ATI CAPSTONE MENTAL HEALTH FINAL EXAM 2024 (VARCAROLIS-BASED) – UPDATED Q&A WITH RATIONALE, Exams of Nursing

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ATI CAPSTONE MENTAL HEALTH FINAL EXAM 2024

(VARCAROLIS-BASED) – UPDATED Q&A WITH

RATIONALES | EXPERT VERIFIED & A+ GRADED

CONTENT

A nurse is assisting in obtaining informed consent from a client who is scheduled for electroconvulsive therapy. Which of the following actions should the nurse take? Ask the client if they understand the procedure. Inform the client of alternative treatments that are available. Discuss the risks of the procedure with the client. Explain the procedure to the client. - - CORRECT-ANSWER IS- - Ask the client if they understand the procedure; The nurse should ask the client if they understand the procedure prior to obtaining their signature on the informed consent form. If the client appears to be incompetent or does not understand the procedure being performed, it is the responsibility of the nurse to notify the provider and document these findings. A nurse manager is teaching a group of newly licensed nurses about reportable conditions. Which of the following situations should the nurse manager include as being required by law to be reported? A client who has a substance abuse disorder and is attempting to leave the hospital against medical advice A client who has dementia with multiple wounds and bruises

A nurse is assisting the parents of a school-age child who has oppositional defiant disorder in identifying strategies to promote positive behavior. Which of the following behaviors should the nurse expect the child to exhibit? Complies with rules Inflated self-esteem Refuses to accept responsibility for actions Is physically cruel to other children - - CORRECT-ANSWER IS- - Refuses to accept responsibility for actions; A child who has oppositional defiant disorder can exhibit passive- aggressive behaviors, argue with authority figures, refuse to comply with requests from authority figures, deliberately annoy others, and blame others for their mistakes or misbehavior. A nurse is assessing a client who has antisocial personality disorder. Which of the following characteristics should the nurse expect? Lack of remorse Fear of abandonment Suicidal behaviors Chronic feelings of emptiness - - CORRECT-ANSWER IS- - Lack of remorse;

Manifestations of antisocial personality disorder include a lack of remorse, a reckless disregard for the safety of one's self and others, and a failure to conform to social norms with respect to lawful behaviors. Clients who have antisocial personality disorder can also be consistently irresponsible, irritable, and aggressive. A nurse in a mental health facility observes a client who is experiencing panic level of anxiety. Which of the following actions should the nurse take first? Encourage the client to discuss the events occurring before the attack. Teach the client relaxation techniques. Tell the client to listen to music. Remain with the client. - - CORRECT-ANSWER IS- - Remain with the client; The nurse should remain with the client during a panic attack. This promotes a feeling of safety and reassurance for the client. A nurse is caring for a client who has moderate Alzheimer's disease. Which of the following actions should the nurse take?

A nurse is assessing a toddler during a well child visit. Which of the following findings should the nurse identify and report to the provider as an indication of physical maltreatment? Several round burns on the soles of the feet An abrasion on the elbow Two bruises on the right shin in various stages of healing A contusion on the forehead - - CORRECT-ANSWER IS- - Several round burns on the soles of the feet; Although minor injuries are common in toddlers due to their general lack of coordination, the nurse should identify that physical findings such as round burns on the soles of a child's feet can indicate potential physical maltreatment. Burns such as these can be made with a cigarette or a cigar and should alert the nurse to a potential instance of maltreatment that should be reported to the provider. A nurse is caring for a client who becomes agitated while playing a game of cards with other clients. The client stands up, throws the cards on the floor, and says, "I don't want to play anymore." Which of the following actions should the nurse take? Ignore the client's outburst.

Whisper reassuring comments in the client's ear. Allow the client to choose another activity. Ask the client to accompany the nurse to another area. - - CORRECT- ANSWER IS- - Ask the client to accompany the nurse to another area; The nurse should ask the client in a calm and nonthreatening manner to walk with them to another area, away from the location of the outburst. Removing the client from the situation will ensure the safety of the other clients as well as deescalate the situation. A nurse is discussing types of crises with a newly licensed nurse. Which of the following experiences should the nurse include as an example of maturational crisis? Assault Retirement House fire Job change - - CORRECT-ANSWER IS- - Retirement; The nurse should include retirement as an example of a maturational crisis. A maturational crisis is an internal crisis that leads to psychosocial regression or growth. It is a naturally occurring event in a client's life. Other examples of a maturational crisis include marriage, the birth of children, and the death of parents.

The nurse should identify lack of emotion as a negative symptom of schizophrenia. Other negative symptoms can include withdrawal from others, lack of energy, negative self talk, lack of motivation, and feelings of rejection. A nurse is caring for a client who is in recovery from a substance use disorder. The client constantly discusses the destructive actions of people use illicit drugs. Which of the following adaptive defense mechanisms is the client demonstrating? Reaction formation Rationalization Suppression Undoing - - CORRECT-ANSWER IS- - Reaction formation; The client is using reaction formation when unacceptable behaviors are controlled and kept out of awareness by developing the opposite behavior. This is an adaptive use of the defense mechanism. A nurse is caring for a client who is in recovery from a substance use disorder and is receiving treatment for withdrawal from heroin. Which of the following manifestations should the nurse expect?

