ATI RN
ATI Mental Health Proctored Exam 2023
1. Gilbert, age 19, is described by his parents as a moody child with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert's early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:
- A. Favorable with medication
- B. In the relapse stage
- C. Improvable with psychosocial interventions
- D. To have a less positive outcome
Correct answer: D
Rationale: The scenario describes Gilbert as having an early and slow onset of schizophrenia, which typically indicates a less positive prognosis. Individuals with such presentations may experience more severe symptoms and difficulties in functioning, leading to a poorer long-term outcome. In Gilbert's case, his challenges with completing tasks, social withdrawal, and fixation on security measures suggest a more challenging prognosis. Early detection and intervention are crucial in managing schizophrenia, but the described symptoms and onset pattern are concerning for a less favorable outcome.
2. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:
- A. The need to dominate others
- B. Inventing traumatic events
- C. A need to develop close relationships
- D. A potential symptom of traumatization
Correct answer: D
Rationale: The behavior of an 8-year-old boy playacting as a police officer and 'locking up' other children to the point of scaring them is likely a symptom of traumatization. Children may reenact traumatic experiences through play, and acting out aggressive or controlling roles can be a sign of underlying trauma. This behavior should be further assessed and addressed with appropriate support and intervention to help the child process and cope with any potential trauma.
3. Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select one that doesn't apply.
- A. Do rules apply to you?
- B. What do you do to manage anxiety?
- C. Do you have a history of disordered eating?
- D. Do you think that you drink too much?
Correct answer: A
Rationale: Questions about anxiety management, disordered eating, and alcohol use are relevant to identifying comorbid conditions with major depressive disorder, but the question 'Do rules apply to you?' does not directly address common comorbid mental health conditions associated with major depressive disorder.
4. Which statement by the patient indicates a need for further teaching regarding the treatment of major depressive disorder?
- A. I have been on this antidepressant for 3 days. I understand that the full effect may take weeks to occur.
- B. I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.
- C. I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.
- D. I realize that there are many antidepressants and it might take a while until we find the one that works best for me.
Correct answer: B
Rationale: Choice B indicates a need for further teaching because the patient is planning to switch directly from Prozac, an SSRI, to a monoamine oxidase inhibitor (MAOI) without allowing for a washout period. This abrupt switch poses a risk of serotonin syndrome, which can be life-threatening. It is essential to educate the patient about the importance of consulting healthcare providers before changing medications to prevent potential adverse effects.
5. During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select one that doesn't apply.
- A. Auditory
- B. Visual
- C. Written
- D. Tactile
Correct answer: C
Rationale: During an admission assessment and interview, nurses should monitor auditory, visual, and tactile channels of communication. Written communication is not typically monitored during a face-to-face interview or assessment, making it the correct choice that doesn't apply in this scenario.
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