2022 ATI Leadership Proctored Exam with Answers (356 Solved Questions)

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ATI - Pediatrics ati questions allPediatrics (Chamberlain University)ATI - Pediatrics ati questions allPediatrics (Chamberlain University)lOMoARcPSD|13778330

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1. A nurse is caring for a client who is dying. The client says, "My mother died in the hospital, but I did not get therebefore she died." Which of the following statements should the nurse make?A. "We will call your family in time for them to get here."Rationale:The nurse dismisses the client’s concerns and gives false reassurance.B. "I wonder if you are fearful of dying alone."Rationale:The nurse dismisses the client’s concerns and gives false reassurance.C. "I will make sure a staff member is in your room at all times."Rationale:The nurse dismisses the client’s concerns and gives false reassurance.D. "I will tell your family of your concern so that they can be here."Rationale:The nurse dismisses the client’s concerns and gives false reassurance.2. A nurse is caring for a young adult client who says he is experiencing increased anxiety and an inability toconcentrate. Which of the following responses should the nurse make?A. "It sounds like you're having a difficult time."Rationale:This therapeutic response is an open-ended, empathetic statement that encourages the client totalk.B. "Have you talked to your parents about this yet?"Rationale:This nontherapeutic response is focused inappropriately on the client's parents. It does notaddress the client's need to communicate or express feelings.C. "Why do you think you are so anxious?"Rationale:This nontherapeutic response can make the client feel defensive, and he might not be able totell the nurse why.D. "How long has this been going on?"Rationale:This nontherapeutic response is a closed-ended statement that does not encourage the client totalk.3. A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse should plan to make which ofthe following room assignments for the client?A. A private room in a quiet location on the unitRationale:A private room in a quiet location is ideal for a client with mania. The client may easily becomeoverstimulated by the number of people and activities in a nursing care unit. A private room canlOMoARcPSD|13778330

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be used for time-out during the day and to settle down to sleep at night.B. A semi-private room with a roommate who has a similar diagnosisRationale:The client should not be given a semi-private room with a roommate who is also experiencingmania because the situation would be too stimulating for each of them.C. A private room close to the nursing stationRationale:The client should not be given a private room close to the nursing station because of the highlevel of activity in that area.D. A seclusion room until the client’s activity level becomes more subdued.Rationale:Legal and ethical guidelines require treatment in the least restrictive setting. Seclusion requiresa provider’s s order and can only be used when there is a specific, documented need to do so.4. A nurse is admitting a client who has experienced a weight loss of 11 kg (25 lb) in the past 3 months. The clientweighs 40 kg (88 lb) and believes she is fat. Which of the following aspects of care should the nurse consider thefirst priority for this client?A. Identify the client's nutritional status.Rationale:According to the nursing process, the nurse should perform an assessment first to gatherenough data regarding nutritional status and other findings in order to plan, implement, andevaluate care. The assessment identifies client nutrition needs as well as complications theclient might be experiencing related to the eating disorder.B. Request a mental health consult.Rationale:Requesting a mental health consult might be necessary but another aspect of care is thepriority.C. Plan a therapeutic diet for the client.Rationale:Rationale C. Planning a therapeutic diet for the client will be necessary but another aspect ofcare is the priority.D. Provide a structured environment for the client.Rationale:It is important to provide a structured environment for the client regarding meals, times forweighing, and monitoring of eating, but another aspect of care is the priority.5. A nurse is caring for a client who has severe manifestations of schizophrenia and is medicated PRN for agitationwith haloperidol. The nurse should assess the client for which of the following adverse effects?A. DysrhythmiasRationale:Cardiac dysrhythmias are a risk for clients taking haloperidol and other conventionalantipsychotic medications. The client should be monitored for changes in vital signs,tachycardia, and ECG changes, including prolonged QT interval, while taking haloperidol. TherelOMoARcPSD|13778330

