ATI RN
ATI Mental Health Practice A
1. For a patient diagnosed with borderline personality disorder exhibiting self-harming behavior, which therapeutic approach is most appropriate?
- A. Dialectical behavior therapy
- B. Psychoanalysis
- C. Supportive therapy
- D. Pharmacotherapy
Correct answer: A
Rationale: The most appropriate therapeutic approach for a patient diagnosed with borderline personality disorder exhibiting self-harming behavior is dialectical behavior therapy (DBT). DBT is specifically designed to address the core symptoms of borderline personality disorder, including self-harming behaviors. It focuses on teaching patients skills to manage emotions, improve interpersonal relationships, and enhance distress tolerance. Psychoanalysis (Choice B) is not the most appropriate for immediate symptom management in this case. Supportive therapy (Choice C) may not provide the structured approach needed to address self-harming behaviors effectively. Pharmacotherapy (Choice D) may be used as an adjunct in some cases, but DBT is the frontline therapy for managing self-harming behaviors in borderline personality disorder.
2. 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.
3. Which therapeutic approach is most effective for managing obsessive-compulsive disorder (OCD)?
- A. Cognitive-behavioral therapy
- B. Psychoanalysis
- C. Medication management
- D. Group therapy
Correct answer: A
Rationale: Cognitive-behavioral therapy (CBT), especially exposure and response prevention, is considered the most effective therapeutic approach for managing obsessive-compulsive disorder (OCD). CBT helps individuals identify and modify their distorted beliefs and behaviors related to OCD, while exposure and response prevention specifically target the core symptoms of OCD by gradually exposing the individual to feared stimuli and preventing compulsive responses. While medication management can be used as an adjunct to therapy, CBT has shown to have long-lasting benefits in reducing OCD symptoms and improving the overall quality of life. Psychoanalysis focuses more on exploring unconscious conflicts and childhood experiences, which may not be as effective for OCD. Group therapy can be beneficial as a supplemental treatment but is not typically as effective as individual CBT tailored to the specific needs of the individual with OCD.
4. A patient with obsessive-compulsive disorder (OCD) is performing a ritualistic handwashing routine. What is the nurse's best initial response?
- A. Interrupt the ritual to help the patient gain control.
- B. Allow the ritual but set limits on the duration.
- C. Ignore the behavior to avoid reinforcing it.
- D. Encourage the patient to stop the ritual and discuss their feelings.
Correct answer: B
Rationale: In managing a patient with OCD engaging in ritualistic behaviors like handwashing, the nurse's best initial response is to allow the ritual but set limits on the duration. This approach helps in managing the behavior while gradually working towards reducing its frequency. Interrupting the ritual abruptly may cause distress to the patient, ignoring the behavior may reinforce it, and encouraging the patient to stop the ritual without setting limits may not be as effective in the initial stage of intervention.
5. 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.
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