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ATI Mental Health Practice A 2023
1. A patient with major depressive disorder is started on fluoxetine. What is a common side effect the nurse should monitor for?
- A. Weight gain
- B. Increased appetite
- C. Nausea
- D. Dry mouth
Correct answer: C
Rationale: Nausea is a common side effect of fluoxetine and should be monitored.
2. What principle should guide a nurse's fear about 'saying the wrong thing' to a patient in nurse-patient communication?
- A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
- B. The patient is more interested in talking to you than listening to what you have to say and is not likely to be offended.
- C. Considering the patient's history, there is little chance that the comment will do any actual harm.
- D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.
Correct answer: A
Rationale: Effective nurse-patient communication is guided by the principle that patients value sincere and respectful interactions. A nurse's well-meaning approach that conveys acceptance, respect, and concern helps establish trust and rapport with patients, even if the nurse is apprehensive about making mistakes. It is essential for the nurse to focus on genuine intent and respect for the patient's situation rather than being consumed by the fear of saying something wrong.
3. Which symptom is most indicative of obsessive-compulsive disorder (OCD)?
- A. Flashbacks of traumatic events
- B. Persistent, intrusive thoughts
- C. Frequent mood swings
- D. Auditory hallucinations
Correct answer: B
Rationale: Persistent, intrusive thoughts are a hallmark symptom of obsessive-compulsive disorder. Individuals with OCD experience persistent and unwanted thoughts or obsessions that are intrusive and cause significant distress. These thoughts often lead to repetitive behaviors or compulsions to try to alleviate the anxiety or distress caused by the obsessions. Flashbacks of traumatic events (Choice A), frequent mood swings (Choice C), and auditory hallucinations (Choice D) are not typical symptoms of OCD. Flashbacks are more commonly associated with post-traumatic stress disorder, mood swings can be seen in mood disorders, and auditory hallucinations are more characteristic of psychotic disorders.
4. Which therapeutic approach is most effective for a patient with generalized anxiety disorder (GAD)?
- A. Psychoanalytic therapy
- B. Cognitive-behavioral therapy (CBT)
- C. Humanistic therapy
- D. Gestalt therapy
Correct answer: B
Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic approach for generalized anxiety disorder (GAD). CBT helps individuals identify and modify negative thought patterns and behaviors that contribute to anxiety. It focuses on changing cognitive distortions and maladaptive behaviors, providing practical strategies to manage anxiety symptoms effectively. Numerous studies have shown the effectiveness of CBT in treating GAD by helping patients develop coping mechanisms and skills to address their anxiety. Choice A, Psychoanalytic therapy, is not the most effective for GAD as it primarily focuses on exploring unconscious conflicts and childhood experiences rather than providing immediate coping strategies. Choice C, Humanistic therapy, emphasizes personal growth and self-improvement, which may not directly target the specific symptoms of GAD. Choice D, Gestalt therapy, focuses on increasing self-awareness and personal responsibility, which might not address the cognitive distortions and behavioral patterns associated with GAD as directly as CBT does.
5. A 32-year-old female patient is diagnosed with generalized anxiety disorder (GAD). Which behavior would the nurse expect to observe?
- A. Complains of persistent and excessive worry.
- B. Frequently fidgets and has difficulty sitting still.
- C. Exhibits ritualistic behaviors.
- D. Reports periods of derealization.
Correct answer: A
Rationale: In generalized anxiety disorder (GAD), individuals often experience persistent and excessive worry about various aspects of their life. This worry is difficult to control and is disproportionate to the actual source of concern. The other options describe behaviors more commonly associated with other anxiety disorders like social anxiety disorder (frequent fidgeting and difficulty sitting still), obsessive-compulsive disorder (ritualistic behaviors), and depersonalization/derealization disorder (periods of derealization). Therefore, the correct behavior to expect in a patient with GAD is persistent and excessive worry.
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