ATI RN
ATI Mental Health Practice A
1. A nurse is assessing a patient with schizophrenia who is experiencing delusions. Which intervention is most appropriate?
- A. Agree with the patient's delusions to avoid confrontation.
- B. Encourage the patient to explore the basis of the delusions.
- C. Engage the patient in reality-based activities.
- D. Ask the patient to explain the delusions in detail.
Correct answer: C
Rationale: The most appropriate intervention when assessing a patient with schizophrenia experiencing delusions is to engage the patient in reality-based activities. This intervention helps distract the patient from the delusions and reorients them to the present, promoting grounding in reality. Choice A is incorrect because agreeing with delusions can reinforce them and hinder treatment. Choice B may exacerbate the delusions by delving deeper into their basis. Choice D may not be beneficial as it focuses solely on the delusions without addressing the need to ground the patient in reality.
2. A patient with schizophrenia is experiencing hallucinations. Which intervention is most appropriate?
- A. Encourage the patient to ignore the voices.
- B. Engage the patient in a reality-based activity.
- C. Provide a quiet environment to reduce stimulation.
- D. Ask the patient to describe the hallucinations in detail.
Correct answer: B
Rationale: Engaging the patient in a reality-based activity is the most appropriate intervention for a patient with schizophrenia experiencing hallucinations. This intervention can help distract the patient from the hallucinations and reorient them to the present, promoting a connection with reality and potentially reducing distress associated with the hallucinations. Choice A, encouraging the patient to ignore the voices, may not be effective as it can be challenging for the patient to dismiss the hallucinations. Choice C, providing a quiet environment, is helpful but may not directly address the hallucinations. Choice D, asking the patient to describe the hallucinations in detail, may increase the patient's focus on the hallucinations, potentially worsening distress.
3. A patient with bipolar disorder has been prescribed lithium. Which dietary advice is important for the nurse to include?
- A. Avoid foods high in tyramine.
- B. Maintain a consistent salt intake.
- C. Increase protein intake.
- D. Avoid foods high in fat.
Correct answer: B
Rationale: Patients prescribed lithium should maintain a consistent salt intake to prevent fluctuations in lithium levels. Salt intake can impact lithium levels, and sudden changes in salt intake can affect how the body absorbs and excretes lithium. Therefore, advising the patient to maintain a stable salt intake is crucial for the effectiveness and safety of lithium therapy. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients taking MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients on lithium therapy.
4. In treating a patient with generalized anxiety disorder (GAD) using cognitive-behavioral therapy (CBT), what is the most appropriate goal of this therapy?
- A. To explore the patient's childhood experiences.
- B. To reduce the patient's symptoms through medication.
- C. To change the patient's negative thought patterns.
- D. To improve the patient's social skills.
Correct answer: C
Rationale: The most appropriate goal of cognitive-behavioral therapy (CBT) in treating generalized anxiety disorder (GAD) is to change the patient's negative thought patterns. This therapy focuses on identifying and modifying distorted thinking patterns that contribute to anxiety. Exploring childhood experiences (Choice A) may be part of therapy, but the primary focus is on present thoughts and behaviors. While medication (Choice B) can help manage symptoms, CBT aims to address the root cause through cognitive restructuring. Improving social skills (Choice D) is not the primary goal of CBT for GAD, although it may be a secondary benefit as confidence improves with reduced anxiety.
5. For a patient diagnosed with borderline personality disorder exhibiting self-harming behavior, which therapeutic approach is most appropriate?
- A. Dialectical behavior therapy
- B. Psychoanalysis
- C. Supportive therapy
- D. Pharmacotherapy
Correct answer: A
Rationale: The most appropriate therapeutic approach for a patient diagnosed with borderline personality disorder exhibiting self-harming behavior is dialectical behavior therapy (DBT). DBT is specifically designed to address the core symptoms of borderline personality disorder, including self-harming behaviors. It focuses on teaching patients skills to manage emotions, improve interpersonal relationships, and enhance distress tolerance. Psychoanalysis (Choice B) is not the most appropriate for immediate symptom management in this case. Supportive therapy (Choice C) may not provide the structured approach needed to address self-harming behaviors effectively. Pharmacotherapy (Choice D) may be used as an adjunct in some cases, but DBT is the frontline therapy for managing self-harming behaviors in borderline personality disorder.
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