicating any personal projection, therefore not exhibiting countertransference.
Question 4 of 5
A nurse is caring for a client who is going through the grieving process. Which of the following actions should the nurse take to meet the client's spiritual needs?
Correct Answer: D
Rationale: The correct answer is D. Offering to contact the client's spiritual advisor shows support for the client's spiritual needs, providing them with an opportunity to seek comfort and guidance from someone who shares their beliefs. This action respects the client's autonomy and individual preferences. It acknowledges the importance of spirituality in the grieving process, which can provide solace and coping mechanisms.
Options A, B, and C are incorrect:
A: Encouraging the client to internalize their feelings may hinder the grieving process and inhibit emotional expression, potentially leading to unresolved issues.
B: Changing the subject when the client expresses anger dismisses their emotions and prevents them from processing their feelings effectively.
C: Allowing the client to be alone during times of spiritual inadequacy may exacerbate feelings of isolation and hinder their ability to seek support and comfort.
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