ATI RN
ATI Mental Health Proctored Exam 2023
1. A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?
- A. Reinforce that the level is above the therapeutic range.
- B. Instruct the patient to hold the next dose of medication and contact the prescriber.
- C. Advise the patient to go to the hospital emergency room immediately.
- D. Inform the patient about the possibility of seizures and appropriate precautions.
Correct answer: B
Rationale: A lithium level of 1.7 mEq/L is above the therapeutic range, indicating a potential risk of toxicity. The initial nursing intervention should be to instruct the patient to hold the next dose of medication and promptly contact the prescriber for further guidance and management. This action aims to prevent adverse effects and ensure the patient's safety by addressing the elevated lithium level appropriately.
2. Tatiana has been hospitalized for an acute manic episode. On admission, the nurse suspects lithium toxicity. What assessment findings would indicate the nurse's suspicion as correct?
- A. Shortness of breath, gastrointestinal distress, chronic cough
- B. Ataxia, severe hypotension, large volume of dilute urine
- C. Gastrointestinal distress, thirst, nystagmus
- D. Electroencephalographic changes, chest pain, dizziness
Correct answer: B
Rationale: The correct answer is B. Ataxia, severe hypotension, and a large volume of dilute urine are classic signs of lithium toxicity. Ataxia refers to a lack of muscle coordination, severe hypotension indicates dangerously low blood pressure, and the large volume of dilute urine is a result of the kidneys' inability to concentrate urine properly, a common feature of lithium toxicity.
3. Which statement made by the patient demonstrates an understanding of the treatment of choice for patients managing the effects of traumatic events?
- A. I attend my therapy sessions regularly.
- B. Those intrusive memories are hidden for a reason and should stay hidden.
- C. Keeping busy is the key to achieving mental health.
- D. I've agreed to move in with my parents so I'll get the support I need.
Correct answer: A
Rationale: Regular attendance at therapy sessions is a crucial aspect of the recommended treatment for managing the effects of traumatic events. Therapy provides a safe space for individuals to process their experiences, develop coping strategies, and work towards healing and recovery. Consistent participation in therapy sessions can help patients address and overcome the impact of trauma on their mental health.
4. A client displays signs and symptoms indicative of hypochondriasis. The nurse would initially expect to see:
- A. Self-preoccupation
- B. La belle indifference
- C. Fear of physicians
- D. Insight into the source of their fears
Correct answer: A
Rationale: In hypochondriasis, individuals are excessively preoccupied with and worried about having a serious illness, despite reassurance from medical professionals. This self-preoccupation is a key characteristic of hypochondriasis. 'La belle indifference' refers to a lack of concern or distress about symptoms, which is not typically seen in hypochondriasis. Fear of physicians may be present due to the individual's persistent belief in their illness despite medical reassurance. Insight into the source of their fears is usually lacking in hypochondriasis, as individuals often believe their physical symptoms are evidence of a serious illness.
5. When explaining one of the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse mention?
- A. Symptoms of the two diagnoses are essentially the same, making it difficult to differentiate between them.
- B. People with narcolepsy awaken from a nap feeling rested and replenished.
- C. People with obstructive sleep apnea syndrome can experience temporary paralysis during naps.
- D. Naps are contraindicated for clients with narcolepsy due to their association with catatonia.
Correct answer: B
Rationale: Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and sudden attacks of sleep, while obstructive sleep apnea syndrome involves the obstruction of the upper airway during sleep. One of the main differences is that people with narcolepsy often experience refreshing naps, feeling rested and replenished upon waking, which is not the case for obstructive sleep apnea syndrome. This distinction is important for healthcare providers to understand as it helps differentiate between these two sleep disorders.
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