a nurse is providing discharge instructions to a client who has been prescribed a monoamine oxidase inhibitor maoi which dietary restriction should th
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Nursing Elites

ATI RN

ATI Mental Health Proctored Exam 2019

1. A client has been prescribed a monoamine oxidase inhibitor (MAOI). Which dietary restriction should the nurse emphasize during discharge instructions?

Correct answer: C

Rationale: The correct answer is C: Avoid foods high in tyramine. Clients taking MAOIs should avoid foods high in tyramine to prevent hypertensive crisis. Tyramine is found in aged, fermented, or spoiled foods. Choices A, B, and D are incorrect because potassium, calcium, and sodium restrictions are not specifically required for clients taking MAOIs.

2. Which of the following are common side effects of selective serotonin reuptake inhibitors (SSRIs)? Select one that does not apply.

Correct answer: C

Rationale: Common side effects of selective serotonin reuptake inhibitors (SSRIs) include nausea, insomnia, weight gain, and sexual dysfunction. Weight loss is not a common side effect associated with SSRIs. Therefore, the correct answer is C. While some individuals may experience weight changes while taking SSRIs, weight loss is less common compared to weight gain as a side effect of these medications.

3. A client diagnosed with borderline personality disorder has been admitted to the psychiatric unit after a suicide attempt. Which of the following actions should the nurse take first?

Correct answer: B

Rationale: The initial priority for the nurse is to ensure the safety of the client. Placing the client on one-to-one observation allows for constant monitoring and intervention if there are any signs of self-harm or a worsening condition. This immediate intervention is crucial to prevent further harm. Options A, C, and D involve therapeutic communication and interventions, which are important but should come after ensuring the client's safety.

4. During a mental health assessment on an adult client, which client action would demonstrate the highest achievement in terms of mental health according to Maslow's hierarchy of needs?

Correct answer: C

Rationale: In Maslow's hierarchy of needs, self-actualization is the highest level. Possessing a feeling of self-fulfillment and realizing full potential reflects self-actualization. This level represents achieving personal growth, self-improvement, and reaching one's full potential, indicating optimal mental health. Choices A, B, and D represent lower levels of needs according to Maslow's hierarchy. Maintaining a long-term relationship indicates belongingness and love needs, achieving self-confidence pertains to esteem needs, and developing a sense of purpose relates to self-esteem and self-actualization needs, but they are not at the pinnacle of self-actualization as in choice C.

5. Which is a correct evaluation of the new psychiatric nurse's statement regarding a client's use of defense mechanisms?

Correct answer: A

Rationale: The correct evaluation is that defense mechanisms can be self-protective responses to stress and do not necessarily need to be eliminated. These mechanisms serve the purpose of reducing anxiety during times of stress. While some defense mechanisms may be maladaptive, they can also help individuals cope with challenging situations. It is essential for the nurse to recognize that addressing defense mechanisms should be done sensitively, as they may be crucial for the client's emotional regulation. Encouraging the development of healthy coping skills while acknowledging the role of defense mechanisms in managing stress is a balanced approach in psychiatric care. Choice B is incorrect because completely eliminating defense mechanisms is not always feasible or beneficial. Choice C is incorrect as it oversimplifies the relationship between defense mechanisms and ego integrity. Choice D is incorrect as it misrepresents the role of defense mechanisms in ego functions.

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