ATI RN
ATI Mental Health Proctored Exam 2019
1. A client diagnosed with generalized anxiety disorder (GAD) states, 'I just can't stop worrying about everything.' Which nursing diagnosis is most appropriate for this client?
- A. Ineffective coping
- B. Disturbed thought processes
- C. Chronic low self-esteem
- D. Social isolation
Correct answer: A
Rationale: The most appropriate nursing diagnosis for a client with generalized anxiety disorder (GAD) who expresses an inability to stop worrying about everything is 'Ineffective coping.' This diagnosis indicates the client's struggle to manage anxiety and worry effectively, which aligns with the client's statement. 'Disturbed thought processes' (Choice B) would involve disorganized or irrational thinking patterns, which are not directly related to the client's statement about excessive worry. 'Chronic low self-esteem' (Choice C) refers to a long-standing negative self-evaluation and is not the most fitting diagnosis for the client's current concern. 'Social isolation' (Choice D) pertains to a lack of social interactions and support, which is not the primary issue highlighted by the client's statement.
2. A patient with posttraumatic stress disorder (PTSD) is experiencing flashbacks. The most appropriate intervention is to:
- A. Encourage the patient to talk about the trauma.
- B. Help the patient reorient to the present.
- C. Leave the patient alone to process the flashback.
- D. Remind the patient that the flashback is not real.
Correct answer: B
Rationale: When a patient with PTSD is experiencing flashbacks, the most appropriate intervention is to help them reorient to the present. This intervention can assist in reducing the intensity of the flashback and providing a sense of safety for the patient. Choice A is incorrect because encouraging the patient to talk about the trauma during a flashback may exacerbate their distress. Choice C is incorrect as leaving the patient alone can increase their feelings of isolation and fear. Choice D is incorrect because reminding the patient that the flashback is not real may invalidate their experience and increase their sense of disconnection.
3. When caring for a client experiencing alcohol withdrawal, which intervention should the nurse implement to prevent complications?
- A. Provide a well-lit environment.
- B. Administer antipsychotic medication as prescribed.
- C. Monitor the client's vital signs closely.
- D. Encourage the client to express their feelings.
Correct answer: D
Rationale: Encouraging the client to express their feelings is essential during alcohol withdrawal as it can help them cope with the emotional and psychological stress associated with the process. This intervention promotes open communication, allows the client to verbalize their emotions, and may prevent escalating anxiety or agitation, ultimately reducing the risk of complications. Providing a well-lit environment (Choice A) is not directly related to preventing complications of alcohol withdrawal. Administering antipsychotic medication (Choice B) is not the standard treatment for alcohol withdrawal; medications such as benzodiazepines are more commonly used. While monitoring vital signs (Choice C) is important, encouraging the client to express their feelings (Choice D) directly addresses emotional well-being, which is crucial during this vulnerable time.
4. A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse implement? Select one that does not apply.
- A. Encourage participation in activities
- B. Promote adequate nutrition and hydration
- C. Monitor for suicidal ideation
- D. Discourage verbalization of feelings
Correct answer: D
Rationale: Interventions for a client with bipolar disorder experiencing a depressive episode include encouraging participation in activities, promoting adequate nutrition and hydration, monitoring for suicidal ideation, and providing a structured daily schedule. Discussing feelings is an essential part of therapy for clients with bipolar disorder, thus discouraging verbalization of feelings is not therapeutic and should not be implemented. Choice D is incorrect because it goes against the principles of therapeutic communication and emotional expression, which are crucial in managing bipolar disorder.
5. How do psychiatrists determine which diagnosis to give a patient?
- A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
- B. Hospital policy dictates how psychiatrists diagnose mental disorders.
- C. Psychiatrists assess the patient and identify diagnoses based on the patient's symptoms and contributing factors.
- D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.
Correct answer: A
Rationale: Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine which diagnosis to give a patient. The DSM-5 is a comprehensive manual published by the American Psychiatric Association (APA) that outlines specific criteria for diagnosing mental disorders. It aims to ensure accurate and consistent diagnosis and treatment. Choices B and D provide inaccurate information. Hospital policy does not dictate psychiatric diagnoses, and the American Medical Association does not provide diagnostic labels for mental disorders. Choice C, although mentioning the assessment of patients, does not highlight the specific criteria and guidelines provided by the DSM-5 that psychiatrists use to assign diagnoses.
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