ATI Chapter Questions (Exam #2)

A nurse is discussing routine follow-up needs for a client who has a new prescription for valproic acid (Depakote). The nurse should inform the client of the need for routine monitoring of which of the following? A. AST/ALT and LDH B. Creatinine and BUN C. WBC and granulocyte counts D. Serum sodium and potassium

A ( AST/ALT and LDH)

A charge nurse is discussing the care of a client who has major depressive disorder (MDD) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. "Care during the continuation phase focuses on treating continued manifestations of MDD." B. "The goal of treatment during the maintenance phase is prevention of future episodes of MDD." C. "The client is at greatest risk for suicide during the first weeks of an MDD episode." D. "Medication and psychotherapy are used to prevent a relapse of MDD."

A ("Care during the continuation phase focuses on treating continued manifestations of MDD.")

A nurse is caring for an adolescent client who has anorexia nervosa with recent rapid weight loss & a current weight of 90 lb. Which of the following statements indicates the client is experiencing the cognitive distortion of catastrophizing? A. "Life isn't worth living if I gain weight." B. "Don't pretend like you don't know how fat I am." C. "If I could be skinny, I know I'd be popular." D. "When I look in the mirror, I see myself as obese."

A ("Life isn't worth living if I gain weight.")

A charge nurse is discussing mirtazapine (Remeron) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding? A. "This medication increases the release of serotonin and norepinephrine." B. "I will need to monitor the client for hyponatremia while taking this medication." C. "This medication is contraindicated for clients who have an eating disorder." D. "Sexual dysfunction is a common adverse effect of this medication."

A ("This medication increases the release of serotonin and norepinephrine.")

A nurse is preparing to obtain a nursing history from a client who has a new diagnosis of anorexia nervosa. Which of the following questions should the nurse to include in the assessment? (Select all that apply.) A. "What is your relationship like with your family?" B. "Why do you want to lose weight?" C. "Would you describe your current eating habits?" D. "At what weight do you believe you will look better?" E. "Can you discuss your feelings about your appearance?"

A ("What is your relationship like with your family?") C ("Would you describe your current eating habits?") E ("Can you discuss your feelings about your appearance?")

A nurse is caring for a client who is experiencing extreme mania due to bipolar disorder. Prior to administration of lithium carbonate, the nurse notes that the lithium blood level is 1.2 mEq/L. Which of the following is an appropriate action by the nurse? A. Administer the next dose of lithium carbonate as scheduled. B. Prepare for administration of aminophylline. C. Notify the provider for a possible increase in the dosage of lithium carbonate. D. Request a stat repeat of the client's lithium blood level.

A (Administer the next dose of lithium carbonate as scheduled.)

A nurse working in an acute mental health facility is caring for a 35-year-old female client who has clinical findings of depression. The client lives at home with her husband and two young children. She currently smokes and has a history of chronic asthma. The nurse should identify which of the following as risk factors for depression for this client? (Select all that apply.) A. Age of 35 years old B. Female gender C. History of chronic asthma D. Currently smokes E. Being married

A (Age of 35 years old) B (Female gender) C (History of chronic asthma) D (Currently smokes)

A nurse is assessing a client who is suicidal. Which of the following is appropriate for the nurse to ask the client? (Select all that apply.) A. Do you have a plan? B. Have you thought about hurting yourself? C. Do you feel that life is not worth living? D. Why do you want to commit suicide? E. Have you experienced a recent change in your mood?

A (Do you have a plan?) B (Have you thought about hurting yourself?) C (Do you feel that life is not worth living?) E (Have you experienced a recent change in your mood?)

A nurse is working with a client who has recently lost his mother. The nurse recognizes that which of the following factors influence grief and coping ability? (Select all that apply.) A. Interpersonal relationships B. Culture C. Birth order D. Size of family E. Prior experience with loss

A (Interpersonal relationships) B (Culture) E (Prior experience with loss)

A nurse working on an acute mental health unit is admitting a client who has major depressive disorder and comorbid anxiety disorder. Which of the following is the highest priority action by the nurse? A. Placing the client on one-to-one observation B. Assisting the client to perform ADLs C. Encouraging the client to participate in counseling D. Teaching the client about medication adverse effects

A (Placing the client on one-to-one observation)

A nurse is teaching a client who has a new prescription for imipramine (Tofranil) how to minimize anticholinergic effects. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Void just before taking the medication. B. Increase the dietary intake of potassium. C. Wear sunglasses when outside. D. Change positions slowly when getting up. E. Chew sugarless gum.

