ATI RN
ATI RN Mental Health 2023 Exam 3 Questions
Extract:
Question 1 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 2 of 5
A nurse is caring for a client who has a new diagnosis of metastatic lung cancer. The client states, 'I can't think about that until after my first grandchild is born next week.' The nurse should identify the client's statement as indicating the maladaptive use of which of the following defense mechanisms?
Correct Answer: A
Rationale: The correct answer is A: Suppression. Suppression involves consciously choosing to postpone dealing with thoughts, feelings, or impulses. In this scenario, the client is avoiding thoughts of their diagnosis by focusing on a future event. Compensation involves overemphasizing a trait to offset a perceived weakness. Regression involves reverting to an earlier stage of development. Sublimation involves channeling unacceptable impulses into constructive activities. In this case, the client's behavior aligns most closely with suppression, as they are consciously delaying thoughts about their diagnosis.
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 3 of 5
A nurse in a mental health facility is admitting a client.Exhibits:A nurse is caring for a client who was admitted for alcohol use disorder. Which of the following findings require follow-up by the nurse? Select all that apply.
Correct Answer: A,C,D,F,G
Rationale: The correct answers are A, C, D, F, and G. A gastrointestinal assessment is needed to monitor for any alcohol-related issues like GI bleeding. Blood alcohol level monitoring is crucial to assess intoxication levels. Recent loss can trigger alcohol use, requiring emotional support. Recent alcohol consumption indicates ongoing abuse. Neurological assessment is needed for potential alcohol-related brain damage. Smoking history and genitourinary assessment are not directly related to alcohol use disorder and do not require immediate follow-up in this scenario.
Extract:
Question 4 of 5
A nurse in an emergency department is assessing a client who reports recently using cocaine. Which of the following clinical manifestations should the nurse expect?
Correct Answer: A
Rationale: The correct answer is A: Hypertension. Cocaine is a stimulant drug that causes vasoconstriction and increases heart rate, leading to elevated blood pressure. This is due to the release of catecholamines like norepinephrine. Cocaine does not typically cause hypothermia or bradycardia. Hypothermia is more commonly associated with sedative overdose, and bradycardia is not a typical effect of stimulant drugs like cocaine.
Therefore, in a client who has recently used cocaine, the nurse should expect hypertension as a common clinical manifestation.
Extract:
Nurses’ Notes
2000:
Client presents to the triage desk accompanied by a friend. The client states, “I need help. I was raped about an hour ago.” The client’s friend states, “I think they may have been drugged.” Allergies: penicillin, doxycycline Physical exam: General: exhibits anxiety Respiratory: breath sounds clear Cardiovascular: S1, S2, no murmur Abdomen: soft, mildly tender Skin: bruising to upper arms bilaterally, broken fingernails
Vital Signs
2015:
Blood pressure: 128/88 mm Hg
Heart rate: 80/min
Respiratory rate: 16/min
Temperature: 37°C (98.6°F)
Weight: 67.1 kg (147.9 lbs.)
Diagnostic Results
2030:
Urine drug screen: GHB (gamma-hydroxybutyric acid): positive
Question 5 of 5
A nurse is caring for a client in the emergency department.Drag words from the choices below to fill in each blank in the following sentence. The nurse should identify that the client’s ------------------------ and -------------------- are consistent with sexual assault.
Correct Answer: A,B
Rationale: Action to Take: A, B; Potential Condition: Sexual assault; Parameter to Monitor: D, E.
Rationale:
1. The nurse should review diagnostic results (Action
A) to identify any physical evidence of sexual assault.
2. Conducting an abdominal examination (Action
B) can reveal signs of trauma or injury related to sexual assault.
3. Sexual assault is the potential condition (
C) the nurse should consider based on the client's presentation.
4. Monitoring the client's temperature (Parameter
D) is important to detect any signs of infection or hypothermia post-assault.
5. Monitoring drug assessment (Parameter E) is crucial to assess for any substances or drugs involved in the assault.