ATI RN
ATI Mental Health Practice A
1. A nurse is assessing a patient with schizophrenia who is experiencing delusions. Which intervention is most appropriate?
- A. Agree with the patient's delusions to avoid confrontation.
- B. Encourage the patient to explore the basis of the delusions.
- C. Engage the patient in reality-based activities.
- D. Ask the patient to explain the delusions in detail.
Correct answer: C
Rationale: The most appropriate intervention when assessing a patient with schizophrenia experiencing delusions is to engage the patient in reality-based activities. This intervention helps distract the patient from the delusions and reorients them to the present, promoting grounding in reality. Choice A is incorrect because agreeing with delusions can reinforce them and hinder treatment. Choice B may exacerbate the delusions by delving deeper into their basis. Choice D may not be beneficial as it focuses solely on the delusions without addressing the need to ground the patient in reality.
2. 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.
3. Which of the following is a common side effect of selective serotonin reuptake inhibitors (SSRIs)?
- A. Hypotension
- B. Sexual dysfunction
- C. Increased appetite
- D. Tachycardia
Correct answer: B
Rationale: Corrected Rationale: Sexual dysfunction is a commonly reported side effect of selective serotonin reuptake inhibitors (SSRIs). SSRIs can affect sexual function by causing issues such as decreased libido, delayed ejaculation, erectile dysfunction, or anorgasmia. Patients should be educated about these potential side effects when starting SSRIs to facilitate informed decision-making and appropriate management strategies. Incorrect Choices: A) Hypotension is not a common side effect of SSRIs. C) Increased appetite is not a common side effect of SSRIs. D) Tachycardia is not a common side effect of SSRIs.
4. A patient with posttraumatic stress disorder (PTSD) is prescribed prazosin. The nurse understands that this medication is used to treat which symptom of PTSD?
- A. Flashbacks
- B. Nightmares
- C. Hypervigilance
- D. Depression
Correct answer: B
Rationale: Prazosin is a medication often prescribed to manage nightmares in patients with PTSD. It works by blocking the action of adrenaline on specific receptors, which helps in reducing the intensity and frequency of nightmares. While flashbacks, hypervigilance, and depression are also common symptoms of PTSD, prazosin is specifically indicated for nightmares associated with the disorder. Flashbacks are typically addressed through therapies like cognitive-behavioral therapy, hypervigilance may be managed through counseling and coping strategies, and depression may necessitate antidepressant medications or therapy tailored for depression.
5. Which neurotransmitter is primarily implicated in the development of schizophrenia?
- A. Serotonin
- B. Norepinephrine
- C. Dopamine
- D. Acetylcholine
Correct answer: C
Rationale: The correct answer is dopamine. Dopamine dysregulation is a key factor in the development of schizophrenia. Excess dopamine activity in certain brain regions is associated with positive symptoms of schizophrenia, such as hallucinations and delusions. Dopaminergic medications that reduce dopamine levels are often used to manage these symptoms, further supporting the role of dopamine in schizophrenia. Serotonin (Choice A) is more commonly associated with mood regulation and is implicated in depression and anxiety disorders. Norepinephrine (Choice B) is involved in the body's 'fight or flight' response and is linked to conditions like anxiety and PTSD. Acetylcholine (Choice D) plays a role in muscle movement and memory but is not primarily implicated in schizophrenia.
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