ATI RN
ATI RN Mental Health 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is providing teaching to a client who is newly diagnosed with Alzheimer's disease. Which of the following treatment options should the nurse include in the teaching?
Correct Answer: D
Rationale: The correct answer is D: Delay cognitive impairment with NMDA receptor antagonist medications. NMDA receptor antagonists, such as memantine, are commonly used to slow the progression of cognitive decline in Alzheimer's disease by regulating glutamate activity in the brain. This treatment option aims to improve cognitive function and delay the worsening of symptoms. Initiating hospice care (
A) is not appropriate for a client newly diagnosed with Alzheimer's disease. Transcranial magnetic stimulation (
B) may help with depression but does not directly improve cognitive status. Barbiturate medications (
C) are not recommended for anxiety in Alzheimer's disease due to their potential side effects. In summary, choosing NMDA receptor antagonist medications is the most appropriate option to address the client's condition effectively.
Question 2 of 5
A nurse is caring for a client who is prescribed massage therapy to treat panic disorder. The client states, 'I can’t stand to be touched by another person.' Which of the following responses should the nurse make?
Correct Answer: A
Rationale:
Correct Answer: A
Rationale: The nurse should prioritize the client's comfort and autonomy. By acknowledging the client's discomfort with massage therapy, the nurse shows respect for the client's preferences and can explore alternative treatment options with the provider. This response promotes client-centered care.
Summary of Other
Choices:
B: This response does not address the client's underlying discomfort with touch and may not adequately address the client's needs.
C: While exploring the client's reasons for not liking touch is important, it does not directly address the immediate issue of the client's preference for a different treatment.
D: Dismissing the client's concerns and suggesting that the anxiety will lessen once the massage begins is not respectful of the client's feelings and may increase their distress.
Question 3 of 5
A nurse in an acute care mental health facility is caring for a client who has been placed in seclusion following an acute violent episode. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Obtain a prescription for seclusion within 30 minutes. This is crucial as seclusion should be prescribed by a healthcare provider promptly to ensure it is appropriate and necessary for the client's safety. Keeping the client in seclusion for a specific time frame (choice
A) may not align with the client's individual needs. Monitoring vital signs (choice
C) and documenting behavior (choice
D) are important but not as time-sensitive as obtaining the prescription. It is essential to prioritize the client's immediate safety by following the appropriate protocols and obtaining the necessary authorization for seclusion promptly.
Question 4 of 5
A nurse is assessing a client who has a recent diagnosis of dissociative identity disorder. The client tells the nurse, 'I think my blackouts are actually caused by low blood sugar.' The nurse should recognize the client is using which of the following defense mechanisms?
Correct Answer: D
Rationale: The correct answer is D: Rationalization. The client is attributing their blackouts to a seemingly logical and acceptable cause (low blood sugar) rather than acknowledging the true underlying issue of dissociative identity disorder. Rationalization involves creating logical explanations or justifications for behaviors, thoughts, or feelings that are otherwise unacceptable. In this case, the client is using rationalization to avoid facing the uncomfortable reality of their dissociative symptoms.
Incorrect choices:
A: Suppression involves consciously avoiding or pushing away thoughts or feelings. This does not apply to the client's situation.
B: Sublimation involves channeling unacceptable impulses into more socially acceptable behaviors. This is not demonstrated in the client's statement.
C: Projection involves attributing one's own thoughts or feelings to others. This is not evident in the client's statement.
Therefore, rationalization is the most appropriate defense mechanism being used by the client in this scenario.
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 5 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.