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is a risk for cardiac arrest due totorsades de pointes.B. CataractsRationale:The client who takes haloperidol is at risk for glaucoma, but cataracts are not an adverse effect.C. PancreatitisRationale:The client who takes haloperidol is at risk for hepatitis, but pancreatitis is not an adverse effect.D. BleedingRationale:The client who takes haloperidol does not have an increased risk for bleeding.6. A client becomes very dejected and states, "No one really cares what happens to me. Life isn't worth livinganymore." Which of the following responses should the nurse make?A. "Of course people care. Your family comes to visit every day."Rationale:Trying to convince the client that his family members care about him is false reassurance thatminimizes the feelings he just communicated.B. "Why do you feel that way?"Rationale:Asking the client a "why" question minimizes his feelings and is nontherapeutic.C. "Tell me who you think doesn't care about you."Rationale:By asking the client to tell what people don't care about him, the nurse is challenging the client'sbeliefs and changing the focus of the client away from his feelings and onto another subject.D. "I care about you, and I am concerned that you feel so sad."Rationale:This is an open-ended therapeutic statement that focuses on the client's feelings, showsempathy, and allows for further exploration of the client's belief that life is not worth living inorder to keep the client safe from suicidal thoughts.7. A nurse on a mental health unit is caring for a client who has generalized anxiety disorder. The client received atelephone call that was upsetting, and now the client is pacing up and down the corridors of the unit. Which of thefollowing actions should the nurse take?A. Instruct the client to sit down and stop pacing.Rationale:The client is experiencing severe or panic-level anxiety and in this condition has difficultycomprehending instructions.B. Allow the client to pace alone until physically tired.Rationale:Not intervening for the client's pacing and allowing it to continue could be a safety hazard for theclient and other clients in the area. The nurse should take measures to reduce the client'sanxiety.lOMoARcPSD|13778330

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C. Have a staff member escort the client to her room.Rationale:The client is experiencing severe or panic-level anxiety and should not be left alone to rest.D. Walk with the client at a gradually slower pace.Rationale:When the client is experiencing increased anxiety, it is important for the nurse to remain with theclient and promote a calm atmosphere. By walking with the client at a gradually slowing pace,the nurse provides gross motor activity as an anxiety outlet that helps to calm the client anddemonstrates therapeutic offering of self.8. A nurse is caring for a client who was involved in heavy combat and observed war casualties. The nurse shouldsuspect that the client is suffering from posttraumatic stress disorder (PTSD) if the client makes which of thefollowing statements?A. "I check any room I enter because the enemy is still after me and could be hiding anywhere."Rationale:This client is making a paranoid statement, something more typical of a client who haspersecutory delusions. This statement is not characteristic of a client who has PTSD.B. "My child was born with a birth defect due to an exposure I had overseas."Rationale:This statement is not characteristic of a client who has PTSD.C. "I killed four enemy soldiers with my bare hands and saved my entire battalion."Rationale:This client is making a grandiose statement, something more typical of a client who has bipolardisorder in the manic phase. This statement is not characteristic of a client who has PTSD.D. "In my dreams, all I can see are the wounded reaching out and trying to grab me."Rationale:Many clients who have PTSD repeatedly re-experience the ordeal in the form of flashbackepisodes, memories, nightmares, or frightening thoughts, especially when they are exposed toevents or objects reminiscent of the trauma. This client's statement about haunting dreams istypical of a client who has PTSD.9. A school nurse is talking with a 13-year-old female at her annual health-screening visit. Which of the followingcomments made by the adolescent should be the nurse's priority to address?A. "My parents treat me like a baby sometimes."Rationale:The nurse should further explore this comment with the client but it does not indicate thegreatest risk.B. "I haven't gotten my period yet, and all my friends have theirs."Rationale:There is a wide variation in maturation among adolescents, who often feel inferior if they are notmaturing at the same pace as their peers. It is considered an expected finding for a 13-year-oldfemale to not have reached menarche. This comment should concern the nurse but it does notindicate the greatest risk to the client.lOMoARcPSD|13778330

