ATI RN
ATI RN Custom NURS 120 Psychiatric Nursing FA23 Exam 2 Questions
Extract:
Question 1 of 5
A nurse reviews the laboratory report for a client who is receiving lithium three times daily PO. The client's current blood lithium level is 1.8 mEq/L. The nurse identifies that this lab value indicates which of the following?
Correct Answer: C
Rationale: A lithium level of 1.8 mEq/L is toxic (>1.5 mEq/L). Therapeutic initial levels are 0.8-1.4 mEq/L (
A), maintenance 0.4-1.3 mEq/L (
D), and it’s not below therapeutic (
B).
Extract:
A nurse in a mental health facility is caring for a client.
Medical History: Antisocial personality disorder.
Substance use disorder.
Nurses' Notes:. 1400: Client admitted to facility by court order for evaluation following arrest for disorderly conduct and resisting arrest.
Client states, "That judge is so stupid.
I don't belong here!" Client has rigid posture, is pacing around the room attempting to intimidate staff and other clients on the unit.
Extra staff members gather.
1500: Client escorted to room.
Client becomes flirtatious with assistant personnel (AP). Client introduced to roommate, whom they ignore.
Continues to flirt with AP. 1800: Client refuses to go to dining room for dinner.
States, "I'm not sitting down with a bunch of nuts.
Question 2 of 5
Bring my food to me!". For each potential nursing action, click to specify if the potential action is anticipated or contraindicated for the client.
| anticipated | contraindicated |
|---|---|
| Use bargaining to improve behavior. | |
| Provide rewards for positive behavior. | |
| Ignore negative behavior. | |
| Maintain a low-stimuli environment. |
Correct Answer:
Rationale: Rewards for positive behavior (
B) and low-stimuli environment (
D) are anticipated for antisocial personality disorder. Bargaining (
A) reinforces manipulation, and ignoring negative behavior (
C) avoids accountability.
Extract:
Question 3 of 5
A nurse is reviewing medications for a newly admitted client who has bipolar disorder and is experiencing mania. Which of the following client prescriptions should the nurse realize is expected to reduce the client's mania?
Correct Answer: C
Rationale: Carbamazepine, a mood stabilizer, reduces mania. Fluvastatin (
A) is for cholesterol, lorazepam (
B) is for anxiety, and propranolol (
D) is for hypertension.
Extract:
Medical History: Borderline personality disorder.
Alcohol use disorder.
History of suicidal ideation.
Medication Administration Record: Fluoxetine 20 mg PO daily.
Nurses' Notes: . 1500: Client admitted for evaluation and treatment following arrest for driving while under the influence of alcohol.
Client reports recent breakup of romantic relationship and subsequent job loss.
States, "I was too upset to go to work, and then they fired me. Like I needed that stress, too.”. 1700: Noted client has multiple cuts on arms and legs and there is a broken mirror with blood on it on the floor.
Client states, "I feel so alone.
Question 4 of 5
There is no one that cares about me.”. For each potential nursing action, click to specify if the potential action is anticipated, nonessential, or contraindicated for the client.
| anticipated | nonessential | contraindicated |
|---|---|---|
| Instruct the client to avoid foods with tyramine. | ||
| Apply wrist restraints. | ||
| Offer sympathy and attention to maladaptive behavior. | ||
| Encourage the client to talk about feelings prior to maladaptive behavior. | ||
| Maintain same staff members caring for the client. |
Correct Answer:
Rationale: Encouraging feelings (
D) and consistent staff (E) are anticipated. Tyramine avoidance (
A) is for MAOIs, restraints (
B) are a last resort, and sympathy to maladaptive behavior (
C) reinforces negativity.
Extract:
Question 5 of 5
A nurse is reviewing abnormal laboratory values for four clients who have schizophrenia and take clozapine. For which of the following clients should the nurse withhold the medication and notify the provider immediately to have clozapine therapy discontinued?
Correct Answer: D
Rationale: A WBC of 2,900 cells/mm^2 indicates possible agranulocytosis, requiring clozapine discontinuation. BUN (
A), potassium (
B), and hematocrit (
C) are not contraindications.