A (Void just before taking the medication) C (Wear sunglasses when outside.) E (Chew sugarless gum)

A nurse is caring for a client who has bipolar disorder. The client states, "I am very rich, and I feel I must give my money to you." Which of the following is an appropriate response by the nurse? A. "Why do you think you feel the need to give money away?" B. "I am here to provide care and cannot accept this from you." C. "I can request that your case manager discuss appropriate charity options with you." D. "You should know that giving away your money is inappropriate."

B ("I am here to provide care and cannot accept this from you.")

A nurse is providing teaching to a client who has a new prescription for amitriptyline (Elavil). Which of the following client statements indicates understanding of the teaching? A. "While taking this medication, I'll need to stay out of the sun to avoid a skin rash." B. "I may feel drowsy for a few weeks after starting this medication." C. "I cannot eat my favorite pizza with pepperoni while taking this medication." D. "This medication will help me lose the weight that I have gained over the last year."

B ("I may feel drowsy for a few weeks after starting this medication.")

A nurse is caring for a client who is on lithium therapy. The client states that he wants to take ibuprofen for osteoarthritis pain relief. Which of the following statements by the nurse is appropriate? A. "That is a good choice. Ibuprofen does not interact with lithium." B. "Regular aspirin would be a better choice than ibuprofen." C. "Lithium decreases the effectiveness of ibuprofen." D. "The ibuprofen will make your lithium level fall too low."

B ("Regular aspirin would be a better choice than ibuprofen.")

A nurse is conducting a class for a group of newly licensed nurses on identifying risk factors for suicide. Which of the following individuals should the nurse include as having the highest risk for suicide? (Select all that apply.) A. Older adult females B. Adolescents C. Native Americans D. Clients who have a depressive disorder E. Clients who have hypomania

B (Adolescents) C (Native Americans) D (Clients who have a depressive disorder)

A nurse is discussing relapse prevention with a client who has bipolar disorder. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Use caffeine in moderation to prevent relapse. B. Difficulty sleeping can indicate a relapse. C. Begin taking your medications as soon as a relapse begins. D. Participating in psychotherapy can help prevent a relapse. E. Anhedonia is a clinical manifestation of a depressive relapse.

B (Difficulty sleeping can indicate a relapse.) D (Participating in psychotherapy can help prevent a relapse) E (Anhedonia is a clinical manifestation of a depressive relapse.)

A nurse is performing an admission assessment of a client who has bulimia nervosa with purging behavior. Which of the following is an expected finding? (Select all that apply.) A. Amenorrhea B. Hypokalemia C. Mottling of the skin D. Slightly elevated body weight E. Presence of lanugo on the face

B (Hypokalemia) D (Slightly elevated body weight)

A client says, "I plan to commit suicide." Which of the following should be the nurse's priority assessment? A. Client's educational and economic background B. Lethality of the method and availability of means C. Quality of the client's social support D. Client's insight into the reasons for the decision

B (Lethality of the method and availability of means)

A nurse is conducting chart reviews of multiple clients at a community mental health facility. Which of the following would be an example of client experiencing a maturational crisis? A. Rape B. Marriage C. Severe physical illness D. Job loss

B (Marriage)

A nurse is planning care for a client who has bipolar disorder and is experiencing a manic episode. Which of the following is appropriate for the nurse to include in the plan of care? (Select all that apply.) A. Provide flexible client behavior expectations B. Offer concise explanations C. Establish consistent limits D. Disregard client complaints E. Use a firm approach with communication

B (Offer concise explanations) C (Establish consistent limits) E (E. Use a firm approach with communication)

A nurse is caring for a client who is taking phenelzine (Nardil). For which of the following adverse effects should the nurse observe? (Select all that apply.) A. Elevated blood glucose level B. Orthostatic hypotension C. Priapism D. Headache E. Bruxism

B (Orthostatic hypotension) D (headache)

A nurse is caring for a client who is experiencing a crisis. Which of the following medications might the provider prescribe? (Select all that apply.) A. Lithium carbonate (Lithobid) B. Paroxetine (Paxil) C. Risperidone (Risperdal) D. Haloperidol (Haldol) E. Lorazepam (Ativan)

B (Paroxetine / Paxil) E (Lorazepam / Ativan)

A nurse is discussing early indications of toxicity with a client who has a new prescription for lithium carbonate for bipolar disorder. The nurse should include which of the following in the teaching? (Select all that apply.) A. Constipation B. Polyuria C. Rash D. Muscle weakness E. Tinnitus

B (polyruria) D (muscle weakness)

A nurse is teaching a newly licensed nurse about the use of electroconvulsive therapy (ECT) for the treatment of bipolar disorder. Which of the following statements by the newly licensed nurse indicates understanding? A. "ECT is the recommended initial treatment for bipolar disorder." B. "ECT is contraindicated for clients who have suicidal ideation." C. "ECT is effective for clients who are experiencing severe mania." D. "ECT is prescribed to prevent relapse of bipolar disorder."

