ATI RN
ATI Mental Health Proctored Exam 2023
1. Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted's wife and his blood tests confirm. To reduce Ted's mania, the psychiatric nurse practitioner recommends:
- A. Clonazepam (Klonopin)
- B. Fluoxetine (Prozac)
- C. Electroconvulsive therapy (ECT)
- D. Lurasidone (Latuda)
Correct answer: C
Rationale: Electroconvulsive therapy (ECT) can be an effective treatment for reducing mania in patients with bipolar disorder who have not responded to medication. In Ted's case, where he has a history of bipolar I disorder, lithium treatment, and manic episodes, ECT may be recommended by the psychiatric nurse practitioner to help manage his symptoms.
2. Cabot has multiple symptoms of depression including mood reactivity, social phobia, anxiety, and overeating. With a history of mild hypertension, which classification of antidepressants dispensed as a transdermal patch would be a safe medication?
- A. Tricyclic antidepressants
- B. Selective serotonin reuptake inhibitors
- C. Serotonin and norepinephrine reuptake inhibitors
- D. Monoamine oxidase inhibitors
Correct answer: D
Rationale: Monoamine oxidase inhibitors dispensed as transdermal patches can be a safer option for patients with mild hypertension due to reduced systemic absorption compared to other forms of antidepressants, potentially minimizing cardiovascular effects associated with hypertension.
3. Which behavior is consistent with therapeutic communication?
- A. Offering your opinion when asked to convey support.
- B. Summarizing the essence of the patient's comments in your own words.
- C. Interrupting periods of silence before they become awkward for the patient.
- D. Telling the patient they did well when you approve of their statements or actions.
Correct answer: B
Rationale: Summarizing the essence of the patient's comments in your own words is a key aspect of therapeutic communication as it demonstrates active listening and understanding. It shows the patient that their words have been heard and understood, fostering a sense of validation and empathy. Offering opinions, interrupting silence, or giving approval may not always align with the principles of therapeutic communication, which focus on patient-centered interactions and empathetic responses.
4. When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:
- A. Medications provided are ineffective.
- B. Nurses are trying to control their minds.
- C. The medications will make them sick.
- D. They are not actually ill.
Correct answer: D
Rationale: Anosognosia is a lack of insight that affects patients with schizophrenia, leading them to deny or lack awareness of their illness. This lack of awareness often results in patients refusing medication because they genuinely believe they are not ill and do not need treatment. It is crucial for healthcare providers to approach such situations with understanding and empathy, recognizing the impact of anosognosia on treatment adherence.
5. Which characteristic in an adolescent female is sometimes associated with the prodromal phase of schizophrenia?
- A. Constantly afraid another student will steal her belongings.
- B. An unusual interest in numbers and specific topics.
- C. Demonstrates no interest in athletics or organized sports.
- D. Appears more comfortable among males.
Correct answer: B
Rationale: During the prodromal phase of schizophrenia, individuals may exhibit subtle changes in behavior or interests. An unusual interest in numbers and specific topics may be a sign of cognitive disturbances that can precede the onset of schizophrenia. While the other choices may also be observed in adolescents, an unusual interest in numbers and specific topics is more specifically linked to potential prodromal symptoms of schizophrenia.
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