ATI RN
ATI RN Mental Health 2023 with NGN Questions
Extract:
Medical History
The client was diagnosed with obsessive-compulsive disorder 4 years ago.
Nurses’ Notes
Day 1 of admission at 1300:
The client is withdrawn, exhibits a flat affect, and makes limited eye contact with others. The client’s clothing is dirty and body odor is noted. The client reports sleeping 2 to 3 hours per night and losing 5.4 kg (12 lb) in the last month. The client also reports handwashing for several minutes multiple times per day. The client’s hands are noted to be red, but the skin is intact. The client is constantly folding and unfolding a small piece of paper during conversation. The client refuses to leave the room or eat lunch and declines the offer to watch a movie in the day room with peers. The client also declines the offer to take a shower at this time.
Day 3 of admission at 1835:
The client showered this morning without prompting. The client ate 75% of lunch and dinner in the day room with peers. The client’s hands remain reddened with a 1 cm x 1 cm area of peeling skin noted on the center of the right palm. The client’s affect rapidly changed throughout the afternoon and early evening; the client is now talkative and appears content. The client was overheard speaking to their sibling on the phone a few minutes ago, telling their sibling they could have the client’s car.
Provider Prescriptions
Day 1 of admission: Fluvoxamine 100 mg PO at bedtime Buspirone 10 mg PO twice daily Paroxetine 20 mg PO daily
Question 1 of 5
A nurse on an inpatient mental health unit is caring for a client.Exhibits:The nurse is discussing the assessment findings on day 3 of admission during the 1900 change of-shift report. For each finding, specify whether the finding indicates potential improvement in or worsening of the client’s condition.
Correct Answer:
Rationale:
Correct Answer:
Rationale:
- Giving away car (1): Potential worsening, as it may indicate a lack of attachment or impulsivity.
- Hygiene (0): No indication provided regarding improvement or worsening based on hygiene.
- Food intake (1): Potential improvement if the client is eating well and maintaining nutrition.
- Condition of skin on right hand (1): Potential worsening if there are signs of self-harm or neglect.
- Rapid change in mood (0): Not listed in the provided options for assessment findings.
Summary:
- A, C, D are the correct answers as they provide indications of potential improvement or worsening in the client's condition.
- B and E are not relevant to the assessment findings provided in the question.
Extract:
Question 2 of 5
A nurse is assessing a client who has a recent diagnosis of dissociative identity disorder. The client tells the nurse, 'I think my blackouts are actually caused by low blood sugar.' The nurse should recognize the client is using which of the following defense mechanisms?
Correct Answer: D
Rationale: The correct answer is D: Rationalization. The client is attributing their blackouts to a seemingly logical and acceptable cause (low blood sugar) rather than acknowledging the true underlying issue of dissociative identity disorder. Rationalization involves creating logical explanations or justifications for behaviors, thoughts, or feelings that are otherwise unacceptable. In this case, the client is using rationalization to avoid facing the uncomfortable reality of their dissociative symptoms.
Incorrect choices:
A: Suppression involves consciously avoiding or pushing away thoughts or feelings. This does not apply to the client's situation.
B: Sublimation involves channeling unacceptable impulses into more socially acceptable behaviors. This is not demonstrated in the client's statement.
C: Projection involves attributing one's own thoughts or feelings to others. This is not evident in the client's statement.
Therefore, rationalization is the most appropriate defense mechanism being used by the client in this scenario.
Extract:
Medical History
The client was diagnosed with obsessive-compulsive disorder 4 years ago.
Nurses’ Notes
Day 1 of admission at 1300:
The client is withdrawn, exhibits a flat affect, and makes limited eye contact with others. The client’s clothing is dirty and body odor is noted. The client reports sleeping 2 to 3 hours per night and losing 5.4 kg (12 lb) in the last month. The client also reports handwashing for several minutes multiple times per day. The client’s hands are noted to be red, but the skin is intact. The client is constantly folding and unfolding a small piece of paper during conversation. The client refuses to leave the room or eat lunch and declines the offer to watch a movie in the day room with peers. The client also declines the offer to take a shower at this time.
Day 3 of admission at 1835:
The client showered this morning without prompting. The client ate 75% of lunch and dinner in the day room with peers. The client’s hands remain reddened with a 1 cm x 1 cm area of peeling skin noted on the center of the right palm. The client’s affect rapidly changed throughout the afternoon and early evening; the client is now talkative and appears content. The client was overheard speaking to their sibling on the phone a few minutes ago, telling their sibling they could have the client’s car.
Provider Prescriptions
Day 1 of admission: Fluvoxamine 100 mg PO at bedtime Buspirone 10 mg PO twice daily Paroxetine 20 mg PO daily
Question 3 of 5
A nurse on an inpatient mental health unit is caring for a client.Exhibits:The nurse is discussing the assessment findings on day 3 of admission during the 1900 change of-shift report. For each finding, specify whether the finding indicates potential improvement in or worsening of the client’s condition.
| Options | Indicates potential improvement | Indicates potential worsening |
|---|---|---|
| Giving away car | ||
| Hygiene | ||
| Food intake | ||
| Condition of skin on right hand | ||
| Rapid change in mood |
Correct Answer:
Rationale:
Correct Answer:
Rationale:
- Giving away car (1): Potential worsening, as it may indicate a lack of attachment or impulsivity.
- Hygiene (0): No indication provided regarding improvement or worsening based on hygiene.
- Food intake (1): Potential improvement if the client is eating well and maintaining nutrition.
- Condition of skin on right hand (1): Potential worsening if there are signs of self-harm or neglect.
- Rapid change in mood (0): Not listed in the provided options for assessment findings.
Summary:
- A, C, D are the correct answers as they provide indications of potential improvement or worsening in the client's condition.
- B and E are not relevant to the assessment findings provided in the question.
Extract:
Question 4 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: The correct answer is B: Encourage the client to express their feelings. This is important because it allows the client to process their emotions, reduce feelings of isolation, and promote a sense of validation. By expressing their feelings, the client can better cope with anticipatory grief associated with dementia. Providing a timeline (choice
A) might not be helpful as grief is a unique process for each individual. Showing sympathy (choice
C) is important, but encouraging the client to express their feelings is more directly beneficial. Sharing personal stories (choice
D) can shift the focus away from the client's needs. The other choices are not relevant to addressing the client's emotional needs in this situation.
Question 5 of 5
A nurse is interviewing a client who reports ongoing feelings of depression after the death of his sibling 9 months ago. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Explain to the client that the duration of grief is highly variable and can last for years. This is the best action because it validates the client's experience and provides reassurance that prolonged grieving is normal. It helps the client understand that everyone copes with loss differently and that there is no set timeline for the grieving process. This approach promotes empathy and allows the client to feel heard and supported.
Explanation for other choices:
A: Cautioning against feeling angry can invalidate the client's emotions and hinder the therapeutic relationship.
B: Recommending solitary activities may isolate the client further and not address the underlying grief.
D: Encouraging avoidance of discussing the death can prevent the client from processing emotions and seeking support.