ATI Custom NUR175 Exam 1 Summer ASN Part 1
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Free ATI Custom NUR175 Exam 1 Summer ASN Part 1 Questions
A client who was recently diagnosed with a chronic illness tells the nurse, "I don't know how I'm supposed to live like this. Everything is changing so fast, and I feel like I'm losing control." Which of the following is the most appropriate therapeutic response by the nurse?
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"It sounds like you're feeling overwhelmed by all the changes."
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"Many people feel that way at first, but you'll adjust over time."
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"Why do you feel like this? Tell me more."
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"I'll call the healthcare provider and let them know you're having a hard time."
Explanation
This response demonstrates reflective listening and empathy by accurately mirroring the emotional content of the client's statement. It validates the client's experience, demonstrates that the nurse is actively listening and understanding, and creates a safe space for the client to continue expressing their feelings without judgment or redirection.
Why the other options are incorrect:
B. Telling the client they will adjust over time minimizes their current distress and offers false reassurance. It dismisses the client's immediate emotional experience and does not encourage further therapeutic dialogue.
C. Asking "why do you feel like this" can feel confrontational or demanding to a distressed client and may put them on the defensive. Open-ended questions that begin with "why" are generally considered less therapeutic than reflective or exploratory approaches.
D. Immediately calling the healthcare provider without first engaging therapeutically with the client escalates the situation unnecessarily and does not address the client's immediate emotional need for acknowledgment and support.
A client with schizophrenia has recently begun a new medication, clozapine. Which is a potential fatal side effect that should be included in the teaching plan?
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Akathisia
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Agranulocytosis
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Akinesia
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Dystonia
Explanation
Correct Answer: (B) Agranulocytosis
Agranulocytosis is a potentially fatal side effect of clozapine characterized by a severe drop in white blood cells, which significantly increases the client's risk for life-threatening infections; this is why clients on clozapine require regular blood monitoring to ensure early detection.
Why the other options are incorrect:
A. Akathisia is a distressing but non-fatal extrapyramidal side effect characterized by subjective and objective restlessness.
C. Akinesia refers to a loss or impairment of voluntary movement and is an extrapyramidal side effect, not a fatal complication.
D. Dystonia involves involuntary muscle contractions and spasms, which, while uncomfortable and sometimes urgent, is not a fatal side effect like agranulocytosis.
A client has been admitted for help with obsessive-compulsive disorder. They have been spending several hours per day cleaning their already clean home. Which nursing intervention would be appropriate for this client?
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Provide proof that their house is clean enough so that the client can stop cleaning all day.
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Arrange for a distractive activity so that the client will stop cleaning and focus on something else.
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Encourage the client to dedicate time to pursuing other interests instead of constantly cleaning.
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Allow more time initially to do the cleaning, then gradually decrease the time spent on rituals.
Explanation
Abruptly stopping or interrupting a client's compulsive rituals can cause a significant increase in anxiety, so the appropriate nursing intervention is to initially allow the client sufficient time to complete their rituals and then gradually decrease that time, helping the client build tolerance to the anxiety in a controlled, therapeutic manner.
Why Other Options are Incorrect:
A. Providing proof that the house is clean enough will not be effective, because compulsive behaviors are driven by anxiety and irrational thought patterns, not a lack of factual reassurance, and offering proof does not reduce the underlying anxiety.
B. Arranging for a distractive activity so that the client will stop cleaning does not address the root anxiety driving the compulsion and may increase the client's distress if the ritual is interrupted abruptly.
C. Encouraging the client to dedicate time to pursuing other interests instead of constantly cleaning does not acknowledge the client's need to gradually reduce ritualistic behavior and may be unrealistic in the early stages of treatment.
A client has just been told she has cervical cancer. When asked about how this is impacting her, the client states, "It's just an infection; it will clear up." What does the client's response indicate?
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Rationalization
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Displacement
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Denial
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Suppression
Explanation
Denial is the refusal to accept a painful reality. By insisting her cancer is merely an infection that will resolve, the client is rejecting the actual diagnosis to protect herself from the emotional impact.