C ("ECT is effective for clients who are experiencing severe mania.")

A nurse working in an outpatient clinic is providing teaching to a client who has a new diagnosis of premenstrual dysphoric disorder (PMDD). Which of the following statements by the client indicates understanding of the teaching? A. "I can expect my problems with PMDD to be worst when I'm menstruating." B. "I will use light therapy 30 min a day to prevent further recurrences of PMDD." C. "I am aware that my PMDD causes me to have rapid mood swings." D. "I should increase my caloric intake with a nutritional supplement when my PMDD is active."

C ("I am aware that my PMDD causes me to have rapid mood swings.")

A nurse is caring for a client who lost his mother to cancer last month. Which of the following statements made by the nurse is a nontherapeutic response? A. "You sound angry." Anger is a normal feeling associated with loss." B. "Tell me more about your how you are feeling." C. "I understand just how you feel. I felt the same when my mother died." D. "Let's discuss how you have been coping."

C ("I understand just how you feel. I felt the same when my mother died.")

A nurse is caring for a client who has bulimia nervosa and who has stopped purging behavior. The client tells the nurse that she is afraid she is going to gain weight. Which of the following is an appropriate response by the nurse? A. "Many clients are concerned about their weight. However, the dietitian will ensure that you don't get too many calories in your diet." B. "Instead of worrying about your weight, try to focus on other problems at this time." C. "I understand you have concerns about your weight, but first, let's talk about your recent accomplishments." D. "You are not overweight, and the staff will ensure that you do not gain weight while you are in the hospital. We know that is important to you."

C ("I understand you have concerns about your weight, but first, let's talk about your recent accomplishments.")

A nurse assesses a client at a community mental health facility using the SAD PERSONS tool. The nurse knows that this tool provides which of the following data related to a client? A. Current anxiety level B. Problem-solving ability C. Suicide potential D. Mood disturbance

C (Suicide potential)

A nurse is reviewing the medical record of a client who has a new prescription for bupropion (Wellbutrin) for depression. Which of the following findings is the highest priority for the nurse to report to the provider? A. The client has a family history of seasonal pattern depression. B. The client currently smokes 1.5 packs of cigarettes per day. C. The client had a motor vehicle crash last year and sustained a head injury. D. The client has a BMI of 25 and has gained 10 lb over the last year.

C (The client had a motor vehicle crash last year and sustained a head injury.)

A nurse is interviewing a 25-year-old client who has a new diagnosis of dysthymia. Which of the following findings should the nurse expect? A. There are wide fluctuations in mood. B. The report of a minimum of five clinical findings of depression. C. The presence of manifestations for at least 2 years. D. There is an inflated sense of self-esteem.

C (The presence of manifestations for at least 2 years.)

A nurse is caring for a client who is on suicide precautions. Which of the following interventions should the nurse include in the plan of care? A. "Assign the client to a private room." B. "Document the client's behavior every hour." C. "Allow the client to keep perfume in her room." D. "Ensure that the client swallows medication."

D ("Ensure that the client swallows medication.")

A nurse is discussing normal uncomplicated grief with a client who recently lost a child. Which of the following statements made by the client requires additional intervention? A. "I may experience feelings of resentment." B. "I may withdraw from others." C. "It is possible to experience changes in sleep." D. "It is possible to experience suicidal thoughts."

D ("It is possible to experience suicidal thoughts.")

A nurse is admitting a client who has a new diagnosis of bipolar disorder and is scheduled to begin lithium therapy. When collecting a medical history from the client's adult daughter, which of the following statements is the highest priority to report to the provider? A. "My mother has diabetes that is controlled by her diet." B. "My mother recently completed a course of prednisone for acute bronchitis." C. "My mother received her flu vaccine last month." D. "My mother is currently on furosemide for her congestive heart failure."

D ("My mother is currently on furosemide for her congestive heart failure.")

A nurse on an acute care unit is planning care for a client who has anorexia nervosa with binge-eating and purging behavior. Which of the following nursing actions is appropriate to include in the client's plan of care? A. Allow the client to select preferred meal times. B. Establish consequences for purging behavior. C. Provide the client with a high-fat diet at the start of treatment. D. Implement one-to-one observation during meal times.

D (Implement one-to-one observation during meal times.)

A nurse in an acute mental health facility is caring for a client who is experiencing a mixed episode of bipolar disorder. Which of the following is the priority nursing action? A. Set consistent limits for expected client behavior. B. Administer prescribed medications as scheduled. C. Provide the client with step-by-step instructions during hygiene activities. D. Monitor the client for escalating behavior.

D (Monitor the client for escalating behavior. )