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C. "None of the kids at this school like me, and I don't like them either."Rationale:This comment indicates the client might be at risk for depression, an eating disorder, orself-harm. Therefore, this comment is the priority for the nurse to address.D. "There's a big pimple on my face, and I worry that everyone will notice it."Rationale:The nurse should further explore this comment, as it might indicate the client has a problem withher body image. However, it does not indicate the greatest risk to the client. Young adolescentsespecially think that everyone is looking at them and seeing all their imperfections. It is difficultfor them to learn to deal with this and can be a major crisis for them as they learn to deal withacceptance of themselves.10. A nurse on a long-term care unit is creating a plan of care for a client who has Alzheimer’s disease. Which of thefollowing interventions should the nurse include in the plan?A. Rotate assignment of daily caregivers.Rationale:The nurse should assign the same staff whenever possible to care for the client to minimizeconfusion and ensure continuity of care for the client.B. Provide an activity schedule that changes from day to day.Rationale:The nurse should provide a structured schedule of activities that does not change from day today to decrease the client's confusion.C. Limit time for the client to perform activities.Rationale:The nurse should allow plenty of time for the client to perform activities to increase comfort anddecrease the client's anxiety level.D. Talk the client through tasks one step at a time.Rationale:The nurse should plan to talk the client through tasks one step at a time to minimize confusionand promote independence, which will decrease the client's anxiety level.11. A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with aprescription for lithium. The nurse should teach the client that which of the following factors puts her at risk forlithium toxicity?A. The client runs 4 miles outdoors every afternoon.Rationale:Strenuous exercise in outdoor heat, which can lead to dehydration, puts the client at risk forlithium toxicity. Mild to moderate exercise will not lead to lithium toxicity, but if the clientengages in strenuous exercise during hot weather, she should take care to replace any waterand sodium that have been lost through profuse sweating. This also applies to other factorsthat can cause the client to become dehydrated, such as having diarrhea or taking diuretics.B. The client drinks 2 liters of liquids daily.Rationale:Drinking 2 to 3 L of liquid daily can help prevent lithium toxicity by promoting normal excretionlOMoARcPSD|13778330

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of lithium from the body.C. The client eats 2 to 3 gm of sodium-containing foods daily.Rationale:Although 2 to 3 gm of sodium-containing foods is above recommended nutrition guidelines, thisamount of sodium does not put the client at risk for lithium toxicity. Eating a diet with consistentand adequate amounts of sodium is important for a client who takes lithium. A very low-sodiumdiet prevents normal excretion of lithium from the body and can cause lithium toxicity. A highsodium intake will lead to excretion of lithium and a possible drop in lithium level. The clientshould be taught to eat an adequate, stable amount of sodium and not to greatly decrease orincrease sodium intake.D. The client eats foods high in tyramine.Rationale:Foods high in tyramine interact with moonamine oxidase inhibitors which are prescribed fordepressive disorders. Tyramine does not affect lithium levels.12. A nurse is providing teaching for a client who has binge-eating disorder and is morbidly obese. The client hasbeen prescribed orlistat. Which of the following statements indicates to the nurse that the client understands theteaching?A. "I will take my dose of orlistat every morning an hour before breakfast."Rationale:Orlistat, a lipase inhibitor, is used as an aid to help clients who are morbidly obese to loseweight. Orlistat prevents the absorption of some of the fat in the client's dietary intake at eachmeal. Therefore, the client should take the medication 3 times daily, during or within 1 hr afterthe meal.B. "I will eat a no-fat diet to prevent side effects from the medication."Rationale:Consuming too little fat may lead to the client not getting enough nutrients, especiallyfat-soluble vitamins, from the diet. Instead, the client should eat a well-balanced, low-calorie,nutritious diet with approximately 30% of calories consisting of fat calories.C. "I will stop taking orlistat and call my doctor if my urine gets darker in color."Rationale:Orlistat can cause severe liver damage; therefore, the client should be taught manifestations ofliver damage, including dark-colored urine, light-colored stools, jaundice, anorexia, vomiting,and fatigue.D. "I will feel less hungry during meals while I am taking orlistat."Rationale:Orlistat works by preventing absorption of dietary fat and is not an appetite suppressant.13. A nurse is caring for a client who has major depressive disorder and was prescribed citalopram 2 weeks ago witha planned dosage increase 1 week ago. The client reports having an improved appetite, but still feels verydepressed and is still having trouble sleeping. Which of the following actions should the nurse take?A. Speak to the provider about adding an MAOI to the current medication regimen.Rationale:Giving a SSRI along with an MAOI is contraindicated due to a greatly increased risk forlOMoARcPSD|13778330

