ATI RN
ATI Mental Health Proctored Exam 2023
1. A patient being treated for insomnia is prescribed ramelteon (Rozerem). Which comorbid mental health condition would make this medication the hypnotic of choice for this particular patient?
- A. Obsessive-compulsive disorder
- B. Generalized anxiety disorder
- C. Persistent depressive disorder
- D. Substance use disorder
Correct answer: D
Rationale: The correct answer is D, Substance use disorder. Ramelteon is preferred for patients with substance use disorder because it lacks abuse potential. This makes it a safer choice for individuals with a history of substance misuse. Choosing a medication with a lower risk of abuse in this population is crucial to prevent potential misuse or dependence issues.
2. Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted's wife and his blood tests confirm. To reduce Ted's mania, the psychiatric nurse practitioner recommends:
- A. Clonazepam (Klonopin)
- B. Fluoxetine (Prozac)
- C. Electroconvulsive therapy (ECT)
- D. Lurasidone (Latuda)
Correct answer: C
Rationale: Electroconvulsive therapy (ECT) can be an effective treatment for reducing mania in patients with bipolar disorder who have not responded to medication. In Ted's case, where he has a history of bipolar I disorder, lithium treatment, and manic episodes, ECT may be recommended by the psychiatric nurse practitioner to help manage his symptoms.
3. In addition to antianxiety agents, which classification of drugs is commonly prescribed to treat anxiety and anxiety disorders?
- A. Antipsychotics
- B. Mood stabilizers
- C. Antidepressants
- D. Cholinesterase inhibitors
Correct answer: C
Rationale: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are frequently used in the treatment of anxiety disorders. These medications help alleviate symptoms by affecting neurotransmitters in the brain associated with mood regulation and anxiety.
4. Adolescents often display fluctuations in mood along with undeveloped emotional regulation and poor tolerance for frustration. Emotional and behavioral control usually increases over the course of adolescence due to:
- A. Limited executive function
- B. Cerebellum maturation
- C. Cerebral stasis and hormonal changes
- D. A slight reduction in brain volume
Correct answer: B
Rationale: During adolescence, emotional and behavioral control typically improves as the cerebellum matures. The cerebellum plays a significant role in regulating emotions and behavior, contributing to the increased control seen in adolescents over time.
5. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, 'Last night, demons came to my room and tried to rape me.' Which response would be most therapeutic?
- A. There are no such things as demons. What you saw were hallucinations.
- B. It is not possible for anyone to enter your room at night. You are safe here.
- C. You seem very upset. Please tell me more about what you experienced last night.
- D. That must have been very frightening, but we'll check on you at night and you'll be safe.
Correct answer: C
Rationale: Response C is the most therapeutic as it shows empathy and encourages the patient to express their feelings and share more about their experience. By actively listening and inviting the patient to talk, the nurse creates a supportive environment that can help the patient feel heard and understood, which is essential in building trust and rapport in therapeutic communication with individuals experiencing schizophrenia.
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