ATI LPN
ATI Mental Health Practice A 2023
1. Which of the following is a positive symptom of schizophrenia?
- A. Apathy
- B. Social withdrawal
- C. Delusions
- D. Flat affect
Correct answer: C
Rationale: The correct answer is 'C: Delusions.' Positive symptoms of schizophrenia involve an excess or distortion of normal functions. Delusions are fixed false beliefs that are not based in reality and are considered positive symptoms because they represent an addition of abnormal behavior or thoughts.
2. What is the most appropriate nursing diagnosis for a patient with agoraphobia who reports not having left their house in months?
- A. Social isolation
- B. Ineffective coping
- C. Risk for injury
- D. Impaired social interaction
Correct answer: A
Rationale: The nursing diagnosis 'Social isolation' is most appropriate for a patient with agoraphobia who has not left their house in months. Agoraphobia often leads to the avoidance of situations or places perceived as unsafe, resulting in social isolation. This diagnosis reflects the patient's limited social interactions and confinement to the home environment, which can impact their overall well-being and mental health. The other options are not as relevant in this scenario: 'Ineffective coping' does not directly address the social withdrawal aspect, 'Risk for injury' is not the primary concern presented, and 'Impaired social interaction' does not capture the extent of isolation described.
3. A nurse is assessing a client for signs of heart failure. Which of the following findings should the nurse monitor?
- A. Decreased heart rate
- B. Peripheral edema
- C. Increased energy levels
- D. Hyperglycemia
Correct answer: B
Rationale: The correct answer is B: Peripheral edema. Peripheral edema, the accumulation of fluid causing swelling in the extremities, is a classic sign of heart failure due to fluid overload. This occurs because the heart's reduced pumping efficiency leads to fluid backup in the circulatory system. Choices A, C, and D are incorrect. Decreased heart rate is not typically associated with heart failure; instead, tachycardia or an increased heart rate may be observed. Increased energy levels are not an expected finding in heart failure, as this condition often causes fatigue and weakness. Hyperglycemia is not a direct sign of heart failure; however, it can be present in individuals with uncontrolled diabetes or as a result of certain treatments, but it is not a specific indicator of heart failure.
4. A client with a history of seizures is being cared for by a nurse. Which of the following interventions should the nurse prioritize?
- A. Ensure the environment is safe
- B. Administer medications as prescribed
- C. Monitor for signs of infection
- D. Educate the client about triggers
Correct answer: A
Rationale: The nurse should prioritize ensuring the environment is safe for a client with a history of seizures. This intervention is crucial to prevent injury during a seizure. Administering medications as prescribed is important but ensuring a safe environment takes precedence to prevent harm. Monitoring for signs of infection and educating the client about triggers are also essential aspects of care but are not the priority when considering the immediate safety of the client during a seizure.
5. During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On data collection, a nurse finds the uterus to be firm, midline, and at the level of the umbilicus. Which of the following findings should the nurse interpret this data as being?
- A. Evidence of a possible vaginal hematoma
- B. An indication of a cervical or perineal laceration
- C. A normal postpartum discharge of lochia
- D. Abnormally excessive lochia rubra flow
Correct answer: C
Rationale: The nurse should interpret this data as a normal postpartum discharge of lochia. Lochia is the normal vaginal discharge after childbirth, and the gush of dark red blood upon ambulation is typical due to the pooling of blood in the vagina when lying down, which is then released upon standing. The firm, midline uterus at the level of the umbilicus indicates normal involution of the uterus postpartum. Therefore, this scenario is consistent with the expected postpartum physiological changes rather than complications like hematoma, lacerations, or abnormal excessive bleeding. Choices A, B, and D are incorrect because the described findings are more indicative of normal postpartum processes rather than complications such as vaginal hematoma, lacerations, or excessive bleeding.
Similar Questions
Access More Features
ATI Basic
- 50,000 Questions with answers
- All ATI courses Coverage
- 30 days access @ $69.99
ATI Basic
- 50,000 Questions with answers
- All ATI courses Coverage
- 90 days access @ $149.99