Why the other options are incorrect:
A. Rationalization This involves justifying behavior with acceptable-sounding reasons, not refusing to acknowledge a reality.
B. Displacement This is transferring feelings from the true source to a safer target, which the client is not doing.
D. Suppression This is the conscious, deliberate setting aside of distressing thoughts, whereas the client is unconsciously rejecting the diagnosis altogether.
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Administer naloxone as prescribed and monitor respiratory status.
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Begin chest compressions and call a code.
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Place the client in a side-lying position and obtain a urine toxicology screen.
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Prepare for endotracheal intubation and mechanical ventilation.
Explanation
Correct Answer: (A) Administer naloxone as prescribed and monitor respiratory status.
Naloxone is an opioid antagonist that rapidly reverses the effects of an opioid overdose, including respiratory depression; given the client's pinpoint pupils, unresponsiveness, and critically low respiratory rate, immediate administration of naloxone is the priority intervention to restore adequate breathing and prevent further deterioration.
Why the other options are incorrect:
B. Beginning chest compressions and calling a code is not appropriate at this time, as the client has a pulse and is still breathing, though inadequately; naloxone should be administered first to address the underlying cause.
C. Placing the client in a side-lying position and obtaining a urine toxicology screen does not address the immediate, life-threatening respiratory depression and delays the priority treatment.
D. Preparing for endotracheal intubation and mechanical ventilation may become necessary if naloxone is ineffective or respiratory status does not improve, but it is not the first-line priority intervention for a suspected opioid overdose.
A client states, "I'm not worth anything. I have negative thoughts about myself. I feel anxious and I'm shaky all the time. Sometimes I feel so sad that I want to go to sleep and never wake up." Which nursing intervention should receive the highest priority?
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Coping skills for anxiety and depression
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Self-esteem-building activities
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Administration of antidepressant medications
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Suicide precautions
Explanation
Correct Answer: (D) Suicide precautions The client's statement about wanting to "go to sleep and never wake up" is a veiled expression of suicidal ideation. Per Maslow's hierarchy and safety principles, the immediate protection of the client's life takes priority over all other interventions.
Why the other options are incorrect:
A. Coping skills for anxiety and depression These are important long-term interventions but cannot be prioritized over immediate safety.
B. Self-esteem-building activities Addressing self-worth is therapeutic but secondary when the client's life may be at risk.
C. Administration of antidepressant medications Medications are part of the treatment plan but take weeks to work and do not address the immediate safety concern.
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Confer with the healthcare provider regarding the use of restraints for this client.
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Arrange for a community meeting in the milieu to discuss this behavior.
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Have an impromptu staff meeting to discuss consistency and limit-setting approaches.
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Explain to the client that their behavior is unacceptable and scares other clients.
Explanation
Correct Answer: (C) Have an impromptu staff meeting to discuss consistency and limit-setting approaches.
A client in acute, severe mania who is manipulating and dividing staff requires a unified, consistent approach; holding a staff meeting ensures all team members agree on limit-setting strategies, preventing staff splitting and burnout while maintaining a therapeutic, structured environment for the client.
Why the other options are incorrect:
A. Conferring with the healthcare provider regarding restraints is premature, as restraints are a last resort intervention only used after less restrictive measures such as consistent limit-setting have failed.
B. Arranging for a community meeting in the milieu to discuss this behavior is inappropriate, as publicly discussing one client's behavior in front of peers can cause embarrassment and escalate the client's agitation.
D. Explaining to the client that their behavior is unacceptable and scares other clients does not address the underlying issue of inconsistent staff responses and may increase the client's defensiveness without a coordinated plan in place.
A nurse is conducting a discharge teaching session for a client who has been prescribed a new antidepressant medication. The client says, "I don't like taking pills every day. I feel fine, so I don't see the point." Which response by the nurse best promotes medication compliance?
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"If you don't take your medication, your suicidal thoughts may come back."