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serotonin syndrome.B. Explain that antidepressants often take several weeks to be fully effective.Rationale:SSRIs are used along with certain anticonvulsant medications in the treatment of bipolardisorder. It can take 4 to 6 weeks before therapeutic effects occur after beginning anantidepressant medication.C. Tell the client that the provider will need to change citalopram to a different medication.Rationale:It would be inappropriate for the nurse to tell the client that citalopram needs to be changed to adifferent prescription. The nurse should teach the client about expected effects of citalopram.D. Recommend a sleep study be done on the client.Rationale:Recommending a sleep study is not appropriate at this time until therapeutic effects of themedication are known. The nurse should teach the client about expected effects of citalopram.14. A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. Thenurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of thefollowing? (Select all that apply.)A. Urinary retention and constipationB. Tongue thrusting and lip smackingC. Fine hand tremors and pill rollingD. Facial grimacing and eye blinkingF.Involuntary pelvic rocking and hip thrusting movementsRationale:Urinary retention and constipation is incorrect. Haloperidol can cause anticholinergic effects,such as dry mucous membranes, urinary retention, and constipation. However, these are notmanifestations of tardive dyskinesia.Tongue thrusting and lip smacking is correct. Individualswho have tardive dyskinesia make repetitive and uncontrollable movements such as tonguethrusting and lip smacking.Fine hand tremors and pill rolling is incorrect. The side effects ofhaloperidol can include extrapyramidal (parkinsonian) symptoms, such as fine hand tremorsand pill rolling. However, these are not manifestations of tardive dyskinesia.Facial grimacingand eye blinking is correct. Individuals who have tardive dyskinesia make repetitive anduncontrollable movements such as facial grimacing and eye blinking.Involuntary pelvic rockingand hip thrusting movements is correct. Repetitive, irregular, and involuntary movements of thehead, neck, trunk, and extremities can occur in tardive dyskinesia.15. A nurse who works in a psychiatric unit is caring for a client who has bipolar disorder. The client comes to thenurse's station at 0300 demanding that the nurse call the provider immediately. Which of the following responsesby the nurse is appropriate?A. "You are being unreasonable, and I will not call your doctor at this hour."Rationale:This response by the nurse shows disapproval and is therefore nontherapeutic.lOMoARcPSD|13778330

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B. "Go back to your room, and I'll try to get in touch with your doctor."Rationale:This response puts the client's feelings on hold and is therefore nontherapeutic.C. "I can't call a doctor in the middle of the night unless it's an emergency."Rationale:This response by the nurse puts the client's feelings on hold and is therefore nontherapeutic.D. "You must be very upset about something."Rationale:This therapeutic response allows the nurse to show empathy for the client's feelings. Theresponse is also open-ended, which allows for further communication and encourages theclient to clarify the situation.16. A nurse caring for a client who has depression observes the client comes to breakfast freshly bathed, wearingclean clothes, and with combed and styled hair. Which of the following responses by the nurse is therapeutic?A. "Everyone feels better after showering."Rationale:This response is nontherapeutic because it involves stereotyping.B. "You must be getting better. You look great!"Rationale:This response is nontherapeutic because it makes assumptions about the client and showsapproval.C. "I see you have done some grooming today."Rationale:This response is open-ended, and this response is therapeutic because it offers the clientrecognition of positive behavior and encourages further discussion.D. "Why are you all dressed up today? Is it a special occasion?"Rationale:This response is nontherapeutic because asking "why" questions can cause the client to feeldefensive.17. A nurse is caring for a client who has schizophrenia and tells the nurse, "They lie about me all the time and theyare trying to poison my food." Which of the following statements should the nurse make?A. "You are mistaken. Nobody is lying about you or trying to poison you."Rationale:This statement is a nontherapeutic response because it directly contradicts the client'sdelusional thinking, which could make the client feel angry and misunderstood.B. "You seem to be having very frightening thoughts."Rationale:When responding to a client who is delusional, the nurse should avoid making statements thatdirectly confront or affirm the client's delusional beliefs. Instead of responding literally to theclient's words, the nurse should respond to the feelings that the client is attempting tocommunicate. By doing this, the nurse is shifting the focus from the delusional beliefs, whichare not real, to the client's fear, which is real.lOMoARcPSD|13778330

