ATI RN
ATI Mental Health Proctored Exam 2023
1. A woman was abducted and raped at gunpoint by an unknown assailant. When found, she was confused and disoriented. The nurse makes the following observations about the client. She is talking rapidly in disjointed phrases, is unable to concentrate, and is indecisive when asked to make simple decisions. The client's level of anxiety can be assessed as
- A. moderate
- B. severe
- C. mild
- D. nonexistent
Correct answer: B
Rationale: The client's presentation, including rapid and disjointed speech, inability to concentrate, and indecisiveness, are indicative of severe anxiety. These symptoms suggest a high level of distress and impairment in cognitive functioning, which aligns with severe anxiety rather than mild or moderate levels. The traumatic experience of being abducted and raped at gunpoint would likely contribute to such a severe level of anxiety.
2. You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic?
- A. A new psychiatrist is a chance to start fresh; I'm sure it will go well for you.
- B. You say you look forward to the meeting, but you appear anxious or unhappy.
- C. I notice that you frowned and avoided eye contact just now. Don't you feel well?
- D. I get the impression you don't really want to see your psychiatrist—can you tell me why?
Correct answer: B
Rationale: Choice B is the most therapeutic response as it acknowledges the discrepancy between the patient's verbal statement and nonverbal cues. By addressing both the patient's expressed anticipation and the conflicting nonverbal cues of frowning and avoiding eye contact, the responder demonstrates attentiveness to the patient's emotional state and encourages further exploration of underlying feelings. This approach fosters open communication and helps the patient feel understood and supported.
3. Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?
- A. Fluoxetine (Prozac)
- B. Isocarboxazid (Marplan)
- C. Amitriptyline
- D. Duloxetine (Cymbalta)
Correct answer: A
Rationale: Fluoxetine (Prozac) is a suitable alternative antidepressant for Tammy due to its approval for the treatment of bulimia nervosa. It belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, similar to citalopram, which Tammy is already taking. Fluoxetine has shown efficacy in treating bulimia nervosa and can be a beneficial choice for individuals with this condition.
4. Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select one that doesn't apply.
- A. I remind myself to consistently drink six 12-ounce glasses of fluid every day.
- B. I discussed the diuretic prescribed by my cardiologist with my psychiatric care provider.
- C. Lithium may help me lose the few extra pounds I tend to carry around.
- D. I take my lithium on an empty stomach to help with absorption.
Correct answer: C
Rationale: Proper hydration, discussing other medications, and taking lithium with or without food are important for effective and safe use of lithium. However, lithium is not prescribed for weight loss, and its usage should not be associated with losing extra pounds.
5. Substance abuse is often present in individuals diagnosed with bipolar disorder. Laura, a 28-year-old with a bipolar disorder diagnosis, chooses to drink alcohol instead of taking her prescribed medications. The nurse caring for this patient recognizes that:
- A. Anxiety may be present.
- B. Alcohol ingestion is a form of self-medication.
- C. The patient is lacking a sufficient number of neurotransmitters.
- D. The patient is using alcohol as a coping mechanism.
Correct answer: B
Rationale: Individuals with bipolar disorder may turn to alcohol as a form of self-medication to cope with their symptoms. This behavior is often seen as an attempt to manage mood swings and alleviate distress. It is important for healthcare providers to address and manage substance abuse issues in patients with bipolar disorder to ensure proper treatment and overall well-being.
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