ATI RN
ATI RN Mental Health 2023 with NGN Questions
Extract:
Nurses’ Notes
The client was 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. The client has a history of alcohol use disorder for over 20 years. The 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. The client is currently unemployed after being laid off. The client’s family member states, “Everything combined caused the drinking to start again.”
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
Day 2, 0800:
Temperature: 37.3 °C (99.1° F)
Blood pressure: 198/86 mm Hg
Heart rate: 116/min
Respiratory rate: 22/min
Hospital day 5, 0800:
Temperature: 36.1 °C (97° F)
Blood pressure: 128/66 mm Hg
Heart rate: 74/min
Respiratory rate: 12/min
Pulse oximetry: 96% on room air
Diagnostic Results
Blood alcohol level (BAC): 310 mg/dL (normal range: 0 to 50 mg/dL)
History & Physical
Neurological: The client is intoxicated, has slurred speech, and is unable to coherently respond to questions.
Cardiovascular: Normal sinus rhythm and pulses are palpable. No history of heart disease.
Respiratory: Chest clear to auscultation and no shortness of breath noted. No history of respiratory disorders, and the client states they quit smoking over 20 years ago.
Gastrointestinal: The client reports weight loss over the past 3 months and minimal appetite.
Genitourinary: The client reports no known problems.
Impression: Relapse of alcohol use disorder.
Plan: Admit for alcohol use disorder and observe for alcohol withdrawal.
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.
Question 1 of 5
A nurse is reviewing the day 5 vital signs.Exhibits: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: A, B, D, E
Rationale: Stable vitals (
A), grief progress (
B), group therapy (
D), and appetite (E) show physical and emotional recovery. Cognition improves slowly, and self-reported limits (F) are unreliable.
Extract:
Question 2 of 5
A nurse is caring for a client who has dementia and is experiencing anticipatory grief. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Encouraging expression aids coping in grief and dementia. Timelines are invalidating, sympathy may feel like pity, and personal stories shift focus.
Question 3 of 5
A nurse is providing teaching to the partner of a client who has Alzheimer's disease and a new prescription for donepezil. Which of the following pieces of information should the nurse include?
Correct Answer: A
Rationale: Donepezil before bedtime reduces nausea and aligns with rest, minimizing side effects. Alzheimer’s worsens, it doesn’t stop progression, and falls risk may increase, not decrease.
Question 4 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: D
Rationale: Severe OCD may involve sensory overload from heightened focus on stimuli, risking distress. Conversion disorder mimics impairments psychologically, anxiety heightens sensitivity, and narcissism doesn’t affect senses.
Extract:
Nurses' Notes
2200:
According to the police officer's report, the client was found sleeping near railroad tracks. Refused to give name, and no identification found. Client states they were, "Just doing what they were told to do. Didn't know it would take so long for the train to come." Client appears disheveled with poor hygiene. Client does not follow simple commands, refuses to answer questions, and will not make eye contact.
2230:
Client refusing to follow prescribed treatment plan. States they believe someone is trying to poison them. Noted to occasionally be mumbling as if talking to unseen others.
Provider Prescriptions
2200:
Clozapine 200 mg PO twice per day
Risperidone 4 mg PO twice per day
Question 5 of 5
A nurse in a mental health facility is admitting a client who was brought in by the police department. Exhibits:Complete the diagram by selecting from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
Correct Answer: A, A,C, B,D
Rationale: Condition: Schizophrenia (
A) fits delusions and hallucinations. Actions: Near nurses’ station (
A) for observation, maintain meds (
C) for symptom control. Parameters: Command hallucinations (
B) and suicidal ideation (
D) assess risk and progress.