ATI RN
ATI Mental Health Proctored Exam 2019
1. After a client with major depressive disorder undergoes electroconvulsive therapy (ECT), which of the following is a priority assessment for the nurse?
- A. Monitoring for signs of infection
- B. Monitoring for signs of respiratory distress
- C. Monitoring for signs of hypotension
- D. Monitoring for signs of bleeding
Correct answer: B
Rationale: The priority assessment for the nurse after a client undergoes electroconvulsive therapy (ECT) is monitoring for signs of respiratory distress. This is crucial due to the potential risk of complications from anesthesia, such as airway compromise or respiratory depression. Prompt identification and intervention in case of respiratory distress are essential to ensure the client's safety and well-being. Monitoring for signs of infection (Choice A) is important but not the priority immediately post-ECT. Hypotension (Choice C) and bleeding (Choice D) are also potential concerns but assessing respiratory distress takes precedence due to the immediate risk it poses to the client's well-being.
2. Who most often prescribes a patient's diet order?
- A. Registered Nurse
- B. Physician
- C. Registered Dietetic Technician
- D. Occupational Therapist
Correct answer: Physician
Rationale: A patient's dietary order is most frequently prescribed by a physician. This is because the physician has a comprehensive understanding of the patient's medical condition and can thus determine the most suitable dietary plan. Registered dietitians often collaborate with physicians in this process, but the final prescription is made by the physician. Although registered nurses, dietetic technicians, and occupational therapists play significant roles in patient care, they typically do not prescribe diet orders.
3. The client has a prescription for sublingual nitroglycerin. What is the nurse's instruction for how to take this medication during an episode of chest pain?
- A. Take one tablet every 5 minutes, up to three tablets.
- B. Take one tablet every hour until the pain subsides.
- C. Take two tablets immediately if chest pain occurs.
- D. Take one tablet with a full glass of water.
Correct answer: A
Rationale: The correct answer is A. The standard instruction for sublingual nitroglycerin during an episode of chest pain is to take one tablet every 5 minutes, up to three tablets. If the pain persists after taking three tablets, the client should seek emergency help. Choice B is incorrect because taking one tablet every hour is not the appropriate dosing for acute chest pain. Choice C is incorrect as taking two tablets immediately is not in line with the recommended dosing instructions. Choice D is incorrect because sublingual nitroglycerin should be placed under the tongue, not swallowed with water.
4. A healthcare professional is preparing to administer an IV bolus of morphine to a client. Which of the following actions should the healthcare professional take first?
- A. Check the client's respiratory rate.
- B. Administer naloxone.
- C. Check the client's pain level.
- D. Assess the client's blood pressure.
Correct answer: A
Rationale: Correct Answer: Checking the client's respiratory rate is the priority before administering morphine because morphine can depress respiration. This action helps the healthcare professional assess the client's baseline respiratory status and detect any potential respiratory depression that may be exacerbated by morphine. Choice B, administering naloxone, is incorrect because naloxone is used as an antidote for opioid overdose and not routinely administered before giving morphine. Choice C, checking the client's pain level, is important but not the first action to take before administering morphine. Choice D, assessing the client's blood pressure, is also important but not the initial priority compared to evaluating respiratory status when preparing to administer morphine.
5. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?
- A. Epinephrine
- B. Lorazepam
- C. Furosemide
- D. Diphenhydramine
Correct answer: C
Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.
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