ATI RN
ATI Mental Health Practice A
1. A patient with major depressive disorder is started on venlafaxine. Which class of antidepressant does this medication belong to?
- A. Selective serotonin reuptake inhibitors (SSRIs)
- B. Tricyclic antidepressants (TCAs)
- C. Monoamine oxidase inhibitors (MAOIs)
- D. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Correct answer: D
Rationale: Venlafaxine is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs work by increasing the levels of both serotonin and norepinephrine in the brain, which helps alleviate symptoms of depression. This mechanism of action distinguishes SNRIs from other classes of antidepressants like SSRIs, TCAs, and MAOIs, making venlafaxine an effective choice for patients with major depressive disorder. Therefore, the correct answer is D. Choice A, SSRIs, primarily target serotonin reuptake only. Choice B, TCAs, work by inhibiting the reuptake of norepinephrine and serotonin, but they are not as selective as SNRIs. Choice C, MAOIs, inhibit the enzyme monoamine oxidase, leading to increased levels of various neurotransmitters, including serotonin and norepinephrine, but they are typically used as second- or third-line agents due to dietary restrictions and potential side effects.
2. Which approach involves surgically implanting electrodes into specific areas of the brain to stimulate regions identified as underactive in depression?
- A. Transcranial magnetic stimulation
- B. Deep brain stimulation
- C. Vagus nerve stimulation
- D. Electroconvulsive therapy
Correct answer: B
Rationale: Deep brain stimulation is a treatment approach that involves the surgical implantation of electrodes into specific areas of the brain to stimulate regions identified as underactive in depression. This method aims to modulate brain activity and has shown effectiveness in treating certain cases of depression.
3. Which patient should be most carefully assessed for fluid and electrolyte imbalance among those receiving the following drugs?
- A. lithium (Eskalith)
- B. clozapine (Clozaril)
- C. diazepam (Valium)
- D. amitriptyline
Correct answer: A
Rationale: Lithium is known to cause polyuria (excessive urination) and polydipsia (excessive thirst), which can lead to fluid and electrolyte imbalances. Therefore, patients receiving lithium should be carefully monitored for signs of fluid and electrolyte disturbances to prevent any potential complications.
4. A patient with bipolar disorder is prescribed lithium. Which dietary advice should the nurse 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. Fluctuations in salt intake can impact lithium levels, potentially leading to toxicity or reduced effectiveness of the medication. It is crucial for patients to adhere to a stable salt intake while taking lithium to ensure optimal treatment outcomes. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients on MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients taking lithium.
5. A nursing instructor is discussing diseases of adaptation with students and when they are likely to occur. Which student response indicates that learning has occurred?
- A. When an individual has limited experience managing stress
- B. When an individual inherits adaptive genes
- C. When an individual faces pre-existing conditions that worsen stress
- D. When an individual's physiological and psychological resources are depleted
Correct answer: D
Rationale: The correct answer is D. During the stage of exhaustion in the general adaptation syndrome, an individual's physiological and psychological resources become depleted, leading to a reduced capacity to adapt effectively. This depletion of resources is when diseases of adaptation, such as stress-related disorders, are more likely to occur. Choices A, B, and C do not reflect an accurate understanding of diseases of adaptation. Limited experience managing stress, inheriting adaptive genes, and facing pre-existing conditions that worsen stress do not directly relate to the concept of physiological and psychological resource depletion leading to diseases of adaptation.
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