ATI LPN
ATI PN Mental Health 2023 Questions
Extract:
Question 1 of 4
A nurse is preparing to administer medications to a client who has schizophrenia. The nurse should clarify the prescription for ___ due to the client’s ___
Correct Answer: B
Rationale: Clozapine risks agranulocytosis; a low WBC count (e.g., 4,800/mm³) requires clarification to prevent severe complications.
Extract:
Nurse's 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 data collection, 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 room, client voided 250 mL of dark yellow, cloudy urine.
0415:
Client admitted to medical-surgical unit.
Peripheral IV initiated in right arm by RN. Client is agitated, trying to pull out IV, and yelling, “I am leaving now!”
1400:
Client is awake, oriented to person and place, but drowsy. Adult child at bedside. Client is watching television. No hallucinations observed since admission to unit. IV fluids infusing to right arm. Providers Notes: 0230:
Client diagnosis: delirium secondary to a urinary tract infection and dehydration.
0400:
Will transfer client to medical-surgical unit.
Medication Administration Record: 0415:
0.9% sodium chloride IV at 125 mL/hr
Lorazepam 1 mg IV
Sulfamethoxazole/trimethoprim 800/160 mg tab PO
Acetaminophen 325 mg 2 tabs PO
0900:
Lorazepam 1 mg IV
Laboratory Results:
0230:
Serum toxicology screen:
Alcohol: 60 mg/dL (80 to 200 mg intoxication)
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
0415:
Temperature 38.6°C (101.5°F)
Heart rate 108/min
Respiratory rate 20/min
Blood pressure 148/94 mm Hg
Oxygen saturation 98% on room air
1400:
Temperature 37.2°C (98.9°F)
Heart rate 78/min
Respiratory rate 16/min
Blood pressure 128/84 mm Hg
Question 2 of 4
The nurse has reviewed the nurses’ notes, medication administration record, and vital signs at 1400.Based on the findings, which of the following client findings indicate an improvement in the client’s condition? (Select all that apply)
Correct Answer: A,B,D,E,F
Rationale: Decreased temperature (
A), no hallucinations (
B), lower heart rate (
D), improved orientation (E), and normalized BP (F) show improvement. Stable oxygen (
C) doesn’t change.
Extract:
Provider’s Note
0230:
Client diagnosis: delirium secondary to a urinary tract infection and dehydration.
Laboratory Results
0230:
Serum toxicology screen:
Alcohol: 60 mg/dL (80 to 200 mg/dL mild to moderate intoxication)
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 data collection, 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 room, client voided 250 mL of dark yellow, cloudy urine.
Question 3 of 4
The nurse has reviewed the nurses’ notes, provider’s note, and laboratory results at 0230. Exhibits For each client finding, click to specify if the finding is consistent with delirium or Alzheimer’s disease. Each finding may support more than one disease process.
| Options | Delirium | Alzheimer’s Disease |
|---|---|---|
| Agitation | ||
| Current medical diagnosis | ||
| Sudden onset of confusion | ||
| Hallucinations |
Correct Answer:
Rationale: Agitation (
A) and hallucinations (
D) occur in both; diagnosis (
B) of delirium and sudden confusion (
C) are delirium-specific, unlike Alzheimer’s gradual onset.
Extract:
Nurses’ Notes
Admission:
• Gastrointestinal upset
• Uncoordinated gait
• Client fell asleep during assessment
12 hr later:
• Client reports blurred vision
• Pale, dry mucous membranes
• Urine output 40 mL/hr
Medical History
• History of bipolar disorder
• Water toxicity
Vital Signs
Admission:
• Temperature 37.7°C (99.9°F)
• Respiratory rate 18/min
• Pulse rate 84/min
• BP 130/84 mmHg
12 hr later:
• Temperature 37°C (98.6°F)
• Respiratory rate 16/min
• Pulse rate 96/min
• BP 88/50 mm Hg
Diagnostic Results
Admission:
• Lithium level 1.8 mEq/L (less than 1.5 mEq/L)
• Glucose level 90 mg/dL (74 to 106 mg/dL)
• Sodium 133 mEq/L (135 to 145 mEq/L)
12 hr later:
• Lithium level 1.2 mEq/L (less than 1.5 mEq/L)
• Glucose level 80 mg/dL (74 to 106 mg/dL)
• Sodium 134 mEq/L (135 to 145 mEq/L)
Question 4 of 4
The nurse is collecting data from the client 12 hr. later. How should the nurse interpret the following findings? For each potential finding, specify whether the finding is an indication of potential improvement or an indication of potential worsening condition.
| Options | indication of potential improvement | indication of potential worsening condition |
|---|---|---|
| Vital signs | ||
| Mucous membranes | ||
| Vision | ||
| Lithium level | ||
| Urine output |
Correct Answer:
Rationale: Low vital signs (
A), dry membranes (
B), and blurred vision (
C) suggest worsening (dehydration/toxicity). Lower lithium (
D) and normal urine (E) indicate improvement.
Extract:
Vital Signs
• Heart rate 115/min
• Respiratory rate 20/min
• BP 90/65 mm Hg
• Temperature 38.6°C (101.5°F)
Nurses’ Notes
0800:
Client is 3 days postoperative. Currently disoriented to time and place, oriented to self. Client is displaying disorganized thinking, a lack of attention when spoken to, and rambling speech that is incoherent at times. Client attempts to get out of bed without assistance. Changes in client’s behavior began the prior evening and client has been awake most of the night. Client has refused to eat or drink since the previous day.
Intake and output from previous day: 250 mL intake, 2,500 mL output.
Call placed to provider to report findings.
0830:
IV fluids initiated by RN. Urine and blood samples collected per provider’s prescription. Client continues to be restless.
Question 5 of 4
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to collect data about the client’s progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale: Delirium (
A) fits postoperative symptoms. Monitor fluids (
A) addresses dehydration, family stay (E) aids orientation. Fall risk (
A) and sleep-wake (E) track progress.