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C. "Why do you think you are being lied about and poisoned?"Rationale:This statement is a nontherapeutic response because it supports the content of the client'sdelusional thinking. Asking a client “why” can cause the client to become defensive.D. "Who is lying about you and trying to poison you?"Rationale:This statement is a nontherapeutic response because it supports the content of the client'sdelusional thinking.18. A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be dischargedwith a prescription for lithium. The nurse's discharge teaching should include information cautioning against whichof the following factors that may cause lithium toxicity?A. Experiencing diarrheaRationale:Lithium is used to treat the manic stage of bipolar disorder. Toxicity occurs when the level oflithium in the blood becomes too high. A low sodium level, or factors which result in a lowsodium level, (such as dehydration, diarrhea, sweating, excess exercise in hot weather, diureticuse, a low sodium diet) increases the lithium level because the kidney processes sodium andlithium in the same way. If sodium levels fall, the body conserves lithium, causing lithium levelsto rise.B. Exercising moderatelyRationale:Moderate exercise should not lead to lithium toxicity.C. Increasing sodium intakeRationale:Increasing sodium intake will lead to excretion of lithium and a drop in the lithium level.D. Drinking green teaRationale:Both green and black tea can lower lithium levels, making it less effective.19. A nurse in an emergency department is caring for an adolescent client who reports being sexually assaulted justprior to admission. Which of the following actions should the nurse take?A. Discuss self-defense techniques with the client.Rationale:During the acute phase following sexual assault, the nurse should avoid implying the clientcould have done something different, which could cause the client to assume guilt for thesituation.B. Inform the client photographs of injuries are required for a police report.Rationale:The nurse should encourage the client to allow photographs of injuries as evidence to includein a police report, but it is not required. The nurse must obtain client consent before takingphotographs.C. Ask the client to describe the situation.Rationale:lOMoARcPSD|13778330

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During the acute phase following assault, the nurse should encourage the client to provideinformation which may be helpful with treatment and to reduce the client’s anxiety.D. Give the client a bed bath prior to physical examination.Rationale:The nurse should check the client for acute injuries that require medical attention. The nursecan offer to assist the client with a bath or shower after physical examination and collection ofevidence.20. A nurse in an emergency department is assessing a client who has been taking haloperidol for 3 months. Theclient has a temperature of 39.5° C (103.4° F), blood pressure of 150/110 mm Hg, and muscle rigidity. Which of thefollowing complications should the nurse suspect?A. AgranulocytosisRationale:The nurse should suspect agranulocytosis if a client reports flulike manifestations and has adecreased white blood cell count.B. Neuroleptic malignant syndromeRationale:Neuroleptic malignant syndrome (NMS) is a rare and potentially fatal adverse effect ofantipsychotic medications that requires emergency medical intervention. Manifestations ofNMS are sudden and include changes in level of consciousness, seizures, and stupor.C. AkathisiaRationale:The nurse should suspect akathisia if the client exhibits motor restlessness, such as foottapping or constantly shifting weight back and forth.D. Tardive dyskinesiaRationale:The nurse should suspect tardive dyskinesia if the client exhibits involuntary muscularmovements.21. A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) andis newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client'scompulsive behaviors?A. Isolate the client for a period of time.Rationale:Because OCD is an anxiety disorder, the nurse should offer presence, and take action to helpthe client feel safe and secure.B. Confront the client about the senseless nature of the repetitive behaviors.Rationale:The nurse should assist the client in identifying the meaning behind his behaviors to help theclient change his actions.C. Plan the client's schedule to allow time for rituals.Rationale:OCD is an anxiety disorder characterized by recurrent patterns of behavior a client feels drivenlOMoARcPSD|13778330

