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ATI Mental Health Practice A
1. Which symptom is most commonly associated with obsessive-compulsive disorder (OCD)?
- A. Frequent mood swings
- B. Intrusive, repetitive thoughts
- C. Hallucinations
- D. Flashbacks
Correct answer: B
Rationale: The correct answer is B: Intrusive, repetitive thoughts. Intrusive, repetitive thoughts are the hallmark symptom of obsessive-compulsive disorder (OCD). Individuals with OCD experience persistent, unwanted thoughts or obsessions that lead to repetitive behaviors or compulsions. These thoughts are intrusive and difficult to control, causing significant distress and interfering with daily activities. While mood swings, hallucinations, and flashbacks can be present in other mental health conditions, they are not the primary symptoms associated with OCD.
2. A client diagnosed with coronary artery disease (CAD) reports chest pain radiating to the left arm. The nurse checks the client's blood pressure and administers nitroglycerin 0.4 mg sublingually. Five minutes later, the client is still experiencing chest pain. What is the next appropriate nursing action?
- A. Administer another dose of nitroglycerin.
- B. Notify the healthcare provider immediately.
- C. Have the client lie down and stay calm.
- D. Give the client aspirin 325 mg to chew.
Correct answer: A
Rationale: If chest pain persists after the first dose of nitroglycerin, it is appropriate to administer a second dose while continuing to monitor the client's response. Nitroglycerin helps dilate blood vessels and improve blood flow to the heart, relieving chest pain associated with coronary artery disease. Reassessing the client's response to a second dose is crucial before considering other interventions like contacting the healthcare provider or providing additional medications. Administering another dose of nitroglycerin aligns with the standard protocol for managing ongoing chest pain in clients with CAD.
3. When caring for the client diagnosed with delirium, which condition is the most important for the nurse to investigate?
- A. Cancer of any type
- B. Impaired hearing
- C. Prescription drug intoxication
- D. Heart failure
Correct answer: C
Rationale: When caring for a client diagnosed with delirium, the most important condition for the nurse to investigate is prescription drug intoxication. Delirium in older adults is commonly caused by medication side effects or interactions. Investigating prescription drug intoxication is crucial as it can be a reversible cause of delirium. While cancer, impaired hearing, and heart failure are important considerations in overall care, prescription drug intoxication takes precedence in cases of delirium.
4. What is the primary nutritional function of the large intestine?
- A. Absorption of fats.
- B. Excretion of waste products.
- C. Excretion of bacteria.
- D. Absorption of water.
Correct answer: D
Rationale: The correct answer is D: Absorption of water. The primary nutritional function of the large intestine is to absorb water from the indigestible food residue that enters it from the small intestine. This absorption of water helps to form solid waste, which is then eliminated from the body. Choices A, B, and C are incorrect because the large intestine is not primarily responsible for the absorption of fats, excretion of waste products, or excretion of bacteria. While the large intestine does play a role in waste elimination and contains bacteria beneficial for digestion, its main function in terms of nutrition is the absorption of water.
5. A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?
- A. Administer a small test dose before giving the full dose
- B. Infuse the medication over 30 seconds
- C. Monitor client closely for hypertension
- D. Administer cyanocobalamin as an antidote if toxicity occurs
Correct answer: A
Rationale: The correct action the nurse should plan to take when preparing to administer iron dextran IV is to administer a small test dose before giving the full dose. This is done to assess for any allergic reactions that the client may have to the medication. Choice B is incorrect because iron dextran should be infused slowly over a longer period, typically over 1-2 hours to reduce the risk of adverse reactions. Choice C is incorrect because iron dextran administration is more commonly associated with hypotension rather than hypertension. Choice D is incorrect because cyanocobalamin is not used as an antidote for iron dextran toxicity; instead, treatment for iron toxicity may involve supportive care, chelation therapy, or in severe cases, iron antidotes like deferoxamine.
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