ATI RN
ATI Mental Health Proctored Exam 2023
1. When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:
- A. Medications provided are ineffective.
- B. Nurses are trying to control their minds.
- C. The medications will make them sick.
- D. They are not actually ill.
Correct answer: D
Rationale: Anosognosia is a lack of insight that affects patients with schizophrenia, leading them to deny or lack awareness of their illness. This lack of awareness often results in patients refusing medication because they genuinely believe they are not ill and do not need treatment. It is crucial for healthcare providers to approach such situations with understanding and empathy, recognizing the impact of anosognosia on treatment adherence.
2. A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching for this client, the nurse should stress:
- A. increasing fluid intake to prevent dehydration.
- B. wearing an appliance pouch at all times.
- C. consuming a low-protein, high-fiber diet.
- D. avoiding enteric-coated medications.
Correct answer: A
Rationale: The correct answer is A: increasing fluid intake to prevent dehydration. An ileostomy typically drains liquid waste, so the client is at risk of fluid loss. By increasing fluid intake, the client can prevent dehydration. It's essential for the client to wear a collection appliance at all times because ileostomy drainage is incontinent. Consuming a low-protein, high-fiber diet is not recommended as high-fiber foods can cause intestinal irritation. Enteric-coated medications should be avoided because they may not be absorbed properly after an ileostomy.
3. Which of the following nutrients provide energy?
- A. Carbohydrates
- B. Fats
- C. Protein
- D. Water
Correct answer: A, B, and C
Rationale: Carbohydrates, fats, and proteins are the three macronutrients that provide energy (calories) to the body. Carbohydrates are the body's primary source of energy, fats act as a secondary source when carbohydrate energy is exhausted, and proteins are used for energy when carbohydrate and fat sources are low. Choice D, Water, is essential for the body's functions, but it does not provide energy.
4. A client with cirrhosis is about to receive a dose of lactulose. The client questions the need for the medication, stating they are not constipated. The nurse should explain that lactulose is used in cirrhosis to reduce levels of which component in the bloodstream?
- A. Glucose
- B. Ammonia
- C. Potassium
- D. Bicarbonate
Correct answer: B
Rationale: Lactulose is administered to clients with cirrhosis to lower blood ammonia levels, thus aiding in the prevention of hepatic encephalopathy. Elevated ammonia levels in cirrhosis can lead to cognitive impairment and hepatic encephalopathy. Therefore, the correct answer is B (Ammonia). Glucose (Choice A) is not the component targeted by lactulose in cirrhosis. Potassium (Choice C) and Bicarbonate (Choice D) are not directly affected by lactulose administration in cirrhosis.
5. A nurse is receiving change-of-shift report on a group of clients. Which of the following clients should the nurse assess first?
- A. A client who has urolithiasis and reports severe ankle pain extending toward the abdomen
- B. A client who has acute cholecystitis and reports abdominal pain radiating to the right shoulder
- C. A client who has had a total knee arthroplasty, is 1 day postoperative, and reports a pain level of 8 on a 0 to 10 pain scale
- D. A client who has a fractured femur and reports sudden sharp chest pain
Correct answer: D
Rationale: The correct answer is D because a client with a fractured femur and sudden chest pain may be experiencing a pulmonary embolism, which requires immediate assessment. Choice A is incorrect because although severe pain is present, it is more indicative of musculoskeletal issues related to urolithiasis rather than a life-threatening condition. Choice B, related to acute cholecystitis, is less urgent than choice D as the pain radiating to the right shoulder is a common symptom but does not indicate an immediate life-threatening situation. Choice C, regarding a client post-total knee arthroplasty with a pain level of 8, is important but not as urgent as a potential pulmonary embolism in choice D.
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