ATI RN
ATI Mental Health Proctored Exam 2019
1. A client diagnosed with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?
- A. The client identifies and challenges negative thoughts.
- B. The client reports an increase in suicidal thoughts.
- C. The client experiences an increase in anxiety.
- D. The client shows no change in behavior.
Correct answer: A
Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).
2. A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching?
- A. I can stop taking this medication once I feel less anxious.
- B. I should avoid drinking alcohol while taking this medication.
- C. It may take several weeks for this medication to take full effect.
- D. This medication can cause dependency.
Correct answer: A
Rationale: The correct answer is A because it indicates a misunderstanding about buspirone. Buspirone should not be abruptly stopped, and patients should follow the prescribed regimen consistently. Stopping the medication without proper guidance can lead to adverse effects or a return of anxiety symptoms. Choices B, C, and D demonstrate an understanding of important aspects of buspirone therapy: avoiding alcohol due to interactions, being patient for the medication to reach full effectiveness, and being aware of the potential for dependency with this medication.
3. A healthcare provider is evaluating the effectiveness of medication therapy for a client diagnosed with bipolar disorder. Which outcome should indicate that the medication has been effective?
- A. The client reports a decrease in manic episodes.
- B. The client experiences fewer mood swings.
- C. The client sleeps for 8 hours each night.
- D. The client maintains a stable weight.
Correct answer: A
Rationale: A decrease in manic episodes is a key indicator of the effectiveness of medication therapy for bipolar disorder. Manic episodes are a hallmark of bipolar disorder, and a decrease in their frequency or intensity suggests that the medication is helping to stabilize the client's mood and manage their symptoms. While choices B, C, and D are important aspects of overall health and well-being, they are not specific indicators of the effectiveness of medication therapy for bipolar disorder. Choice B focuses on mood swings in general, which may include depressive episodes as well, while choice C addresses sleep patterns and choice D relates to weight stability, which can be influenced by various factors unrelated to bipolar disorder treatment.
4. A client has been prescribed sertraline for depression, and the nurse is providing discharge instructions. Which dietary instruction should the nurse include?
- A. Avoid foods high in sodium.
- B. Avoid foods high in calcium.
- C. Avoid foods high in tyramine.
- D. Avoid foods high in potassium.
Correct answer: C
Rationale: Clients prescribed sertraline should avoid foods high in tyramine to prevent a hypertensive crisis. Sertraline, an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class, can interact with tyramine-rich foods, potentially causing a dangerous increase in blood pressure known as a hypertensive crisis. Choices A, B, and D are incorrect because there is no specific dietary restriction related to sodium, calcium, or potassium intake when taking sertraline.
5. A client with bipolar disorder is in the manic phase. Which nursing intervention should the nurse implement to ensure the client's safety?
- A. Provide a structured environment with minimal stimuli.
- B. Encourage the client to participate in group activities.
- C. Monitor the client closely for signs of exhaustion.
- D. Encourage the client to rest and sleep as needed.
Correct answer: A
Rationale: During the manic phase of bipolar disorder, individuals may engage in impulsive behaviors that can put them at risk of harm. Providing a structured environment with minimal stimuli can help reduce the risk of injury by minimizing triggers for impulsive actions. This intervention promotes a safe and controlled setting for the client, which is crucial in managing the symptoms of mania. Encouraging the client to participate in group activities (Choice B) may increase stimuli and potentially exacerbate manic symptoms. Monitoring for signs of exhaustion (Choice C) is important but does not directly address the safety concerns related to impulsive behaviors during mania. Encouraging the client to rest and sleep as needed (Choice D) may be challenging during the manic phase when individuals typically experience decreased need for sleep.
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