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"Taking your medication every day is part of your treatment plan, so you must follow it as prescribed."
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"Most people don't like taking daily medications. Maybe your doctor can lower the dose so it's not as frequent."
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"You feel fine now because the medication is helping. Let's talk about ways to make it easier to remember to take it."
Explanation
Correct Answer: (D) "You feel fine now because the medication is helping. Let's talk about ways to make it easier to remember to take it." This response validates the client's feeling of wellness while educating them that their current wellbeing is a result of the medication working. It then collaboratively shifts to problem-solving adherence strategies, which is the most therapeutic and compliance-promoting approach.
Why the other options are incorrect:
A. "If you don't take your medication, your suicidal thoughts may come back." This is fear-based and threatening, which is not a therapeutic way to promote compliance and may damage trust.
B. "Taking your medication every day is part of your treatment plan, so you must follow it as prescribed." This is authoritative and dismisses the client's concerns, reducing the likelihood of genuine compliance.
C. "Most people don't like taking daily medications. Maybe your doctor can lower the dose so it's not as frequent." This undermines the prescribed treatment plan and is outside the nurse's scope to suggest without consulting the provider.
A nurse recently administered chlorpromazine to their client. The client developed a high fever, muscle rigidity, and increased blood pressure and heart rate. The client is also confused. The nurse suspects which of the following conditions?
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Stevens-Johnson syndrome
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Hypertensive crisis
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Neuroleptic malignant syndrome
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Serotonin syndrome
Explanation
Correct Answer: (C) Neuroleptic malignant syndrome
Neuroleptic malignant syndrome is a rare but life-threatening reaction to antipsychotic medications such as chlorpromazine. Its hallmark presentation includes hyperthermia, severe muscle rigidity, autonomic instability such as elevated blood pressure and heart rate, and altered mental status including confusion. The temporal relationship between chlorpromazine administration and symptom onset makes NMS the primary suspect.
Why the other options are incorrect:
A. Stevens-Johnson syndrome is a severe skin reaction typically caused by medications such as anticonvulsants or antibiotics, characterized by widespread skin blistering and mucous membrane involvement. It does not present with muscle rigidity and autonomic instability.
B. Hypertensive crisis involves severely elevated blood pressure but does not explain the combination of high fever, muscle rigidity, and confusion following antipsychotic administration.
D. Serotonin syndrome shares some features with NMS, including hyperthermia and autonomic instability, but is caused by excess serotonergic activity from serotonergic medications such as SSRIs or MAOIs, not from antipsychotics like chlorpromazine. Muscle rigidity in NMS also tends to be more severe and described as lead-pipe rigidity, distinguishing it from the neuromuscular hyperactivity seen in serotonin syndrome.
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Serotonin syndrome. Administer lorazepam intramuscularly.
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Tardive dyskinesia. Withhold the next dose of medication.
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Neuroleptic malignant syndrome. Notify the healthcare provider.
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Akathisia. Administer benztropine by mouth.
Explanation
Correct Answer: (C) Neuroleptic malignant syndrome. Notify the healthcare provider.
Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotic medications such as risperidone, characterized by severe muscle rigidity, hyperthermia, autonomic instability (elevated pulse, respirations, and blood pressure), diaphoresis, and altered mental status; this constellation of findings requires the nurse to notify the healthcare provider immediately, as NMS is a medical emergency requiring prompt intervention.
Why the other options are incorrect:
A. Serotonin syndrome is caused by excess serotonergic activity, typically from serotonergic medications, and while it shares some overlapping symptoms, this client's presentation following risperidone with progressive rigidity, hyperthermia, and autonomic instability is more consistent with NMS.
B. Tardive dyskinesia presents with involuntary, repetitive movements such as lip-smacking or grimacing, not severe rigidity, fever, and autonomic instability; withholding medication alone is also insufficient given the severity of this presentation.
D. Akathisia presents as subjective and objective restlessness or an inability to sit still, not muscle rigidity, hyperthermia, and confusion; benztropine would not address this life-threatening presentation.
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