Mental Health ATI Practice Assessment A 2020/2021

Mental Health ATI Practice Assessment A 2020/2021 A nurse is planning prevention strategies for intimate partner abuse in the community. Which of the following strategies should the nurse include as a meth ...

Mental Health ATI Practice Assessment A 2020/2021 A nurse is planning prevention strategies for intimate partner abuse in the community. Which of the following strategies should the nurse include as a method of secondary prevention? A) Provide teaching about the use of positive coping mechanisms. B) Establish screening programs to identify at-risk clients. C) Refer survivors of intimate partner abuse to legal advocacy program. D) Organize rehabilitation therapy for clients who have experienced intimate partner abuse. Answer: B - This is an example of secondary prevention. By establishing screening programs, the nurse can identify individuals who are at risk for intimate partner abuse in the community and can take the necessary steps to address individual client needs. A nurse in an outpatient mental health setting is collecting a health history from a client who is taking paroxetine for depression. The client reports to the nurse that he also takes herbal supplements. The nurse should advise the client that which of the following supplements interacts adversely with paroxetine? A) St. John's Wort B) Saw palmetto C) Echinacea D) Ginkgo Answer: A - St. John's Wort is an herbal preparation that decreases the reuptake of serotonin. The nurse should advise the client that taking St. John's Wort with another medication that also inhibits the reuptake of serotonin, such as paroxetine, places the client at risk for serotonin syndrome. A nurse is planning care for an adolescent who is being admitted to an acute care unit following a suicide attempt. Which of the following interventions should the nurse identify as the priority? A) Arrange one-to-one observation of the client. B) Encourage interaction with the client's peers. C) Administer medication for depressive disorder. D) Encourage the client to attend a support group. Answer: A - The greatest risk to the client is self-injury. Therefore, the priority nursing intervention is one-to-one observation to promote client safety. A client who has a diagnosis of depression is attending group therapy. During the group meeting, the nurse asks each member to identify one goal for the day. When it is the client's turn, she does not respond. Which of the following actions should the nurse take before repeating the request to the client? A) Allow the client time to collect her thoughts. B) Prompt the client to give a response. C) Move on to the next client. D) Offer the client a suggestion for a goal. Answer: A - Slowed response time is common in clients who have depression. The nurse should allow the client time to comprehend and formulate an answer to the question. A home health nurse is assessing an older adult client whose sibling is the primary caregiver. Which of the following findings should the nurse identify as a possible indicator of neglect? A) Increased confusion B) Sleep disturbances C) Cluttered environment D) Inappropriate dress Answer: D - Clothing that is soiled or clothing that is not appropriate for weather conditions is a possible indicator of neglect. While observing group therapy, a nurse recognizes that a client is behaving in a way suggestive of dependent personality disorder. Which of the following behaviors is consistent with this condition? A) The client needs excessive external input to make everyday decisions. B) The client demonstrates a dedication to his job that excludes time for leisure activities. C) The client adheres to a rigid set of rules. D) The client has difficulty starting new relationships unless he feels accepted Answer: A - Client's who have dependent personality disorder need excessive input from others to make everyday decisions.