ATI LPN
ATI Mental Health Practice A
1. A patient with social anxiety disorder is learning cognitive-behavioral therapy (CBT) techniques. Which skill is most likely being taught?
- A. Avoiding social situations that cause anxiety
- B. Challenging and changing negative thoughts
- C. Using deep breathing exercises during social interactions
- D. Taking anti-anxiety medication before social events
Correct answer: B
Rationale: The correct answer is B. In cognitive-behavioral therapy (CBT) for social anxiety disorder, the focus is on challenging and changing negative thoughts that contribute to anxiety. This process involves identifying distorted thought patterns and replacing them with more balanced and realistic thoughts, helping individuals develop healthier perspectives on social situations. Choices A, C, and D are incorrect because avoiding social situations, using deep breathing exercises, and taking medication are not the primary skills taught in CBT for social anxiety disorder. CBT aims to address the underlying thought patterns and behaviors that maintain anxiety, rather than avoidance or temporary relief.
2. A 45-year-old man with a history of chronic heartburn presents with progressive difficulty swallowing solids and liquids. He has lost 10 pounds in the past two months. What is the most likely diagnosis?
- A. Esophageal stricture
- B. Esophageal cancer
- C. Achalasia
- D. Peptic ulcer disease
Correct answer: B
Rationale: In this scenario, the patient's presentation of progressive dysphagia to both solids and liquids, along with significant weight loss, is concerning for esophageal cancer. The history of chronic heartburn further raises suspicion as chronic gastroesophageal reflux disease is a risk factor for the development of esophageal adenocarcinoma. Esophageal stricture could cause dysphagia but is less likely to be associated with significant weight loss. Achalasia typically presents with dysphagia to solids more than liquids and does not commonly cause weight loss. Peptic ulcer disease is less likely to lead to progressive dysphagia and significant weight loss compared to esophageal cancer.
3. Why should the client diagnosed with rheumatic heart disease be advised to notify the dentist before dental procedures?
- A. The client requires prophylactic antibiotics before treatment.
- B. The client may experience dysrhythmias with high-speed drills.
- C. The client may have an adverse reaction to lidocaine with epinephrine.
- D. The client may develop heart failure during stressful events.
Correct answer: A
Rationale: Clients with rheumatic heart disease are at risk for infective endocarditis, a serious infection of the heart lining or valves. They need prophylactic antibiotics before invasive procedures, including dental work, to prevent this life-threatening complication. While dysrhythmias with high-speed drills, adverse reactions to local anesthesia, and the risk of heart failure during stressful events are all concerns for clients with heart conditions, the primary reason for notifying the dentist before dental procedures in rheumatic heart disease is the need for prophylactic antibiotics to prevent infective endocarditis.
4. Following a CVA, the nurse assesses that a client has developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?
- A. Continuous tube feeding at 65 ml/hr via gastrostomy.
- B. Total parenteral nutrition to be infused at 125 ml/hour.
- C. Nasogastric tube connected to low intermittent suction.
- D. Metoclopramide (Reglan) intermittent piggyback.
Correct answer: A
Rationale: In a client with dysphagia and gastrointestinal symptoms such as hypoactive bowel sounds and a firm, distended abdomen, continuous tube feeding might exacerbate the symptoms. This can lead to complications and should be questioned by the nurse.
5. What is the priority in managing a client diagnosed with delirium?
- A. Administer anti-anxiety medication
- B. Identify any underlying causes of delirium
- C. Reduce environmental stimulation to calm the client
- D. Encourage deep breathing exercises
Correct answer: B
Rationale: The priority in managing a client diagnosed with delirium is to identify any underlying causes. Delirium can be caused by various factors such as infections, medications, or metabolic imbalances. By determining the root cause, healthcare providers can address the issue effectively and tailor the treatment plan accordingly. Administering anti-anxiety medication (Choice A) may help manage symptoms but does not address the underlying cause of delirium. Similarly, reducing environmental stimulation (Choice C) and encouraging deep breathing exercises (Choice D) may provide some relief, but they do not target the primary concern of identifying and addressing the underlying causes of delirium.
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