ATI RN
Mental Health ATI RN Questions
Extract:
Question 1 of 5
A nurse auscultates a client's lung sounds and identifies crackles in the left lower lobe. Which of the following interventions should the nurse take?
Correct Answer: A
Rationale: Crackles are abnormal lung sounds that may indicate the presence of fluid or mucus in the lungs. Placing the client on bed rest in a semi-Fowler position helps to improve lung expansion and oxygenation by reducing the pressure on the diaphragm promoting optimal lung ventilation and facilitating drainage of fluid from the affected area of the lung. Fluid restriction is typically for conditions like heart failure not crackles. Antibiotics require evidence of infection and repeating auscultation does not immediately improve oxygenation.
Question 2 of 5
The nurse working in an outpatient clinic is performing an intake assessment for a female client. Which priority question will the nurse ask the client as part of the initial assessment?
Correct Answer: B
Rationale: Assessing safety identifies risks like domestic violence a critical priority. Financial substance use and medical care questions are secondary to immediate safety concerns.
Question 3 of 5
The nurse is working with an adolescent client that is argumentative with staff and peers on the behavioral health unit. Which therapeutic response will be most beneficial for the client to decrease acting out behavior?
Correct Answer: D
Rationale: This response demonstrates the use of therapeutic communication specifically offering the client an opportunity to express their feelings and concerns in a non-confrontational manner. By suggesting a private and quiet area to talk to the nurse provides a safe and supportive environment for the client to explore and process their emotions. This approach can help the client feel heard validated and understood which may reduce their need to act out or engage in argumentative behaviors to express their feelings. Threats medication demands or dismissive comments may escalate behavior.
Question 4 of 5
After an angry outburst a client quickly appears calmer and receptive to input from the nurse. Which is the most helpful response to the client at this time?
Correct Answer: B
Rationale: When a client has an angry outburst and then quickly appears calmer and receptive to input from the nurse it is important for the nurse to address the underlying cause of the outburst and explore the client's feelings and emotions. By asking What happened that got you so upset? the nurse is inviting the client to express their feelings and share what triggered their anger. This can help the nurse understand the client's perspective provide appropriate support and potentially de-escalate any remaining tension. Dismissing focusing on the nurse’s feelings or judging the behavior hinders therapeutic communication.
Question 5 of 5
A nurse is questioning another nurse about whether it is ethical to seclude a client because of loud and intrusive behavior on the unit. Which is the ethical principle that will best guide the nurse's decision on the appropriate use of seclusion?
Correct Answer: C
Rationale: Beneficence is the ethical principle that focuses on doing good and acting in the best interest of the patient. It involves taking actions that promote the well-being of patients and prevent harm. In the context of seclusion beneficence guides the nurse to consider whether secluding the patient will prevent harm to the patient and others thereby promoting overall safety and well-being. Autonomy justice and veracity do not directly address the safety-driven decision for seclusion.