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ATI Comprehensive Exit Exam

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1. A patient’s father died a week ago. Both the patient and the patient’s spouse talk about the death. The patient’s spouse is experiencing headaches and fatigue. The patient is having trouble sleeping, has no appetite, and gets choked up most of the time. How should the nurse interpret these findings as the basis for a follow-up assessment? a. The patient is dying and the spouse is angry. b. The patient is ill and the spouse is malingering. c. Both the patient and the spouse are likely in denial. d. Both the patient and the spouse are likely grieving. ANS: D Both are likely grieving from the loss of the patient’s father. Symptoms of normal grief include headache, fatigue, insomnia, appetite disturbance, and choking sensation. Different people manifest different symptoms. There is no data to support the spouse is angry or malingering. There is no data to support the patient is dying or ill. Denial is assessed when the person cannot accept the loss; both talked about the loss. MULTIPLE RESPONSE 1. A nurse is documenting end-of-life care. Which information will the nurse include in the patient’s electronic medical record? (Select all that apply.) a. Reason for the death b. Time and date of death c. How ethically the family grieved d. Location of body identification tags e. Time of body transfer and destination

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NURS 6630 Final Exam Latest 2021, Walden University.docx Course NURS -6630N Test Week 11 Final Exam • Question 1 0 out of 1 points A patient diagnosed with obsessive compulsive disorder has been taking a high -dose SSRI and is participating in therapy twice a week. He reports an inability to carry out responsibilities due to consistent interferences of his obsessions and compulsions. The PMHNP knows that the next step would be which of the following? Selected Answer: B. Decrease his SSRI and add an MAOI. • Question 2 0 out of 1 points Which statement best describes a pharmacological approach to treating patients for impulsive aggression? NURS 6630 Final Exam Latest 2021, Walden University.docx Selected B. Answer: Atypical antipsychotics can increase subcortical dopaminergic stimulation. • Question 3 0 out of 1 points The PMHNP evaluates a patient presenting with symptoms of dementia. Before the PMHNP considers treatment options, the patient must be assessed for other possible causes of dementia. Which of the following answers addresses both possible other causes of dementia and a rational treatment option for Dementia? Selected B. Answer: Possible other causes: hypothyroidism, adrenal insufficiency, hyperparathyroidism Possible treatment option: donepezil • Question 4 1 out of 1 points An 80 -year-old female patient diagnosed with Stage II Alzheimer’s has a history of irritable bowel syndrome. Which cholinergic drug may be the best choice for treatment given the patient’s gastrointestinal problems? Selected Answer: A. Donepezil (Aricept) NURS 6630 Final Exam Latest 2021, Walden University.docx • Question 5 0 out of 1 points The PMHNP is teaching parents ab out their child’s new prescription for Ritalin. What will the PMHNP include in the teaching? Selected Answer: D. There will be continued effects into the evening. • Question 6 1 out of 1 points The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? Selected Answer: A. It will bind to the alpha -2-delta ligand subunit of voltage -sensitive calcium channels. • Question 7 1 out of 1 points An opioid -naive patient is taking MS Contin (morphine sulfate) to treat his pain that is secondary to cancer. Under what circumstances would the PMHNP order naloxone (Narcan) IM/SQ? Selected D. Answer: The patient’s vital signs are 98.4F temp, 88 pulse, 104/62 blood pressure, and 8 respirations. • Question 8 1 out of 1 points A patient is prescribed D -methylphenidate, 10 -mg extended -release NURS 6630 Final Exam Latest 2021, Walden University.docx capsules. What should the PMHNP include when discussing the side effects with the patient? Selected Answer: C. The medication can affect your blood pressure. • Question 9 1 out of 1 points A young patient is prescribed Vyvanse. During the follow -up appointment, which comment made by the patient makes the PMHNP think that the dosing is being done incorrectly? Selected Answer: B. “I am unable to fall asleep at night.” • Question 10 1 out of 1 points A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states it is bothersome to put a shirt on most days. This patient has end stage renal disease (ESRD) and is scheduled to have hemodialysis tomorrow but states that he does not know how he can lie in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority? Selected A nswer: C. Prescribe lidocaine 5% • Question 11 0 out of 1 points
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