MENTAL HEALTH ATI B QUESTIONS AND ANSWER

MENTAL HEALTH ATI B A nurse in a community health center is working with a group of clients who have traumatic stress disorder. Which of the following interventions should the nurse include to reduce anxiety among g ...

MENTAL HEALTH ATI B A nurse in a community health center is working with a group of clients who have traumatic stress disorder. Which of the following interventions should the nurse include to reduce anxiety among group members? ans: Guided imagery A client who has a recent diagnosis of bipolar disorder is placed in a room with a client who has severe depression. The client who has depression reports to the nurse, "My roommate never sleeps and keeps me up, too." Which of the following actions should the nurse take? ans: Move the client who has bipolar disorder to a private room. A nurse is reviewing laboratory results for a client who has schizophrenia and is taking clozapine. Which of the following values should the nurse identify as a contraindication for receiving clozapine? ans: WBC count 2,500/mm3 A nurse is caring for four clients in an ED. The nurse should identify that which of the following clients can give informed consent? ans: A 35-year-old client who has major depressive disorder. A nurse is facilitating a community meeting for acute care clients. One client is constantly talking and using the majority of the group's time. Which of the following interventions should the nurse implement? ans: Ask group members to discuss feelings about this client's monopolizing behavior. A nurse in a community center is teaching families of clients who have post-traumatic stress disorder (PTSD) about expected clinical manifestations. Which of the following manifestations should the nurse include? ans: Experiences feelings of isolation. A nurse is preparing to administer diazepam 7.5 mg IV bolus to a client for alcohol withdrawal. Available is diazepam injection 5 mg/mL. How many mL should the nurse expect to administer? ans: 1.5 mL A nurse is planning prevention strategies for partner violence in the community. Which of the following strategies should the nurse include as a method of secondary prevention? ans: Establish screening programs to identify at-risk clients. A nurse is assessing a client for risk factors for the development of depression. The nurse should identify that which of the following factors places the client at an increased risk for depression? ans: The client has COPD. A nurse is preparing to discharge to home an older adult client who attempted suicide. The client lives at home and has difficulty performing ADLs. Which of the following referrals should the nurse initiate? (Select all that apply). ans: Occupational therapy Meal delivery services PT Home health services A nurse is receiving change-of-shift report for four clients. Which of the following clients should the nurse plan to see first? ans: A client who is taking clozapine and reports sore throat and chills. A nurse in a mental health clinic is planning care for four clients. Which of the following tasks should the nurse delegate to an assistive personnel (AP)? ans: Stay with a client who has anorexia nervosa for 1 hr after mealtimes. A nurse on a mental health unit observes a client who has acute mania hit another client. Which of the following action should the nurse take first? ans: Call a team of staff members to help with the situation. A nurse is teaching a group of newly licensed nurses about the use of mechanical restraints. Which of the following should the nurse include in the teaching? ans: Apply restraints when other means of managing the clients behavior have failed. A nurse is teaching the guardians of a client about their adolescent child's diagnosis of bulimia nervosa. Which of the following statements made by the guardian indicates an understanding of their child's illness? ans: "It is important for our child to have regular dental checkups." A nurse is teaching coping strategies to a client who is experiencing depression related to partner violence. Which of the following statements by the client indicates an understanding fo the teaching? ans: "I will talk about my feelings with a close friend." A nurse is caring for an older adult client who is experiencing delirium. Which of the following interventions should the nurse include in the client's plan of care? ans: Permit the client to perform daily rituals to decrease anxiety. A nurse in a mental health clinic is caring for a client who has post-traumatic stress disorder (PTSD) after returning from military deployment. Which of the following is the priority action for the nurse to take? ans: Stay with the client when flashbacks occur. A nurse is caring for a client who gave birth to a stillborn baby. Which of the following statements should the nurse make? ans: "I'll stay with you just in case you want to talk." A nurse is caring for a child who has conduct disorder and is behaving in a destructive manner, throwing objects, and kicking others. Which of the following therapeutic nursing interventions is the priority? ans: Reduce environmental stimuli. A nurse is caring for an older adult client who begins to cry and states, "I knew God would punish me and I deserve this horrible sickness!" Which of the following responses should the nurse make? ans: "Let's talk about what is upsetting you." A nurse is performing a cognitive assessment to distinguish delirium from dementia in a client whose family reports episodes of confusion. Which of the following assessment findings supports the nurse's suspicion of delirium? ans: Easily distracted. A nurse on a medical-surgical unit is assessing a client who sustained injuries 12 hr ago following a MVC. The client's admission blood alcohol level was 325 mg/dL. Which of the following findings should indicate to the nurse that the client is experiencing alcohol withdrawal? ans: Blood pressure 154/96 mm Hg A nurse is teaching the partner of a client who has bipolar disorder how to identify manifestations of acute mania. Which of the following findings should the client' partner report to the provdier? ans: Inability to sleep A nurse on a mental health unit is caring for a group of clients. Which of the following actions by the nurse is an example of the ethical principle of justice? ans: Spending adequate time with a client who is verbally abusive. A nurse is planning care for a client who has made repeated physical threats toward others on the unit. Although the client does not want to leave the unit, the nurse requests the provider to transfer the client to another unit, the nurse request the provider to transfer the client to a unit that is equipped to manage violent behavior. Which of the following ethical principles should the nurse apply in the situation? ans: Nonmaleficence A nurse is caring for a client who is in an abusive relationship and is assisting in the development of a safety plan. Which of the following actions is the first component of a safety plan? ans: Identify signs of escalation of violence. A nurse is caring for a client who has alcoholic cardiomyopathy. Which fo the following laboratory findings should the nurse expect? ans: Increased creatine phosphate (CPK) A nurse is assessing a client who has major depressive disorder and has been receiving amitriptyline for 1 week. Which of the following outcomes should the nurse expect? ans: Greater risk of attempting suicide as affect and energy improve. A nurse is teaching a newly licensed nurse about nursing care plans for clients who have depressive disorders. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? ans: "I will update the plan of care as a client's manifestations of depression change." A nurse on an acute mental health facility is receiving change-of-shift report for four clients. Which of the following clients should the nurse assess first? ans: A client who is experiencing delusions of persecution. A nurse is updating the POC for a client who has bulimia nervosa and is 5% above their ideal body weight. Which of the following interventions should the nurse include in the plan? ans: Identify the client's trigger foods. A nurse is preparing to participate in an interdisciplinary conference for a client who has bipolar disorder. Which of the following behaviors is the priority for the nurse to report to the treatment team? ans: Giving away possessions. A nurse at a provider's office is interviewing an older adult client. Which of the following actions should the nurse plan to take? (Click on the "Exhibit" button for additional information about the client. There are three tabs that contain separate categories of data.) ans: Use a screening tool to evaluate the client for depression.