ATI RN
ATI Mental Health
1. Which of the following are therapeutic communication techniques that a healthcare professional can use when interacting with clients?
- A. Using silence
- B. Discouraging the client from washing their hands
- C. Giving advice
- D. Providing reassurance
Correct answer: A
Rationale: Therapeutic communication techniques aim to establish a trusting and supportive relationship between the healthcare professional and the client. Using silence is a valid therapeutic technique that allows the client to reflect and express their thoughts. On the other hand, discouraging the client from washing their hands goes against good hygiene practices and is not therapeutic. Giving advice and providing reassurance can be non-therapeutic if not used appropriately, as they may undermine the client's autonomy and problem-solving abilities.
2. During an admission assessment for a client with severe Aspirin toxicity, which finding should the nurse expect?
- A. Body temperature 35°C (95°F)
- B. Lung crackles
- C. Cool, dry skin
- D. Respiratory depression
Correct answer: D
Rationale: In severe Aspirin toxicity, respiratory depression is an anticipated finding due to the development of respiratory acidosis. Aspirin toxicity can lead to metabolic acidosis, causing the individual to hyperventilate initially to compensate. However, as the condition progresses, respiratory depression can occur, resulting in impaired gas exchange and respiratory acidosis.
3. A client with type 1 diabetes mellitus is receiving foot care education from a nurse. Which of the following instructions should the nurse include?
- A. Soak your feet in warm water daily.
- B. Wear cotton socks.
- C. Apply lotion to your feet after bathing.
- D. Trim toenails straight across.
Correct answer: D
Rationale: The correct answer is D: 'Trim toenails straight across.' In clients with diabetes, trimming toenails straight across is important to prevent ingrown toenails, reducing the risk of infections. Soaking feet in warm water daily (choice A) can lead to dry skin and potentially cause skin breakdown in diabetic clients. While wearing cotton socks (choice B) is beneficial for good foot hygiene, it is not as crucial as trimming toenails correctly. Applying lotion to feet after bathing (choice C) is helpful for moisturizing the skin, but the emphasis should be on nail care to prevent complications like ingrown toenails.
4. What is the expected finding in a patient with compartment syndrome?
- A. Unrelieved pain, pallor, and pulselessness
- B. Localized swelling and redness
- C. Numbness and tingling
- D. Fever and infection
Correct answer: A
Rationale: In a patient with compartment syndrome, the expected finding includes unrelieved pain, pallor, and pulselessness. These are classic signs of compartment syndrome and indicate compromised blood flow and tissue perfusion, necessitating urgent intervention. Choices B, C, and D are incorrect because localized swelling and redness, numbness and tingling, as well as fever and infection, are not typical findings associated with compartment syndrome.
5. In an emergency department, a healthcare provider is preparing to care for a client with multiple system trauma following a motor vehicle crash. What should be the priority focus of care?
- A. Airway protection
- B. Decreasing intracranial pressure
- C. Stabilizing cardiac arrhythmias
- D. Preventing musculoskeletal disability
Correct answer: Airway protection
Rationale: In a client with multiple system trauma, airway protection is the priority focus of care. Ensuring a patent airway is crucial for oxygenation and ventilation, which are essential for maintaining vital functions. Without a clear airway, the client's oxygenation and ventilation could be compromised, leading to severe consequences. While decreasing intracranial pressure, stabilizing cardiac arrhythmias, and preventing musculoskeletal disability are important aspects of care, ensuring airway protection takes precedence in this emergency situation.
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