ATI LPN
ATI LPN Mental Health 2023 II Questions
Extract:
Question 1 of 5
A nurse is caring for a newly admitted client who has obsessive-compulsive disorder. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: Calculating the Hamilton Rating Scale for Anxiety provides an initial assessment of the client's anxiety severity, guiding further interventions. This baseline data collection is the priority upon admission to tailor subsequent care.
Question 2 of 5
A nurse is caring for a group of clients in a pediatric clinic. Which of the following clients is at highest risk for physical abuse?
Correct Answer: D
Rationale:
Toddlers with chronic illnesses like cystic fibrosis may be at higher risk for physical abuse due to the increased stress and demands on caregivers. This vulnerability elevates their risk compared to typically developing peers.
Question 3 of 5
A nurse is caring for a client who was placed in four-point restraints by the nursing staff following an episode of violent behavior. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: Providing range-of-motion exercises every 2 hours helps to prevent complications associated with immobility, such as muscle atrophy and pressure ulcers. This is a critical safety measure for clients in restraints.
Question 4 of 5
A nurse is caring for a client who becomes extremely agitated and asks if they can go to a separate room to be alone for an hour. The nurse should document which of the following de-escalation techniques in the client's medical record?
Correct Answer: D
Rationale: Timeout allows the client to have a moment away from stimuli to regain control and calm down, which is a recognized de-escalation technique. This matches the client’s request and supports de-escalation efforts.
Question 5 of 5
A nurse is reinforcing teaching with a client who started taking haloperidol decanoate 125 mg IM 1 month ago. Which of the following statements by the client should the nurse address?
Correct Answer: D
Rationale: Spending several hours outside in the sun could increase the risk of photosensitivity, a side effect of haloperidol. The nurse should address this to educate the client on protective measures like sunscreen use.