ATI RN
ATI RN Mental Health 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is providing teaching to the caregiver of an older adult client who has Alzheimer's disease and is being cared for at home. The client wanders at night and has a history of previous falls. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
Correct Answer: B,C,E
Rationale: The correct instructions are B, C, and E. Installing sensor devices on outside doors helps prevent wandering. Positioning the mattress on the floor reduces fall risk. Putting locks at the top of doors prevents the client from wandering. Placing the client in a reclining chair does not address the wandering issue. Encouraging physical activity prior to bedtime may increase agitation and worsen wandering.
Question 2 of 5
A nurse is teaching a client who is about to start taking fluoxetine. The nurse should instruct the client that which of the following supplements interacts adversely with fluoxetine?
Correct Answer: A
Rationale: The correct answer is A: St. John's wort. St. John's wort is an herbal supplement that can interact adversely with fluoxetine, a selective serotonin reuptake inhibitor (SSRI), leading to serotonin syndrome. This occurs due to the combination of both substances increasing serotonin levels in the brain excessively, causing symptoms like confusion, agitation, rapid heart rate, and high blood pressure. Soy protein (
B), Echinacea (
C), and Ginkgo biloba (
D) do not have known significant interactions with fluoxetine.
Question 3 of 5
A nurse is caring for a client who has an anxiety disorder and is scheduled for a procedure. The client informs the nurse that they do not want to have the procedure. Which of the following actions should the nurse take?
Correct Answer: A
Rationale:
Correct Answer: A
Rationale: The nurse should inform the client that they have the legal right to refuse treatment at any time. This respects the client's autonomy and right to make decisions about their own healthcare. Encouraging the client to have the procedure (
B) goes against their wishes. Obtaining consent from the client's family member (
C) is not appropriate as the decision lies with the client. Requesting another nurse to review the procedure with the client (
D) may not address the client's concerns about not wanting the procedure.
Question 4 of 5
A nurse is providing teaching to the caregiver of an older adult client who has Alzheimer's disease and is being cared for at home. The client wanders at night and has a history of previous falls. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
Correct Answer: B,C,E
Rationale: The correct instructions are B, C, and E. Installing sensor devices on outside doors helps prevent wandering. Positioning the mattress on the floor reduces fall risk. Putting locks at the top of doors prevents the client from wandering. Placing the client in a reclining chair does not address the wandering issue. Encouraging physical activity prior to bedtime may increase agitation and worsen wandering.
Question 5 of 5
A nurse is caring for an adult client who has been placed in physical restraints due to aggressive behavior. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Offer hydration and nutrition to the client every 2 hours. This is essential to ensure the client's basic physiological needs are met while in restraints. Hydration and nutrition are vital for the client's well-being and overall health. Offering these every 2 hours helps prevent dehydration and malnutrition. Checking on the client every 30 minutes (Option
A) is important, but providing hydration and nutrition takes precedence. Assessing the client's need for toileting every 15 minutes (Option
B) may not be necessary unless there are specific concerns. Asking the provider to renew the prescription every 8 hours (Option
C) is not directly related to the client's immediate care needs.