ATI RN
ATI Mental Health Proctored Exam 2023
1. Kyle, a patient with schizophrenia, began taking the first-generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is okay, he seems unable to respond verbally. His vital signs are: BP 170/100, P 110, T 104.2°F. What is the priority nursing intervention? Select one that does not apply.
- A. Hold his medication and contact his prescriber.
- B. Wipe him with a washcloth wet with cold water or alcohol.
- C. Administer a medication such as benztropine IM to correct this dystonic reaction.
- D. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass.
Correct answer: C
Rationale: The patient's symptoms, including stiffness, diaphoresis, inability to respond verbally, and vital sign abnormalities, are indicative of neuroleptic malignant syndrome (NMS), a serious and potentially life-threatening side effect of antipsychotic medications. Administering a medication such as benztropine intramuscularly is the priority to address the dystonic reaction associated with NMS. This intervention can help alleviate symptoms and prevent further complications. Holding the medication and contacting the prescriber may be necessary but addressing the acute symptoms takes precedence. Wiping the patient with a cold washcloth or alcohol would not address the underlying medical emergency. Reassuring the patient about tardive dyskinesia is irrelevant and not the immediate concern in this scenario.
2. 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.
3. In the care plan of a male patient diagnosed with a dissociative disorder, the nursing diagnosis of ineffective coping is included. Which behavior demonstrated by the patient supports this nursing diagnosis?
- A. Has no memory of the physical abuse he endured.
- B. Using both alcohol and marijuana.
- C. Often reports being unaware of surroundings.
- D. Reports feelings of 'not really being here.'
Correct answer: B
Rationale: The correct answer is B because using substances like alcohol and marijuana can be a sign of ineffective coping mechanisms in patients with dissociative disorders. Substance abuse is often used as a maladaptive way to cope with stress, trauma, or other underlying issues. Choices A, C, and D may be related to dissociative symptoms but do not directly reflect ineffective coping behaviors as substance abuse does.
4. Which statement made by the nurse demonstrates the best understanding of nonverbal communication?
- A. The patient's verbal and nonverbal communication is often different.
- B. When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.
- C. If a patient is slumped in the chair, I can be sure he's angry or depressed.
- D. It's easier to understand verbal communication than nonverbal communication.
Correct answer: B
Rationale: Checking for congruence between verbal and nonverbal communication helps validate the patient's response.
5. 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.
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