ATI RN
ATI RN Mental Health 2023 Exam 2 Questions
Extract:
Medication Administration Record
• Escitalopram 20 mg once daily
Medical History
Client is 19 years old, has severe anxiety, and was admitted to an inpatient mental health facility for observation and behavioral therapy 2 weeks ago. The client’s weight at the time of admission was 54.4 kg (120 lb). The client reported sleeping 3 to 4 hours per night due to recurrent nightmares as well as a decrease in appetite. The client’s family member stated that the client had separated themselves from friends, refused to leave their house, and picked their skin until it bled. The client’s family member stated that there is a family history of anxiety. The client reported previous participation in cognitive-behavioral therapy.
Nurses’ Notes
Client appears to be well-groomed. The client’s current weight is 54 kg (119 lb). The client states they are sleeping 5 to 6 hours per night but having an occasional nightmare. The client verbalizes decreased appetite and gastrointestinal discomfort. The client states, “I feel anxious about leaving my house. I feel like everyone is staring at me and judging me.” The client verbalizes that bullying experienced during high school has led to anxiety. The client engages in thought-stopping behavioral therapy and cognitive restructuring. The client reports taking escitalopram 20 mg daily 2 hours after breakfast.
Question 1 of 5
A nurse working in an outpatient mental health facility is caring for a client who has anxiety and was discharged from an inpatient mental health facility 1 week ago.Exhibits: A nurse in an outpatient mental health facility is assessing a client who has anxiety. Click to highlight the findings in the Nurses’ Notes that indicate an improvement in the client’s condition. To deselect a finding, click on the finding again.
Correct Answer: A,C,E,F
Rationale: The correct answer is A, C, E, F. A: Well-groomed appearance indicates self-care and improvement in mood. C: Verbalizing decreased appetite and gastrointestinal discomfort may indicate decreased anxiety symptoms. E: Engaging in thought-stopping therapy and cognitive restructuring shows active participation in treatment. F: Taking prescribed medication as directed indicates compliance with the treatment plan. These findings suggest the client's condition is improving.
Choices B, D, and G do not indicate clear improvement in the client's condition. B: Occasional nightmares suggest ongoing sleep disturbances. D: Statement about anxiety leaving the house indicates ongoing anxiety symptoms. G: Past bullying experiences may contribute to the client's anxiety but do not directly indicate improvement in the current condition.
Extract:
Question 2 of 5
A nurse is caring for a client who has a depressive disorder. The client states, 'I don’t always go to bed at night, so I get in trouble for falling asleep at work.' Which of the following interventions should the nurse recommend?
Correct Answer: C
Rationale: Rationale for Correct Answer C: Keeping a sleep diary to promote a consistent sleep schedule is the most appropriate intervention. By tracking sleep patterns, the client and nurse can identify underlying issues impacting sleep and work together to establish a structured routine. This intervention promotes sleep hygiene and helps regulate the client's sleep-wake cycle, potentially improving sleep quality and work performance.
Summary for Incorrect Answers:
A: Taking a 1-hour nap every day may disrupt the client's circadian rhythm and worsen insomnia.
B: Exercising late in the day can increase alertness and make it harder for the client to fall asleep at night.
D: Discontinuing medication without medical guidance can be dangerous and may exacerbate the client's depressive symptoms.
Question 3 of 5
A nurse is caring for a client who is under observation for suicidal ideations and has verbalized a suicide plan. The client demands privacy and to be left alone. Which of the following statements should the nurse make?
Correct Answer: D
Rationale: The correct answer is D: "We are concerned about you and need to keep you safe." This response is appropriate because it acknowledges the client's demand for privacy while also emphasizing the nurse's primary responsibility to ensure the client's safety. It addresses the client's feelings of being cared for and understood, which can help build trust.
Choice A is incorrect because it does not address the client's request for privacy and may come across as dismissive.
Choice B is incorrect as it suggests compliance with the treatment plan as a condition for privacy, which may not be appropriate in this situation.
Choice C is incorrect as safety contracts are not considered effective in preventing suicide and may provide a false sense of security.
Question 4 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: B
Rationale: The correct answer is B. The nurse should explain to the client that the duration of grief is highly variable and can last for years. This is important because grief is a complex and individual process that can take a significant amount of time to work through. By providing this information, the nurse can help the client understand that feeling depressed after 9 months is not uncommon and that it is okay to take the time needed to heal.
Choice A is incorrect because recommending more solitary activities may further isolate the client, exacerbating feelings of depression.
Choice C is incorrect as avoiding discussing the events surrounding the sibling's death may hinder the client's ability to process their grief.
Choice D is incorrect as cautioning the client against feeling angry at the sibling may invalidate the client's emotions.
Question 5 of 5
A nurse is caring for a client who is receiving end-of-life care. The client states, 'The nurses here don’t do a good job caring for me.' Which of the following responses should the nurse make?
Correct Answer: D
Rationale:
Correct Answer: D - Can you tell me more about what is upsetting you?
Rationale: This response demonstrates active listening and empathy. By encouraging the client to express their feelings, the nurse can better understand the underlying issues causing dissatisfaction. It shows willingness to address concerns and provide emotional support.
Incorrect
Choices:
A: Asking about family is not directly addressing the client's expressed concern about nursing care.
B: Anticipatory grieving is not the main issue here, so this response may dismiss the client's feelings.
C: Assuming the nurses are doing a good job without addressing the client's specific concerns may invalidate their feelings.
E, F, G: No information provided, but they are likely incorrect as they do not directly address the client's expressed dissatisfaction.