ATI RN
ATI Mental Health Proctored Exam
1. A client diagnosed with OCD spends hours bathing and grooming. During a one-on-one interaction, the client discusses the rituals in detail but avoids any feelings that the rituals generate. Which defense mechanism should the nurse identify?
- A. Dissociation
- B. Rationalization
- C. Sublimation
- D. Intellectualization
Correct answer: D
Rationale: Intellectualization is a defense mechanism where an individual focuses on rational, logical explanations to distance themselves from uncomfortable emotions. In this scenario, the client discusses the OCD rituals in a detailed and analytical manner, avoiding the emotional aspects associated with them. This behavior reflects intellectualization rather than dissociation, rationalization, or sublimation. Dissociation involves a disconnection from reality, rationalization is the attempt to justify behaviors, and sublimation is redirecting unacceptable impulses into socially acceptable activities.
2. In what significant way should the therapeutic environment differ for a client who has ingested LSD from that of a client who has ingested PCP?
- A. For LSD ingestion, maintain a regimen of limited interaction and minimal verbal stimulation. For PCP ingestion, place client on one-on-one intensive supervision.
- B. For LSD ingestion, place the client in restraints. For PCP ingestion, place the client on seizure precautions.
- C. For LSD ingestion, provide continual medieval simulation involving as many senses as possible. For PCP ingestion, provide continual high-level stimulation.
- D. For PCP ingestion, place the client on one-on-one intensive supervision. For LSD ingestion, maintain a regimen of limited interaction and minimal verbal stimulation.
Correct answer: D
Rationale: When managing a client who has ingested PCP, it is crucial to provide one-on-one intensive supervision to ensure their safety and prevent any harm to themselves or others. This level of supervision is necessary due to the unpredictable and potentially dangerous effects of PCP. On the other hand, for a client who has ingested LSD, it is recommended to maintain a calm environment with limited interaction and minimal verbal stimulation. This approach aims to prevent exacerbating any adverse effects of LSD, such as anxiety or paranoia, by reducing external stimuli. Therefore, the correct approach is to provide one-on-one intensive supervision for PCP ingestion and limit interaction and verbal stimulation for LSD ingestion.
3. During the assessment of an adolescent who collapsed during Olympic figure skating training and was diagnosed with severe malnutrition due to anorexia nervosa, which client statement supports the use of a family-based approach?
- A. I eat just as much as everyone else on the team
- B. I'm tired of fighting with my parents about eating
- C. I just didn't drink enough water during practice
- D. I have to practice until my skating routine is perfect
Correct answer: B
Rationale: The statement 'I'm tired of fighting with my parents about eating' indicates a struggle related to food and parental conflicts, suggesting family dynamics play a role in the client's eating disorder. In cases of anorexia nervosa in adolescents, involving the family in the treatment process through a family-based approach has shown to be effective. This approach recognizes the influence of family interactions on the development and maintenance of eating disorders, aiming to improve communication, support, and understanding within the family unit to facilitate recovery.
4. A client is diagnosed with somatic symptom disorder. Which question will help the nurse develop nursing diagnoses for this client’s plan of care?
- A. Are you satisfied with your appearance?
- B. Do you take medication for anxiety as prescribed?
- C. When did you last feel detached from your environment?
- D. How long have you had these memory problems?
Correct answer: B
Rationale: In clients with somatic symptom disorder, it is crucial to assess their adherence to medication for anxiety as prescribed. This question helps the nurse understand the client's treatment compliance, which can impact the development of nursing diagnoses and the overall plan of care. Monitoring medication adherence is essential in managing the client's symptoms and improving outcomes.
5. After 1 week of continuous mental confusion, an elderly African American client is admitted with a preliminary diagnosis of a neurocognitive disorder due to dementia. Which statement would cause the nurse to question this diagnosis?
- A. There has been no triiodothyronine or thyroxine level evaluation ordered
- B. Neurocognitive disorders do not typically occur in African American clients
- C. The symptoms presented are more indicative of parkinsonism
- D. Dementia does not develop suddenly
Correct answer: D
Rationale:
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