ATI RN
ATI RN Mental Health 2023 Exam 2 Questions
Extract:
Question 1 of 5
A nurse is receiving a change-of-shift report about a group of assigned clients at a mental health facility. Which of the following clients should the nurse assess for risks related to sensory impairments?
Correct Answer: B
Rationale: The correct answer is B: A client who has conversion disorder. Clients with conversion disorder may experience sensory impairments such as blindness or paralysis that cannot be explained by medical conditions. The nurse should assess for risks related to these impairments to ensure the client's safety.
Incorrect choices:
A: A client with narcissistic personality disorder does not typically present with sensory impairments.
C: A client with mild anxiety disorder may have heightened sensory perception but not necessarily sensory impairments.
D: A client with severe obsessive-compulsive disorder may have sensory sensitivities but not impairments like those seen in conversion disorder.
Question 2 of 5
A nurse is obtaining a history from a client who has been taking olanzapine to treat schizophrenia. Which of the following questions should the nurse ask the client?
Correct Answer: C
Rationale: The correct answer is C: "Have you noticed an increase in thirst?" This question is relevant because olanzapine, an antipsychotic medication, can cause side effects like increased thirst due to its impact on the body's regulation of water balance. By asking this question, the nurse can assess for potential side effects of the medication and monitor for dehydration.
Choices A, B, and D are less relevant as they do not directly relate to common side effects of olanzapine.
Choice A about decreased taste is not a common side effect of olanzapine.
Choice B about ringing in the ears is more likely related to ototoxic medications.
Choice D about unintentional weight loss is not a common side effect of olanzapine, which is more commonly associated with weight gain.
Question 3 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: Rationale for Correct Answer C: Keeping a sleep diary to promote a consistent sleep schedule is the most appropriate intervention. By tracking sleep patterns, the client and nurse can identify underlying issues impacting sleep and work together to establish a structured routine. This intervention promotes sleep hygiene and helps regulate the client's sleep-wake cycle, potentially improving sleep quality and work performance.
Summary for Incorrect Answers:
A: Taking a 1-hour nap every day may disrupt the client's circadian rhythm and worsen insomnia.
B: Exercising late in the day can increase alertness and make it harder for the client to fall asleep at night.
D: Discontinuing medication without medical guidance can be dangerous and may exacerbate the client's depressive symptoms.
Extract:
Medication Administration Record
• Escitalopram 20 mg once daily
Medical History
Client is 19 years old, has severe anxiety, and was admitted to an inpatient mental health facility for observation and behavioral therapy 2 weeks ago. The client’s weight at the time of admission was 54.4 kg (120 lb). The client reported sleeping 3 to 4 hours per night due to recurrent nightmares as well as a decrease in appetite. The client’s family member stated that the client had separated themselves from friends, refused to leave their house, and picked their skin until it bled. The client’s family member stated that there is a family history of anxiety. The client reported previous participation in cognitive-behavioral therapy.
Nurses’ Notes
Client appears to be well-groomed. The client’s current weight is 54 kg (119 lb). The client states they are sleeping 5 to 6 hours per night but having an occasional nightmare. The client verbalizes decreased appetite and gastrointestinal discomfort. The client states, “I feel anxious about leaving my house. I feel like everyone is staring at me and judging me.” The client verbalizes that bullying experienced during high school has led to anxiety. The client engages in thought-stopping behavioral therapy and cognitive restructuring. The client reports taking escitalopram 20 mg daily 2 hours after breakfast.
Question 4 of 5
A nurse working in an outpatient mental health facility is caring for a client who has anxiety and was discharged from an inpatient mental health facility 1 week ago.Exhibits: A nurse in an outpatient mental health facility is assessing a client who has anxiety. Click to highlight the findings in the Nurses’ Notes that indicate an improvement in the client’s condition. To deselect a finding, click on the finding again.
Correct Answer: A,C,E,F
Rationale: The correct answer is A, C, E, F. A: Well-groomed appearance indicates self-care and improvement in mood. C: Verbalizing decreased appetite and gastrointestinal discomfort may indicate decreased anxiety symptoms. E: Engaging in thought-stopping therapy and cognitive restructuring shows active participation in treatment. F: Taking prescribed medication as directed indicates compliance with the treatment plan. These findings suggest the client's condition is improving.
Choices B, D, and G do not indicate clear improvement in the client's condition. B: Occasional nightmares suggest ongoing sleep disturbances. D: Statement about anxiety leaving the house indicates ongoing anxiety symptoms. G: Past bullying experiences may contribute to the client's anxiety but do not directly indicate improvement in the current condition.
Extract:
Vital Signs
0200:
•
o Temperature: 38.6° C (101.5° F)
o Heart rate: 104/min
o Respiratory rate: 18/min
o Blood pressure: 158/96 mm Hg
o Oxygen saturation: 98% on room air
0415:
•
o Temperature: 38.6° C (101.5° F)
o Heart rate: 108/min
o Respiratory rate: 20/min
o Blood pressure: 148/94 mm Hg
o Oxygen saturation: 98% on room air
Nurses’ Notes
0205:
The client was brought to the ED by police after being found wandering on the street. The client was able to provide their identity to the police, but was not able to identify the place or time. The family was notified. The client appeared confused and agitated. Their appearance was disheveled. Their mucous membranes were dry. Their lungs were clear and equal, and their heart rhythm was regular. During the assessment, the client stated, “Can you ask that person to leave my room?” The client was pointing to an empty chair.
0230:
The client’s adult child arrived at the ED and went to the client’s room. The client identified the family member. The client was pacing and agitated, and stated, “I don’t understand why I am here.” The adult child asked the nurse to talk outside of the room and stated, “I don’t know why they are so confused. They are not normally like this.” The adult child stated that the client has a past medical history of hypertension and alcohol-related cirrhosis. Upon returning to their room, the client voided 250 mL of dark yellow, cloudy urine.
0415:
The client was admitted to the medical-surgical unit. A peripheral IV was initiated in the right arm. The client was agitated, trying to pull out the IV, and yelling, “I am leaving now!”
Provider’s Note
0230: Client diagnosis: Delirium secondary to a urinary tract infection and dehydration.
0400: The client will be transferred to the medical-surgical unit.
Laboratory Results
0230: Serum toxicology screen: Alcohol 60 mg/dL (80 to 200 mg/dL indicates mild to moderate intoxication)
Question 5 of 5
The nurse reviewed the nurses’ notes, provider’s note, and vital signs at 0415.Exhibits:Which of the following interventions should the nurse include in the client’s care? Select the three interventions the nurse should implement.
Correct Answer: B,D,E
Rationale: The correct answer is B, D, and E. Reorienting the client helps maintain their cognitive function. Approaching slowly minimizes agitation and builds trust. Maintaining a low-stimulation environment supports the client's well-being. A is incorrect as family support can be beneficial. C is unnecessary unless there are specific reasons.