ATI RN
ATI RN Mental Health 2023 Exam 3 Questions
Extract:
History & Physical
Neurological: Client is intoxicated, has slurred speech, and is unable to coherently respond to questions.
Cardiovascular: Normal sinus rhythm and pulses palpable. No history of heart disease.
Respiratory: Chest clear to auscultation and no shortness of breath noted. No history of respiratory disorders and client states they quit smoking over 20 years ago.
Gastrointestinal: Client reports weight loss over the past 3 months and minimal appetite.
Genitourinary: Client reports no known problems.
Impression:
Relapse of alcohol use disorder.
Plan:
Admit for alcohol use disorder and observe for alcohol withdrawal.
Diagnostic Results
Blood alcohol level (BAC) 310 mg/dL (0 to 50 mg/dL)
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
Nurses’ Notes
Client 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.’
Client has a history of alcohol use disorder for over 20 years.
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.
Client is currently unemployed after being laid off.
Client’s family member states, 'Everything combined caused the drinking to start again.’
Family members estimate the client’s last drink was 2 hours ago.
Vital Signs
Admission, 1600:
•
o Temperature: 36.1°C (97°F)
o Blood pressure: 98/66 mm Hg
o Heart rate: 76/min
o Respiratory rate: 10/min
o Pulse oximetry: 95% on room air
Day 2, 0800:
•
o Temperature: 37.3°C (99.1°F)
o Blood pressure: 198/86 mm Hg
o Heart rate: 116/min
o Respiratory rate: 22/min
Hospital day 5, 0800:
•
o Temperature: 36.1°C (97°F)
o Blood pressure: 128/66 mm Hg
o Heart rate: 74/min
o Respiratory rate: 12/min
o Pulse oximetry: 96% on room air
Question 1 of 5
A nurse is reviewing the day 5 vital signs and nurse’s notes.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: B,C,D,E
Rationale: The correct answer is B, C, D, E. Participation in group therapy (
B) indicates engagement in treatment. Stable appetite (
C) shows physical improvement. Maintained cognition (
D) signifies mental progress. Consistent vital signs (E) reflect physiological stability.
Choice A lacks specificity and doesn't measure treatment progress.
Choice F is not directly related to the client's plan of care.
Extract:
Question 2 of 5
A nurse is caring for a client who has just received a terminal cancer diagnosis from their provider. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Allow the client unlimited time for the grieving process. This option acknowledges the client's emotional needs and respects their autonomy in dealing with the terminal cancer diagnosis. It is essential for the nurse to provide emotional support and create a safe space for the client to express their feelings without rushing them. Offering unsolicited advice (
A) may not be helpful as the client's treatment choices are personal and may not be the priority at this time. Discouraging the client from forming new relationships (
B) is inappropriate as social connections can provide comfort during difficult times. Changing the subject when the client becomes upset (
D) can invalidate their emotions and hinder the therapeutic relationship.
Question 3 of 5
A nurse is beginning a therapeutic relationship with a client. The nurse should plan to accomplish which of the following tasks during the working phase?
Correct Answer: B
Rationale: The correct answer is B: Evaluate progress toward predetermined goals. During the working phase of a therapeutic relationship, the nurse assesses the client's progress towards the goals set during the initial phase. This step is crucial in determining the effectiveness of the interventions and making adjustments as needed. Informing the client about confidentiality rights (choice
A) is important in the orientation phase. Establishing boundaries (choice
C) is relevant in the introductory phase. Setting short- and long-term objectives (choice
D) is typically done in the initial phase.
Question 4 of 5
A nurse is assessing a client who has bipolar disorder. Which of the following findings should the nurse identify as an indication that the client is experiencing acute mania?
Correct Answer: D
Rationale: The correct answer is D because reporting a lack of sleep is a classic symptom of acute mania in bipolar disorder. During manic episodes, individuals often experience decreased need for sleep or even insomnia. This can lead to heightened energy levels, racing thoughts, and increased impulsivity. Writing a detailed daily activity schedule (
A) may suggest organization rather than mania. Refusing to engage in conversation (
B) and isolating self from others (
C) are more indicative of depression or social withdrawal, which are not specific to acute mania.
Extract:
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
Diagnostic Results
Blood alcohol level (BAC): 310 mg/dL (0 to 50 mg/dL)
History & Physical
Neurological: Client is intoxicated, has slurred speech, and is unable to coherently respond to questions.
Cardiovascular: Normal sinus rhythm and pulses palpable. No history of heart disease.
Respiratory: Chest clear to auscultation and no shortness of breath noted. No history of respiratory disorders and client states they quit smoking over 20 years ago.
Gastrointestinal: Client reports weight loss over the past 3 months and minimal appetite.
Genitourinary: Client reports no known problems.
Impression: Relapse of alcohol use disorder.
Plan: Admit for alcohol use disorder and observe for alcohol withdrawal.
Nurses’ Notes
Client 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.”
Client has a history of alcohol use disorder for over 20 years.
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.
Client is currently unemployed after being laid off.
Client’s family member states, “Everything combined caused the drinking to start again.”
Family member estimates the client’s last drink was 2 hours ago.
Question 5 of 5
A nurse in a mental health facility is admitting a client.Exhibits:Complete the following sentence by using the lists of options. The client is at risk for developing ___ as evidenced by the client's ___.
Correct Answer: A,B
Rationale: Action to Take: A, B; Potential Condition: C; Parameter to Monitor: E, F.
Rationale: The correct actions are A (monitor for alcohol withdrawal symptoms) and B (assess history of alcohol consumption). The potential condition is seizures (
C) which can be a complication of alcohol withdrawal. Parameters to monitor are High Blood Alcohol Level (E) and Hallucinations (F) as indicators of alcohol-related issues. Unemployment (
D) is not directly related to alcohol withdrawal, making it incorrect.