ATI RN
ATI Mental Health Practice A
1. A patient with generalized anxiety disorder (GAD) is prescribed escitalopram. The nurse should educate the patient that the full therapeutic effect of this medication may take:
- A. 1-2 days
- B. 1-2 weeks
- C. 2-4 weeks
- D. 6-8 weeks
Correct answer: D
Rationale: Escitalopram, an SSRI used in treating generalized anxiety disorder, typically takes 6-8 weeks to achieve its full therapeutic effect. While some improvement may be noticed earlier, the maximum benefit is usually experienced after this timeframe. Options A, B, and C are incorrect because they underestimate the time required for escitalopram to reach its full effectiveness. Educating patients about the realistic timeline for medication effectiveness is crucial in managing expectations and ensuring adherence to the prescribed treatment.
2. For a patient with obsessive-compulsive disorder (OCD) who spends several hours a day washing her hands, which type of therapy is most appropriate?
- A. Exposure and response prevention
- B. Dialectical behavior therapy
- C. Family therapy
- D. Interpersonal therapy
Correct answer: A
Rationale: Exposure and response prevention (ERP) is the most appropriate therapy for managing OCD. ERP involves exposing the patient to anxiety-provoking stimuli (such as touching dirty objects) and preventing the compulsive response (hand washing), thus helping the patient learn to tolerate the anxiety without performing the ritualistic behavior. Dialectical behavior therapy (DBT) focuses more on emotional regulation and interpersonal skills, making it less suitable for directly addressing OCD symptoms. Family therapy and interpersonal therapy may be beneficial for other conditions or relationship issues but are not specifically designed to target OCD symptoms like ERP.
3. In a patient with bipolar disorder, which symptom would indicate a manic episode?
- A. Excessive sleeping
- B. Low self-esteem
- C. Decreased need for sleep
- D. Anhedonia
Correct answer: C
Rationale: The correct answer is C: Decreased need for sleep. A decreased need for sleep is a hallmark symptom of a manic episode in bipolar disorder. During manic episodes, individuals may experience significantly reduced sleep without feeling tired, which can lead to increased energy levels, impulsivity, and other manic symptoms. Excessive sleeping (choice A) is more indicative of depression rather than mania. Low self-esteem (choice B) and anhedonia (choice D) are also more commonly associated with depressive episodes rather than manic episodes in bipolar disorder.
4. A patient with schizophrenia is experiencing hallucinations. Which intervention is most appropriate?
- A. Encourage the patient to ignore the voices.
- B. Engage the patient in a reality-based activity.
- C. Provide a quiet environment to reduce stimulation.
- D. Ask the patient to describe the hallucinations in detail.
Correct answer: B
Rationale: Engaging the patient in a reality-based activity is the most appropriate intervention for a patient with schizophrenia experiencing hallucinations. This intervention can help distract the patient from the hallucinations and reorient them to the present, promoting a connection with reality and potentially reducing distress associated with the hallucinations. Choice A, encouraging the patient to ignore the voices, may not be effective as it can be challenging for the patient to dismiss the hallucinations. Choice C, providing a quiet environment, is helpful but may not directly address the hallucinations. Choice D, asking the patient to describe the hallucinations in detail, may increase the patient's focus on the hallucinations, potentially worsening distress.
5. Which therapeutic approach is most effective for managing borderline personality disorder?
- A. Dialectical behavior therapy
- B. Cognitive-behavioral therapy
- C. Psychoanalysis
- D. Supportive therapy
Correct answer: A
Rationale: Dialectical behavior therapy (DBT) is considered the most effective therapeutic approach for managing borderline personality disorder. DBT is a specialized form of cognitive-behavioral therapy that focuses on providing skills to cope with intense emotions, improve relationships, and regulate behavior. It has been extensively studied and shown to be effective in reducing self-harm, suicidal behaviors, and improving overall functioning in individuals with borderline personality disorder. Cognitive-behavioral therapy (Choice B) is a common and effective treatment for many mental health conditions but is not as specifically tailored to address the core symptoms of borderline personality disorder as DBT. Psychoanalysis (Choice C) is a more intensive and long-term therapy that focuses on exploring unconscious patterns and early life experiences, which may not be as practical or effective for the impulsive and emotional dysregulation seen in borderline personality disorder. Supportive therapy (Choice D) provides emotional support but lacks the structured skills training and strategies that are essential in managing borderline personality disorder.
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