ATI LPN
ATI LPN Mental Health Exam IV Questions
Extract:
Question 1 of 5
A nurse is reinforcing teaching with a middle-aged client about hypertension. Which of the following information should the nurse include in the teaching?
Correct Answer: C
Rationale: Reducing sodium to <2,300 mg/day lowers blood pressure by decreasing fluid retention, a key hypertension management strategy. Weight goals use BMI (18.5–24.9), not a vague 25% range. Alcohol limits are stricter for hypertension, and potassium checks apply to diuretics, not general teaching. Sodium reduction is broadly applicable.
Question 2 of 5
A nurse is caring for a client who becomes verbally abusive when the nurse enters her room. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: Maintain eye contact until the behavior stops. Maintaining eye contact can be perceived as confrontational and may escalate the situation. Tell the client her behavior is disappointing. Telling the client her behavior is disappointing is judgmental and not therapeutic. Punish the client for the behavior. Punishing the client is not appropriate or therapeutic. Leave the client's room. Leaving the room can help de-escalate the situation by removing the immediate trigger for the client's anger.
Question 3 of 5
A nurse recognizes unexplained fussiness and irritability in an infant, as well as unexplained injuries. The nurse should suspect which of the following?
Correct Answer: D
Rationale: Sexual abuse: While sexual abuse can cause physical and emotional symptoms, the combination of unexplained injuries and fussiness/irritability is more suggestive of physical trauma. Neglect: Neglect involves failure to provide for the child's basic needs, which can lead to developmental issues, but is less likely to cause unexplained injuries. Munchausen syndrome by proxy: Munchausen syndrome by proxy involves a caregiver fabricating or inducing illness in a child for attention. It can cause unexplained injuries, but the focus is more on medical symptoms. Shaken baby syndrome: Shaken baby syndrome results from violently shaking an infant, leading to physical injuries, irritability, and fussiness. It fits the description of unexplained injuries and behavioral changes.
Question 4 of 5
A nurse is caring for a client who has deep vein thrombosis (DVT). The client has received intravenous (IV) heparin for the past 5 days and now has a new prescription for oral warfarin in addition to the heparin. The client asks the nurse if both medications are necessary. Which of the following is an appropriate response by the nurse?
Correct Answer: D
Rationale: Heparin acts quickly to prevent clot growth, while warfarin takes days to reach therapeutic INR (2.0–3.0). Overlap ensures anticoagulation continuity. Neither dissolves clots (
A), heparin doesn’t enhance warfarin (
B), and deferring explanation (
C) avoids education. D reflects standard DVT protocol.
Question 5 of 5
A nurse is making a home visit for a 16-year-old adolescent who attempted suicide. Which of the following behaviors should alert the nurse that the adolescent still has suicidal intent?
Correct Answer: A
Rationale: Planning to give his CD collection to his girlfriend: Giving away prized possessions is a common warning sign of suicidal intent, indicating that the person is preparing for their absence. Preferring to eat his meals while watching TV: This behavior is relatively normal and does not necessarily indicate suicidal intent. Stating that he wants to be with his peers more than with his parents: Wanting to spend time with peers is typical for adolescents and does not specifically indicate suicidal intent. Telling his parents that he doesn't want to talk about the attempt: Not wanting to discuss the attempt could be due to embarrassment, guilt, or other reasons, but it is not as direct an indicator of ongoing suicidal intent as giving away possessions.