ATI LPN
ATI Mental Health Practice A
1. During an intake assessment, a healthcare professional is evaluating a patient diagnosed with obsessive-compulsive disorder (OCD). Which question would be most appropriate?
- A. Do you often experience periods of sadness?
- B. Do you have difficulty controlling your worrying?
- C. Do you find yourself repeating behaviors or thoughts?
- D. Do you experience sudden, unexpected panic attacks?
Correct answer: C
Rationale: The most appropriate question when assessing a patient with obsessive-compulsive disorder (OCD) is to inquire about repeating behaviors or thoughts. This is a hallmark feature of OCD, where individuals often engage in repetitive actions or mental rituals to alleviate anxiety or distress. This behavior distinguishes OCD from other mental health conditions such as generalized anxiety disorder (choice B), major depressive disorder (choice A), and panic disorder (choice D). Therefore, recognizing repetitive behaviors or thoughts helps in identifying the presence of OCD and tailoring appropriate interventions for the patient.
2. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include that a severe allergy to which of the following medications is a contraindication to ceftriaxone?
- A. Gentamicin
- B. Clindamycin
- C. Piperacillin
- D. Sulfamethoxazole-trimethoprim
Correct answer: C
Rationale: The correct answer is C. Ceftriaxone, a cephalosporin antibiotic, has a cross-sensitivity with penicillin antibiotics like piperacillin. Therefore, a severe allergy to penicillin or penicillin-related antibiotics would be a contraindication to ceftriaxone. Choices A, B, and D are incorrect because they are not associated with a known cross-sensitivity with ceftriaxone.
3. A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which of the following should the nurse assess for?
- A. Respiratory rate
- B. Chest pain
- C. Use of accessory muscles
- D. Oxygen saturation
Correct answer: C
Rationale: In a client with COPD, the nurse should assess for the use of accessory muscles. This is important because COPD can lead to increased work of breathing, causing the client to engage accessory muscles to help with respiration. Assessing for the use of accessory muscles provides crucial information about the client's respiratory effort. Respiratory rate (Choice A) is a standard assessment parameter but may not specifically indicate the severity of COPD. Chest pain (Choice B) is not typically associated with COPD unless there are complicating factors. Oxygen saturation (Choice D) is essential to monitor in COPD clients, but assessing for the use of accessory muscles takes priority as it directly reflects the client's respiratory status in COPD.
4. When in doubt about using restraints on an agitated patient, it is prudent for nurses to:
- A. Restrain the patient for their own safety
- B. Use minor restraints such as a bed side rail or a tray on a wheelchair
- C. Use alternatives such as a bed alarm with increased staff supervision
- D. Avoid using any device or procedure to limit liability
Correct answer: C
Rationale: The correct answer is C: 'Use alternatives such as a bed alarm with increased staff supervision.' The Omnibus Budget Reconciliation Act (OBRA) established strict standards on restraint use in long-term care facilities. Restraints can be considered a form of false imprisonment and neglect, leading to potential litigation. Therefore, it is advisable to avoid restraints whenever possible. A bed alarm coupled with enhanced staff supervision provides an effective and non-restrictive approach for managing an agitated patient. Choices A, B, and D are incorrect because restraining the patient, using minor restraints, or avoiding all devices without providing an alternative can pose risks to patient safety, violate regulations, or increase liability concerns.
5. A nurse is caring for a client who has a prescription for a narcotic medication. After administration, the nurse is left with an unused portion. What should the nurse do?
- A. Discard the medication in the trash
- B. Return the medication to the pharmacy
- C. Discard the medication with another nurse as a witness
- D. Store the medication for future use
Correct answer: C
Rationale: The correct action for the nurse to take when left with an unused portion of a narcotic medication is to discard the medication with another nurse as a witness. This procedure ensures accountability and proper disposal of controlled substances. Choice A is incorrect as discarding in the trash can lead to potential misuse or environmental harm. Choice B is incorrect because returning controlled substances to the pharmacy is not the appropriate method for disposal. Choice D is incorrect as storing the medication for future use is not permitted with controlled substances.
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