ATI LPN Mental Health Quiz Chapters

Extract:

Question 1 of 5

A soldier arrives at the airport after completing a combat assignment. He reports a new-onset blindness but was able to identify his wife in the crowd awaiting passenger arrivals. He is likely experiencing symptoms of

A. hypochondriasis B. conversion disorder C. malingering D. somatization

Correct Answer: B

Rationale: Hypochondriasis, now known as illness anxiety disorder, involves excessive worry or preoccupation with having a serious illness despite medical reassurance and lack of significant physical symptoms. It does not typically involve sensory or neurological symptoms such as blindness. Conversion disorder involves the presence of neurological symptoms that are inconsistent with known neurological or medical conditions. These symptoms often manifest as sensory or motor deficits, such as blindness, paralysis, or seizures, without a clear organic basis. The symptoms are not intentionally produced and are not explained by another medical or psychiatric condition. Malingering involves the intentional production or exaggeration of symptoms for secondary gain, such as financial compensation, avoiding military duty, or obtaining drugs. In malingering, there is typically a clear external incentive for the behavior, which is not evident in the soldier's case. Somatization disorder (now termed somatic symptom disorder) involves multiple and recurrent physical symptoms that are distressing and lead to excessive thoughts, feelings, and behaviors related to these symptoms. It does not typically present with sudden onset of sensory deficits like blindness.

Question 2 of 5

Hospitalization of a client with a dissociative disorder is required in which situation?

A. Loss of memory associated with sudden travel B. Adjustment of medication C. Monitoring of identities D. Reliving of traumatic events

Correct Answer: D

Rationale: Dissociative amnesia is characterized by significant memory loss that cannot be explained by ordinary forgetfulness. If a client experiences sudden travel and cannot remember how they arrived at a distant location, it could indicate dissociative amnesia. Hospitalization is not absolutely necessary. Dissociative disorders are primarily treated with psychotherapy rather than medication adjustments. However, if medication adjustments are necessary for co-occurring conditions or to manage symptoms like anxiety or depression, hospitalization is not necessary. Monitoring of identities is typically done on an outpatient basis, unless there are additional complications or risks identified by a healthcare professional. Dissociative disorders, particularly post-traumatic stress disorder (PTS
D) and acute stress disorder, can involve the reliving of traumatic events through flashbacks, nightmares, or intrusive memories. Hospitalization may be required if the client experiences severe distress, is at risk of self-harm or harm to others during flashbacks.

Question 3 of 5

Which of the following are indicative of hypochondriasis? (Select all that apply.)

A. Symptoms most commonly appear in early childhood B. First diagnosed following a severe stressor C. Sufferers usually have strained interpersonal relationships D. The course of the disorder follows a see-saw pattern and tends to become chronic E. More frequent in person exposed to a serious illness in childhood

Correct Answer: C,D

Rationale: C. Hypochondriasis can strain interpersonal relationships due to excessive preoccupation with health concerns, frequent doctor visits, and seeking reassurance from others. D. Hypochondriasis often follows a chronic course with periods of intense anxiety about health alternating with periods of relative calm. Despite reassurances and negative medical tests, individuals with hypochondriasis may continue to worry about their health. A. Hypochondriasis typically develops in adulthood rather than childhood. It involves persistent anxiety about health and the interpretation of normal bodily sensations as signs of serious illness. Childhood is less commonly associated with the onset of hypochondriasis. B. While stress can exacerbate symptoms of hypochondriasis, it is not typically diagnosed immediately following a specific stressor. The disorder often develops gradually over time due to a combination of factors, including anxiety, personality traits, and past experiences with illness. E. There is no consistent evidence suggesting that exposure to serious illness in childhood predisposes individuals to hypochondriasis. The disorder is more associated with individual psychological factors, cognitive biases, and anxiety sensitivity rather than childhood illness exposure.

Question 4 of 5

A female client with anorexia nervosa and a cardiac condition was prescribed an antidepressant before she regained weight during her treatment course. The nurse should be aware of the possibility of which condition in this client?

A. Low serum sodium level B. Low serum sodium level C. Low serum potassium level D. High serum potassium level

Correct Answer: C

Rationale: Anorexia nervosa can lead to electrolyte imbalances, including hyponatremia (low serum sodium level), due to inadequate intake of sodium and fluid restriction. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can also contribute to hyponatremia by causing the syndrome of inappropriate antidiuretic hormone secretion (SIADH), which leads to water retention and dilutional hyponatremia. However, it is not as life-threatening as hypokalemia. This is a common and potentially life-threatening complication in individuals with anorexia nervosa who are undergoing treatment. It can lead to cardiac arrhythmias. Anorexia nervosa typically does not lead to hyperkalemia (high serum potassium level), as potassium is usually lost through purging behaviors or inadequate intake. Antidepressants also do not commonly cause hyperkalemia as a side effect.

Question 5 of 5

Which client would the nurse expect to prepare for electroconvulsive therapy (ECT)?

A. A male client with severe long-lasting major depression and at risk for suicide B. A male client with major depressive disorder and history of heart disease C. A female client with dysthymic disorder D. A female client with major depression and brain metastasis

Correct Answer: A

Rationale: ECT is often considered for severe major depression that has not responded to other treatments, especially when there is a risk of suicide. ECT can provide rapid relief of symptoms, which is crucial in cases where immediate intervention is needed to prevent harm to the patient. While ECT is generally safe for individuals with medical conditions, including heart disease, special precautions might be needed. However, the presence of heart disease alone would not necessarily preclude ECT if the benefits outweigh the risks and if the client's cardiac status is stable. Dysthymic disorder, characterized by persistent depressive symptoms that are less severe than major depression, typically does not warrant ECT. ECT is usually reserved for more severe forms of depression that significantly impair daily functioning or pose a risk to the patient's safety. ECT may be contraindicated or require careful consideration in clients with brain metastasis due to potential risks related to increased intracranial pressure or neurological complications. Alternative treatments may be preferred in such cases.

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