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to perform. This behavior can be a physical action or a mental act that is aimed at neutralizinganxiety or distress. In the initial phase of treatment, the nurse should allow adequate time forthe client to perform rituals to help the client handle anxiety.D. Set strict limits on the behaviors so that the client can conform to the unit rules and schedules.Rationale:The nurse should provide a structured, flexible environment initially, and gradually increaselimits on client behavior as the client’s anxiety becomes more manageable.22. A nurse in a psychiatric unit is caring for several clients. Which of the following clients should the nurserecommend for group therapy?A. A client who has been taking amitriptyline for 3 months for depressionRationale:Psychotherapy groups provide clients with the opportunity to enhance their personalrelationships, increase self-awareness, and try new behaviors in a safe social setting.Amitriptyline can take 4 to 8 weeks to become effective; therefore, this client should beexperiencing improvement in depressive manifestations and be ready to interact in a groupsetting.B. A client exhibiting psychotic behaviorRationale:The nurse should not recommend this client for group therapy until the psychosis resolves.C. A client admitted 12 hr ago for acute maniaRationale:The nurse should not plan to include this client in group therapy until the client can interactappropriately with others.D. A client who is experiencing alcohol intoxicationRationale:The nurse should not plan to include this client in group therapy until the intoxication resolves.23. A nurse is planning care for a client newly admitted with major depressive disorder. Which of the following actionsshould the nurse plan to take?A. Ask the client to create her own schedule of daily activities.Rationale:The nurse should expect a client who has major depressive disorder to have difficulty makingdecisions.B. Teach the client to use passive communication when interacting with others.Rationale:The nurse should encourage the client to use assertiveness techniques to increaseself-esteem.C. Determine the client’s need for assistance with grooming.Rationale:The nurse should promote problem-solving by helping the client identify situations which can orcannot be controlled. This can help the client deal with unresolved issues.lOMoARcPSD|13778330

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D. Limit the client’s involvement in unit activities.Rationale:The nurse should recognize the client will want to spend most of her time alone; the nurseshould encourage interaction with groups to increase her self-esteem.24. A nurse at a college campus mental health counseling center is caring for a student who just failed anexamination. The student spends the session berating the teacher and the course. The nurse should recognizethis behavior as which of the following defense mechanisms?A. ConversionRationale:The nurse should identify conversion as a defense mechanism in which the clientunconsciously expresses emotional conflict via physical symptoms, such as paralysis or loss ofsensory function.B. ProjectionRationale:Projection is a defense mechanism in which the client refuses to acknowledge unacceptablepersonal characteristics and transfers feelings, thoughts, or traits onto another person. Insteadof dealing with his own failures, the client is describing the shortcomings of the course andteacher.C. UndoingRationale:The nurse should identify undoing as a defense mechanism in which the client takes an actionto make up for a wrong action or statement.D. RegressionRationale:The nurse should identify regression as a defense mechanism in which the client adopts amore primitive, immature behavior in response to an unwanted situation.25. A nurse in a drug and alcohol detoxification center is planning care for a client who has alcohol use disorder.Which of the following interventions should the nurse identify as the priority?A. Helping the client identify positive personality traitsRationale:Assessment of coping skills is important, but it is not the primary focus of care during the earlyphase of alcohol withdrawal.B. Providing for adequate hydration and restRationale:Providing for the client's physical needs should be the nurse's priority until the client completesthe detoxification phase of treatment. Rest is important for two reasons: alcohol use disruptsnormal sleep patterns, and alcohol withdrawal or detoxification is often associated withincreased restlessness and agitation. Restoring and maintaining fluid and electrolyte balance isanother important goal during detoxification to prevent fluid and electrolyte imbalances.C. Confronting the use of denial and other defense mechanismsRationale:The nurse should help the client admit a problem, but this is not the primary focus of carelOMoARcPSD|13778330