Bradycardia Hypertension Slurred speech Pinpoint pupils - - CORRECT-ANSWER IS- - Hypertension; Hypertension is a manifestation of opioid withdrawal. Additionally, a client who is experiencing withdrawal can experience tachycardia, hyperthermia, and tachypnea. A nurse is assessing a client who has a prescription for fluoxetine. Which of the following findings is a potential adverse effect of the medication? Urinary retention Bradycardia Increased temperature Orthostatic hypotension - - CORRECT-ANSWER IS- - Increased temperature; Hyperpyrexia or fever is a potential adverse effect of fluoxetine. Serotonin syndrome is a rare life-threatening occurrence associated with SSRIs. The effects include fever, tachycardia, elevated blood pressure, sweating, diarrhea, delirium, mood swings, hostility, seizures, apnea, and possible death.

Clozapine can cause agranulocytosis. Manifestations of agranulocytosis includes signs of infections such as chills, sore throat, and fever. The client should have complete blood counts to monitor WBC count and absolute neutrophil count (ANC) routinely. alzheimer's disease agitated and combative when approached for nursing care - appropriate action? - - CORRECT-ANSWER IS- - remain calm and talk quietly to the client typical characteristic of clients w anorexia? - - CORRECT-ANSWER IS- - relentless exercise eldery w alzheimer's has begun to strike out - awake and restless most of the night - contact provider for med order. anticipated med? - - CORRECT-ANSWER IS- - lorazepam as needed question a benzo for tx of? - - CORRECT-ANSWER IS- - chronic pain syndrome male client admitted to psych hospital under court order w dx of antisocial personality disorder - stealing a car and pushing it over a cliff - which behaviors should the nurse expect? - - CORRECT-ANSWER IS- - little responsibility or concern for his current situation

er following rape - may manifest PTSD - can be described as? - - CORRECT-ANSWER IS- - re-experiencing the fear and hopelessness of the original trauma counseling for GAD and buspirone to control extreme restlessness and irritability - most common SE? - - CORRECT-ANSWER IS- - drowsiness caring for client admitted w ETOH detox - commonly used to manage? -

- CORRECT-ANSWER IS- - antianxiety agents client dx w Wernicke Korsakoff syndrome - expect to exhibit? - - CORRECT-ANSWER IS- - short-term memory loss and disorientation client tells nurse TV is a two way radio and states "voices are coming from the tv...." - appropriate response? - - CORRECT-ANSWER IS- - "That must be very frightening" caring for client hospitalized w acute manic episode - priority nursing intervention? - - CORRECT-ANSWER IS- - protect the client from impulsive behavior providing a teaching to a client who is taking disulfiram - avoid? - - CORRECT-ANSWER IS- - vanilla extract

client is transferred to a psych from the ED - treated for self-inflicted injuries - highest priority? - - CORRECT-ANSWER IS- - promoting and maintaining client safety admitting a client to outpatient for a second series of ECT - give immediate consideration w which statement? - - CORRECT-ANSWER IS- - "I only ate a light breakfast this morning" caring for elderly in inpatient - understand which w regard to client's antidepressant? - - CORRECT-ANSWER IS- - elderly clients require lower doses of antidepressants than younger clients nurse outpatient mental health clinic - client dx w antisocial - most appropriate nursing intervention? - - CORRECT-ANSWER IS- - set limits on the inappropriate behavior caring for a client w agoraphobia - most effective technique? - - CORRECT-ANSWER IS- - gradual desensitization by controlled exposure to the situation of client fears hx of extremely elevated, irritable mood for a week - nurse notes grandiosity, insomnia, flight of ideas, and psychomotor agitation - priority short term goal? - - CORRECT-ANSWER IS- - adequate nutrition and rest patterns

caring for client who has been taking lithium for last 6 months - no longer responding well - after dc lithium, provider prescribes valproic acid - instructions? - - CORRECT-ANSWER IS- - liver fxn and hematology levels must be monitored regularly after a depressed client is discharged, client's spouse stops attending family counseling sessions - "i don't have time" - therapeutic response?

• - CORRECT-ANSWER IS- - "it must be difficult for you to talk about these family problems" dx w antisocial - making progress w tx SATA - - CORRECT-ANSWER IS- - assisting another client to complete a menu requesting a weekend pass to go home acute care mental facility newly dx w antisocial - include in plan of care?
• - CORRECT-ANSWER IS- - setting clear rules and expectations for the client's behavior admitted yed w alcoholism - "i have not had anything to drink for 24 hours" - anxious and shaky - other behaviors expected? - - CORRECT- ANSWER IS- - coarse tremors, tachycardia, insomnia