ATI RN
ATI RN Mental Health 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is preparing to administer 7 mg of haloperidol IM to a client who is severely agitated. Haloperidol injection of 5 mg/mL is available. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 1.4
Rationale:
To determine the mL needed, divide the total dose by the concentration of the medication. In this case, 7 mg / 5 mg/mL = 1.4 mL. The correct answer is 1.4 mL.
Choice A, 2.5 mL, is incorrect as it is not the result of the correct calculation.
Choices B, C, D, E, F, and G are also incorrect as they do not reflect the accurate calculation based on the dose and concentration provided.
Extract:
Provider Prescriptions
Olanzapine 10 mg tablet, taken orally daily.
Alprazolam 1 mg tablet, taken orally three times daily as needed for anxiety.
Nurses’ Notes
The client reports hearing voices that are discussing race cars and race tracks. The client appears diaphoretic and pale. The client also reports a weight gain of 2.2 kg (4.9 lb) in the past week.
Graphic Record
Blood Pressure (BP): 128/82 mm Hg
Pulse Rate: 98/min
Respiratory Rate: 20/min
Temperature: 39.4° C (103° F)
Oxygen Saturation (SaO2): 95%
Question 2 of 5
A nurse is assessing a client who has schizophrenia. Which of the following findings should the nurse report to the provider? (Click on the “Exhibit” button for additional information about the client. There are three tabs that contain separate categories of data.)
Correct Answer: B
Rationale:
Step 1: The nurse should report the client's temperature to the provider because it could indicate a potential infection or other physical health issue.
Step 2: Changes in temperature can impact overall health and may require medical intervention.
Step 3: Hallucinations are common in schizophrenia and may not necessarily require immediate medical attention.
Summary: Weight gain and blood pressure can be side effects of medications used to treat schizophrenia. Hallucinations are a common symptom of the disorder and may not always be alarming. Temperature, however, is a vital sign that can indicate a physical health concern requiring prompt attention.
Extract:
Nurses' Notes
2200:
According to the police officer's report, the client was found sleeping near railroad tracks. Refused to give name, and no identification found. Client states they were, "Just doing what they were told to do. Didn't know it would take so long for the train to come." Client appears disheveled with poor hygiene. Client does not follow simple commands, refuses to answer questions, and will not make eye contact.
2230:
Client refusing to follow prescribed treatment plan. States they believe someone is trying to poison them. Noted to occasionally be mumbling as if talking to unseen others.
Provider Prescriptions
2200:
Clozapine 200 mg PO twice per day
Risperidone 4 mg PO twice per day
Question 3 of 5
A nurse in a mental health facility is admitting a client who was brought in by the police department. Exhibits:Complete the diagram by selecting from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
Correct Answer: A, A,C, B,D
Rationale: Action to Take: A, A; Potential Condition: C; Parameter to Monitor: B, D.
Rationale: The client is likely experiencing schizophrenia based on brought in by the police, so actions to take include providing a safe environment (placing client in a room near the nurses' station) and administering antipsychotic medications to address the condition. Potential condition of seizures (
C) should be monitored closely. Parameters to monitor include behavior changes (
B) and medication efficacy (
D) to assess progress and ensure safety. Other choices are incorrect as they do not align with the client's likely condition or best practices in mental health care.
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 4 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:
Nurses’ Notes
The client was 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. The client has a history of alcohol use disorder for over 20 years. The client attended an 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. The client is currently unemployed after being laid off. The client’s family member states, “Everything combined caused the drinking to start again.”
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
Pulse oximetry: 96% on room air
Diagnostic Results
Blood alcohol level (BAC): 310 mg/dL (normal range: 0 to 50 mg/dL)
History & Physical
Neurological: The client is intoxicated, has slurred speech, and is unable to coherently respond to questions.
Cardiovascular: Normal sinus rhythm and pulses are palpable. No history of heart disease.
Respiratory: Chest clear to auscultation and no shortness of breath noted. No history of respiratory disorders, and the client states they quit smoking over 20 years ago.
Gastrointestinal: The client reports weight loss over the past 3 months and minimal appetite.
Genitourinary: The client reports no known problems.
Impression: Relapse of alcohol use disorder.
Plan: Admit for alcohol use disorder and observe for alcohol withdrawal.
Provider Prescriptions
Perform Alcohol Use Disorders Identification Test (AUDIT).
Complete blood count.
Basic metabolic profile.
Nutrition consultation.
Consult counselor for grief therapy.
Substance use group therapy.
Diazepam 10 mg PO three times a day.
Propranolol 40 mg PO twice a day.
Metoclopramide 10 mg IM every 6 hr PRN nausea and/or vomiting.
Question 5 of 5
A nurse is reviewing the day 5 vital signs.Exhibits: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:
Correct
Answer: A, B, D, E
Rationale:
A: Vital signs - Monitoring vital signs helps assess the client's physiological response to treatment. Stable vital signs indicate progress.
B: Movement through stages of grief - Progression through grief stages signifies emotional healing and adaptation to treatment.
D: Participation in group therapy - Active participation in therapy shows engagement and willingness to work on recovery.
E: Appetite - Improved appetite suggests physical improvement and response to treatment.
Incorrect
Choices:
C: Cognition - Although important, cognition alone may not always directly indicate progress in response to treatment.
F: The client resolves to limit alcohol consumption - While important for health, this choice does not directly reflect progress in response to treatment.