ATI RN
ATI Mental Health Proctored Exam 2023
1. Which response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar disorder and her support system? Select the incorrect one.
- A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
- B. Due to the risk of a manic episode, antidepressant therapy is never used with bipolar disorder.
- C. It's critical to inform your healthcare provider immediately if you are experiencing sleep disturbances.
- D. Is your family prepared to be actively involved in helping manage this disorder?
Correct answer: B
Rationale: In managing bipolar disorder, it is vital to educate the patient and their support system about triggers like alcohol and caffeine, the significance of good sleep, and the need for family involvement. However, the statement in choice B is incorrect. While antidepressants need to be carefully monitored in bipolar disorder, they can be used in conjunction with mood stabilizers to manage depression in some cases.
2. Tatiana has been hospitalized for an acute manic episode. On admission, the nurse suspects lithium toxicity. What assessment findings would indicate the nurse's suspicion as correct?
- A. Shortness of breath, gastrointestinal distress, chronic cough
- B. Ataxia, severe hypotension, large volume of dilute urine
- C. Gastrointestinal distress, thirst, nystagmus
- D. Electroencephalographic changes, chest pain, dizziness
Correct answer: B
Rationale: The correct answer is B. Ataxia, severe hypotension, and a large volume of dilute urine are classic signs of lithium toxicity. Ataxia refers to a lack of muscle coordination, severe hypotension indicates dangerously low blood pressure, and the large volume of dilute urine is a result of the kidneys' inability to concentrate urine properly, a common feature of lithium toxicity.
3. When using therapeutic communication with a withdrawn patient who has major depression, an effective method of managing the silence is to:
- A. Engage in a quiet meditation
- B. Ask simple questions even if the patient will not answer
- C. Use the technique of making observations
- D. Simply sit quietly and leave when the patient falls asleep
Correct answer: C
Rationale: Using the technique of making observations is an effective method of managing silence when communicating with a withdrawn patient who has major depression. This approach can encourage the patient to engage and feel understood without the pressure to respond, fostering a therapeutic connection and helping the patient open up at their own pace.
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. A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?
- A. Reinforce that the level is above the therapeutic range.
- B. Instruct the patient to hold the next dose of medication and contact the prescriber.
- C. Advise the patient to go to the hospital emergency room immediately.
- D. Inform the patient about the possibility of seizures and appropriate precautions.
Correct answer: B
Rationale: A lithium level of 1.7 mEq/L is above the therapeutic range, indicating a potential risk of toxicity. The initial nursing intervention should be to instruct the patient to hold the next dose of medication and promptly contact the prescriber for further guidance and management. This action aims to prevent adverse effects and ensure the patient's safety by addressing the elevated lithium level appropriately.
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