ATI Custom MH NUR3210 Final Exam International College of Health Sciences
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Free ATI Custom MH NUR3210 Final Exam International College of Health Sciences Questions
A nurse is caring for a client who is dying.
Nurses' Notes
Day 1 1000: Client resting quietly in bed. Client's partner in bedside chair. Partner has been providing comfort measures and non-pharmacologic interventions. States that they feel overwhelmed at times when providing care and becomes very emotional when talking about the future.
Day 2 1230: Client's partner overheard crying in the bathroom. States that the impending death is too much to bear right now and the decisions that must be made are exhausting. They are not sleeping well at night and their appetite is significantly decreased. Verbalizes feelings of anxiety. Hospice care arranged for client's upcoming discharge. Respite care discussed with the client's partner.
Day 3 1300: Client alert and oriented x4. Client discharged to home with hospice care. Partner will be providing care to the client at home.
A nurse is planning self-care education for the caregiver of a client who is dying. Which of the following recommendations should the nurse include? (Select all that apply.)
- Increase recommended daily caloric intake.
- Walk for at least 30 min each day outside.
- Limit leisure activities for the caregiver.
- Establish a sleep routine of at least 7 hr of sleep per night.
- Encourage the caregiver to develop a rigid emotional barrier.
Explanation
Explanation:
Correct Answer: (B) Walk for at least 30 min each day outside, and (D) Establish a sleep routine of at least 7 hr of sleep per night.
Caregivers of dying clients are at high risk for caregiver burnout, anxiety, and physical deterioration. Regular physical activity such as walking for 30 minutes daily helps reduce stress, improve mood, and maintain physical health. Establishing a consistent sleep routine of at least 7 hours per night is essential as adequate sleep supports emotional resilience, cognitive function, and overall wellbeing, especially important given the caregiver's documented sleep difficulties.
Why Other Options are Incorrect:
A. Increase recommended daily caloric intake. – There is no clinical indication to increase caloric intake beyond recommended daily amounts. The goal is to maintain adequate nutrition, not increase caloric consumption.
C. Limit leisure activities for the caregiver. – This is the opposite of what should be recommended. Leisure activities are an important component of self-care and stress relief for caregivers and should be encouraged, not limited.
E. Encourage the caregiver to develop a rigid emotional barrier. – Developing rigid emotional barriers is not a healthy coping strategy. Caregivers should be encouraged to process their emotions, seek support, and maintain emotional openness rather than suppressing feelings.
A nurse is assessing a client who has paranoid personality disorder. Which of the following findings should the nurse expect?
- Lack of feelings of remorse
- Inflated sense of self
- Requiring frequent reassurance from others
- Suspiciousness of others
Explanation
Explanation:
Correct Answer: (D) Suspiciousness of others.
Pervasive and unwarranted suspiciousness and mistrust of others is the hallmark defining characteristic of paranoid personality disorder. Clients with this disorder persistently believe without sufficient basis that others are exploiting, harming, or deceiving them. They question the loyalty of friends and family, hold grudges, and read hidden threatening meanings into benign remarks or events. This chronic pattern of distrust is the central diagnostic feature.
Why Other Options are Incorrect:
A. Lack of feelings of remorse — Absence of remorse is a defining feature of antisocial personality disorder, not paranoid personality disorder. Clients with antisocial personality disorder demonstrate callousness and disregard for the rights of others without guilt or empathy.
B. Inflated sense of self — An inflated, grandiose sense of self is characteristic of narcissistic personality disorder, in which clients have an exaggerated sense of their own importance, entitlement, and need for admiration.
C. Requiring frequent reassurance from others — Excessive need for reassurance, approval, and support from others is characteristic of dependent personality disorder, in which clients have difficulty making decisions independently and fear abandonment.
A team of providers, nurses, social workers, and counselors work together to provide care for a client with a substance use disorder. Which of the following names describes this group of clinicians?
- Tactical team
- Triage team
- Interdisciplinary team
- Collaborative team
Explanation
Explanation:
Correct Answer: (C) Interdisciplinary team
An interdisciplinary team consists of professionals from multiple disciplines who work together in a coordinated manner to provide comprehensive care for a client. In this case, providers, nurses, social workers, and counselors each contribute their unique expertise toward a shared care plan, which is the defining characteristic of an interdisciplinary team approach.
Why Other Options are Incorrect:
A. Tactical team – This term is not used in healthcare settings to describe a multidisciplinary group providing client care.
B. Triage team – A triage team is specifically focused on assessing and prioritizing the severity of clients' conditions, typically in emergency settings, and does not describe an ongoing collaborative care group.
D. Collaborative team – While collaboration is a feature of interdisciplinary work, "collaborative team" is not the recognized clinical term used to describe this type of structured, multi-professional care team.
