ATI RN
ATI Mental Health Proctored Exam 2023 Quizlet
1. A teenage boy is attracted to a female teacher. Without objective evidence, a school nurse overhears the boy state, 'I know she wants me.' This statement reflects which defense mechanism?
- A. Displacement
- B. Projection
- C. Rationalization
- D. Sublimation
Correct answer: B
Rationale: The correct answer is B: Projection. The nurse should determine that the client's statement reflects the defense mechanism of projection. Projection refers to the attribution of one's unacceptable feelings or impulses to another person. In this case, the boy is projecting his own desires onto the female teacher, believing that she wants him. By externalizing his feelings, the boy reduces his anxiety and discomfort about his own attraction. Displacement involves transferring emotions from one target to another, not attributing one's own feelings to others. Rationalization involves creating logical explanations for unacceptable behaviors, not projecting feelings onto others. Sublimation is the channeling of unacceptable impulses into socially acceptable actions, which is not demonstrated in this scenario.
2. A client is scheduled for oral cholecystography. Which one of the following actions would the nurse plan to implement before the test?
- A. Have the client drink 1000 mL of water.
- B. Ask the client about possible allergies to iodine or shellfish.
- C. Administer an intravenous contrast agent the evening before the test.
- D. Administer tap-water enemas until clear.
Correct answer: B
Rationale: Iodine compounds used as radiographic contrast agents, such as iopanoic acid (Telepaque), should not be administered to the client with iodine and seafood allergies because anaphylaxis may occur.
3. A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?
- A. A headache indicates a serious allergic reaction to nitroglycerin.
- B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
- C. Nitroglycerin does not cause a headache.
- D. The most common side effect of nitroglycerin is a headache.
Correct answer: D
Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.
4. A nurse is reviewing the medical record of a client who has chronic kidney disease. The client's potassium level is 6.5 mEq/L. Which of the following actions should the nurse take?
- A. Administer sodium bicarbonate
- B. Administer sodium polystyrene sulfonate
- C. Administer calcium gluconate
- D. Administer calcium carbonate
Correct answer: B
Rationale: The correct answer is B: Administer sodium polystyrene sulfonate. Sodium polystyrene sulfonate is used to treat hyperkalemia by promoting the excretion of potassium. Choice A, administering sodium bicarbonate, is incorrect as it is not used to treat hyperkalemia. Choice C, administering calcium gluconate, is incorrect as it is used to treat hypocalcemia, not hyperkalemia. Choice D, administering calcium carbonate, is incorrect as it is used to treat conditions like osteoporosis and indigestion, not hyperkalemia.
5. While taking the history of an older adult client, which assessment finding alerts the nurse that the client needs further assessment for fluid or electrolyte imbalance?
- A. “I am often cold and need to wear a sweater.”
- B. “I seem to urinate more when I drink coffee.”
- C. “In the summer, I feel thirsty more often.”
- D. “My rings seem to be tighter this week.”
Correct answer: “My rings seem to be tighter this week.”
Rationale: The correct answer is 'My rings seem to be tighter this week.' This assessment finding indicates possible fluid retention, which can be a sign of fluid or electrolyte imbalance in an older adult. Choices A, B, and C do not specifically point towards fluid or electrolyte imbalance. Feeling cold, increased urination with coffee consumption, and feeling thirsty in the summer are not direct indicators of fluid or electrolyte imbalance in this context.
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