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during the early phase of alcohol withdrawal.D. Educating the client about the consequences of alcohol misuseRationale:The nurse should help the client understand consequences, but this is not the primary focus ofcare during the early phase of alcohol withdrawal.26. A nurse is caring for a client who has bipolar disorder and is in the manic phase. The client says he is bored.Which of the following activities is appropriate for the nurse to suggest to this client?A. Watching a video with a group in the day roomRationale:The nurse should limit the client’s exposure to groups and crowds because it can increase theclient’s hyperactivity.B. Walking with the nurse in the courtyardRationale:Clients who have bipolar disorder are prone to hyperactivity. The nurse should provideactivities that provide a way for the client to release physical energy, while avoiding situationsthat might provoke the client. In addition, walking with the nurse provides an opportunity fortherapeutic communication.C. Participating in a basketball game in the gymRationale:The nurse should not encourage the client to participate in competitive games because it canincrease the client’s hyperactivity.D. Joining a group discussion about a local electionRationale:The nurse should limit the client’s exposure to groups and crowds because it can increase theclient’s hyperactivity.27. A nurse in a hospital is caring for a client who has agoraphobia. Which of the following statements by the clientindicates understanding of the goals of treatment?A. "I plan to sit on a park bench for a few minutes each day."Rationale:Agoraphobia is fear of being in places in which help may not be available. This typicallymanifests as a fear of being outside alone. Therefore, the nurse should identify this statementas understanding of the goals of treatment.B. "I can try participating in group therapy every week."Rationale:The client's phobia does not concern exposure to other people.C. "I will join a book club in my neighborhood."Rationale:The client's phobia does not concern exposure to other people.D. "I should avoid entering elevators and other closed spaces."Rationale:lOMoARcPSD|13778330

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The client's phobia does not concern exposure to other people.28. A nurse asks a client who is suicidal to make a safety contract, but the client declines. Which of the followingactions should the nurse identify as the priority?A. Lock the doors to the unit and secure windows so they cannot be opened.Rationale:The nurses should lock the doors and windows on the unit so the client cannot leave the unit,or obtain objects for inflicting self-harm; however, the nurse should identify another action asthe priority.B. Provide the client with plastic eating utensils for meals.Rationale:The nurse should provide the client with plastic eating utensils to avoid providing the client withan object for inflicting self-harm; however, the nurse should identify another action as thepriority.C. Remove any objects from the client’s environment that could be used for self-harm.Rationale:The nurse should remove objects from the environment that could be used for self-harm.Additionally, the nurses should check the client’s belongings, and prevent visitors from briningin harmful objects; however, the nurse should identify another action as the priority.D. Assign a staff member to stay with the client at all times.Rationale:The greatest risk to this client is self-injury during unsupervised time; therefore, the nurseshould identify the priority action is to assign a staff member to stay with the client at all times.The staff member can monitor all of the client’s behaviors and actions and prevent the clientfrom harming herself.29. A nurse in an emergency department is assessing a client for suspected cocaine intoxication. Which of thefollowing findings should the nurse expect?A. NystagmusRationale:Nystagmus, a rapid involuntary oscillation of the eyeballs, is not associated with cocaineintoxication. The client can experience perspiration and tremors.B. Dilated pupilsRationale:Dilated pupils are a finding of cocaine intoxication due to the stimulation of the sympatheticnervous system.C. HypersomniaRationale:The nurse should expect the client to exhibit hypervigilance and have increased energy.D. DepressionRationale:The nurse should expect the client to exhibit euphoria and grandiosity.lOMoARcPSD|13778330

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