A nurse is assessing a client who has a mental illness. Which of the following factors are important when assessing social determinants of mental health? (Select all that apply.)
- Employed part-time at minimum wage
- Living in a homeless shelter
- History of diabetes mellitus
- Access to a grocery store
- Owning a small dog
Explanation
Explanation:
Correct Answer: (A) Employed part-time at minimum wage, (B) Living in a homeless shelter, and (D) Access to a grocery store
Social determinants of mental health refer to the conditions in which people are born, grow, live, work, and age that influence mental health outcomes. Financial instability, lack of safe housing, and limited access to nutritious food are all recognized social determinants that directly impact mental health.
Why Other Options are Incorrect:
C. History of diabetes mellitus – This is a medical/physical health condition, not a social determinant of mental health. It is a clinical finding, not an environmental or social factor.
E. Owning a small dog – While pet ownership may provide emotional comfort, it is not a recognized social determinant of mental health in a clinical assessment context.
A nurse in a mental health clinic is caring for a client who is grieving. A nurse is caring for a client who is grieving. Which of the following findings should the nurse identify as a priority to address? Select all that apply.
Clinical Information:
Nurses' Notes:
1000: Client presents to the mental health clinic and is tearful and angry. They recently experienced the loss of a child due to illness. Information provided to client about group therapy and individual therapy.
1100: Client is continuing to sob and states, "I can't go on living without my child." Current list of home medications reviewed. Client states they have not been taking the prescribed medication "because it will not help."
1300: Client spoke in group therapy session regarding feelings and prescribed treatment. Acknowledges the role of the therapist and expectations of support group, yet confides, "My anger and sadness are still very intense."
Vital Signs (1015): Temperature 36.8°C (98.4°F), Heart rate 85/min, Respiratory rate 15/min, BP 147/86 mm Hg, Oxygen saturation 99%
Medication Administration: Sertraline 100 mg PO BID
- Statement regarding outlook on living.
- Statement related to feelings of sadness and anger.
- Knowledge of expectations during group meetings.
- Awareness of the therapist's role.
- Statement related to use of pharmacological interventions.
Explanation
Explanation:
Correct Answer: (A, E) Statement regarding outlook on living and Statement related to use of pharmacological interventions.
The statement "I can't go on living without my child" is the highest priority finding as it represents a potential suicidal ideation or passive death wish, which is an immediate safety concern requiring urgent nursing assessment and intervention. Safety always takes priority in mental health nursing care. Additionally, the client's refusal to take their prescribed sertraline "because it will not help" is a critical priority because non-adherence to antidepressant therapy in a grieving client with possible suicidal ideation significantly increases the risk of deteriorating mental health and self-harm. These two findings together represent the most urgent threats to the client's safety and wellbeing.
Why Other Options are Incorrect:
B. Statement related to feelings of sadness and anger — While sadness and anger are important emotional findings to acknowledge and address, they are expected and normal manifestations of the grief process and do not represent an immediate safety threat requiring priority intervention above the safety and medication adherence concerns.
C. Knowledge of expectations during group meetings — The 1300 nurses' note documents that the client already acknowledges the role of the therapist and the expectations of the support group, indicating that this area of teaching has been successfully addressed and is no longer a priority concern.
D. Awareness of the therapist's role — Similar to option C, the client's 1300 statement confirms they have an understanding of the therapist's role. This is therefore not an outstanding priority concern that requires immediate nursing attention.
A nurse is caring for a client who has a new diagnosis of somatic symptoms disorder. The nurse should identify that the client must have been experiencing manifestations of the disorder for how long before diagnosis?
- 4 weeks
- 1 week
- 3 months
- 6 months
Explanation
Explanation:
Correct Answer: (D) 6 months
According to the DSM-5 diagnostic criteria, somatic symptom disorder requires that the client has been experiencing at least one somatic symptom that is distressing or results in significant disruption of daily life, along with excessive thoughts, feelings, or behaviors related to the somatic symptoms, for a minimum of 6 months before a diagnosis can be made.
Why Other Options are Incorrect:
A. 4 weeks – Four weeks is insufficient to meet the diagnostic criteria for somatic symptom disorder. This timeframe does not satisfy the DSM-5 requirement of persistent symptoms.
B. 1 week – One week is far too brief to establish the chronic, persistent pattern required for a diagnosis of somatic symptom disorder.
C. 3 months – While 3 months represents a longer duration, it still does not meet the minimum 6-month requirement specified in the DSM-5 diagnostic criteria for somatic symptom disorder.
A nurse is talking with a newly hired nurse. The newly hired nurse states, "I really thought that I would easily transition from school to work. I am just exhausted, and now I wonder if I should even be a nurse." This statement indicates that the nurse is experiencing which of the following types of stress?
