ATI RN
ATI Mental Health Practice B
1. When assessing a client diagnosed with anorexia nervosa, which of the following findings should the nurse expect? Select one that does not apply.
- A. Amenorrhea
- B. Lanugo
- C. Hypotension
- D. Hyperkalemia
Correct answer: D
Rationale: In a client diagnosed with anorexia nervosa, expected findings include amenorrhea, lanugo, hypotension, and bradycardia. Hyperkalemia is not typically associated with anorexia nervosa; instead, hypokalemia, which is low potassium levels, is more common. Hypokalemia can result from decreased intake of potassium-rich foods or excessive purging behaviors commonly seen in individuals with anorexia nervosa.
2. Which is a correct evaluation of the new psychiatric nurse's statement regarding a client's use of defense mechanisms?
- A. Defense mechanisms can be self-protective responses to stress and need not be eliminated.
- B. Defense mechanisms are a maladaptive attempt by the ego to manage anxiety and should always be eliminated.
- C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged but not eliminated.
- D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
Correct answer: A
Rationale: The correct evaluation is that defense mechanisms can be self-protective responses to stress and do not necessarily need to be eliminated. These mechanisms serve the purpose of reducing anxiety during times of stress. While some defense mechanisms may be maladaptive, they can also help individuals cope with challenging situations. It is essential for the nurse to recognize that addressing defense mechanisms should be done sensitively, as they may be crucial for the client's emotional regulation. Encouraging the development of healthy coping skills while acknowledging the role of defense mechanisms in managing stress is a balanced approach in psychiatric care. Choice B is incorrect because completely eliminating defense mechanisms is not always feasible or beneficial. Choice C is incorrect as it oversimplifies the relationship between defense mechanisms and ego integrity. Choice D is incorrect as it misrepresents the role of defense mechanisms in ego functions.
3. The physician has ordered a peripheral IV to be inserted before the patient goes for computed tomography. What should the nurse do when selecting a site on the hand or arm for insertion of an IV catheter?
- A. Choose a site with minimal hair if available.
- B. Consider potential effects on the patient's mobility when selecting a site.
- C. Instruct the patient to hold his arm in a dependent position before insertion.
- D. Remove the tourniquet after 2 minutes.
Correct answer: B
Rationale: When selecting a site for IV insertion on the hand or arm, it is important to consider the potential effects on the patient's mobility. The chosen site should not interfere with the patient's movement. Instructing the patient to hold his arm in a dependent position helps increase blood flow, aiding in vein visualization and insertion. It is advisable to choose a site with minimal hair if possible for better adhesion of the dressing. Removing the tourniquet after 2 minutes is recommended to prevent complications like hemoconcentration and potential vein damage. Therefore, option B is the correct choice as it aligns with best practices for IV insertion.
4. How do social determinants impact health?
- A. They directly affect health behaviors and outcomes.
- B. They primarily influence genetic predisposition.
- C. They have minimal impact on overall health.
- D. They determine access to health resources.
Correct answer: A
Rationale: Social determinants play a significant role in impacting health by directly influencing health behaviors and outcomes. These determinants include factors such as socioeconomic status, education, neighborhood, and access to healthcare, which shape the conditions in which individuals live, work, and age, ultimately affecting their health status.
5. The healthcare professional working in the PACU is aware that which of the following procedures may contribute to extracellular losses?
- A. Removal of an ingrown toenail
- B. Tooth extraction
- C. Abdominal surgery
- D. Cataract surgery
Correct answer: C
Rationale: Fluid loss from the extracellular compartment can be caused by abdominal surgery as it involves opening the abdominal cavity, potentially leading to significant fluid losses. Choices A, B, and D do not typically result in substantial extracellular losses compared to abdominal surgery.
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