- Trauma grief
- Anxiety
- Burnout
- Grief
Explanation
Explanation:
Correct Answer: (C) Burnout.
Burnout is a state of chronic occupational stress characterized by emotional exhaustion, depersonalization, and reduced sense of personal accomplishment. The newly hired nurse's statement reflects all three dimensions of burnout: physical and emotional exhaustion ("I am just exhausted"), disillusionment with the profession ("I wonder if I should even be a nurse"), and a gap between expectations and reality ("I really thought I would easily transition"). This is a classic presentation of professional burnout, particularly common during the transition from student to practicing nurse.
Why Other Options are Incorrect:
A. Trauma grief — Trauma grief involves the grief response following exposure to a traumatic event or traumatic loss. The nurse's statement does not describe a specific traumatic experience or loss that triggered this response.
B. Anxiety — Anxiety involves excessive worry, fear, and apprehension about future events. While the nurse may experience some anxiety, the statement more specifically describes exhaustion, disillusionment, and questioning of professional identity — hallmarks of burnout rather than anxiety.
D. Grief — Grief is the emotional response to loss, typically associated with bereavement or significant personal loss. The nurse's statement does not reflect a grief response to a specific loss but rather occupational exhaustion and professional disillusionment consistent with burnout.
A nurse on an inpatient unit is caring for a client who has somatic symptom disorder. The client comes to the nurse's station and reports chest pain. The nurse knows this is a new symptom for the client. Which of the following actions should the nurse take?
- Assess the client's vital signs.
- Encourage the client to use relaxation techniques.
- Explain to the client that the pain is not real.
- Reassure the client that pain is an expected part of their disorder.
Explanation
Explanation:
Correct Answer: (A) Assess the client's vital signs.
Even though the client has somatic symptom disorder, new physical complaints must always be taken seriously and assessed as potentially organic in origin. A new complaint of chest pain could represent a genuine cardiac or pulmonary emergency such as a myocardial infarction, pulmonary embolism, or aortic dissection. The nurse must perform a thorough physical assessment including vital signs first before attributing the symptom to the client's psychiatric diagnosis.
Why Other Options are Incorrect:
B. Encourage the client to use relaxation techniques — While relaxation techniques are part of the management plan for somatic symptom disorder, they should not be the first response to a new complaint of chest pain before ruling out a life-threatening physical cause.
C. Explain to the client that the pain is not real — This is dismissive, therapeutically harmful, and clinically dangerous. The pain experience in somatic symptom disorder is genuinely felt by the client, and dismissing it invalidates their experience while also risking missing a real medical emergency.
D. Reassure the client that pain is an expected part of their disorder — Labeling a new symptom as part of the existing disorder without proper assessment is a dangerous assumption that could lead to missing a serious acute medical condition.
The provider orders 3,600 mg of a medication. The tablets available are labeled as 600 mg each. How many tablets should the nurse administer?
- 5 tablets
- 4 tablets
- 7 tablets
- 6 tablets
Explanation
Explanation:
Correct Answer: (D) 6 tablets.
Using the standard dose calculation formula: Desired dose ÷ Available dose per tablet = Number of tablets. 3,600 mg ÷ 600 mg per tablet = 6 tablets. Six 600 mg tablets precisely deliver the complete ordered dose of 3,600 mg.
A nurse manager and a newly licensed nurse are engaged in an interview with a client. The newly licensed nurse tells the client, "You look like my sister. I love my sister and would do anything for her." Which of the following actions should the nurse manager take?
- Assign the newly licensed nurse to a different client.
- Ask the newly licensed nurse if they are comfortable providing care to the client.
- Record that the newly licensed nurse is able to maintain professional nurse-client boundaries.
- Inform the newly licensed nurse that they are successfully building trust and rapport.
Explanation
Explanation:
Correct Answer: (A) Assign the newly licensed nurse to a different client.
The newly licensed nurse's comment represents a boundary violation by introducing personal information and creating a non-therapeutic comparison between the client and a family member. This type of statement blurs the professional nurse-client relationship and can compromise objective, therapeutic care. The nurse manager's most appropriate action is to reassign the nurse to a different client to protect the therapeutic relationship and the client's wellbeing.
Why Other Options are Incorrect:
B. Ask the newly licensed nurse if they are comfortable providing care to the client. – The issue is not the nurse's comfort level but rather the professional boundary violation that has already occurred. This response does not address the core problem.
C. Record that the newly licensed nurse is able to maintain professional nurse-client boundaries. – This is incorrect as the nurse's statement is an example of a boundary violation, not an example of maintaining professional boundaries.
D. Inform the newly licensed nurse that they are successfully building trust and rapport. – This response is incorrect and potentially reinforces the boundary-crossing behavior, which could escalate into further professional boundary violations.
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