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ATI Mental Health Practice A 2023
1. When developing a care plan for a patient with borderline personality disorder, which intervention should be included to address self-harm behaviors?
- A. Encouraging the patient to keep a journal of their thoughts and feelings.
- B. Setting clear and consistent boundaries with the patient.
- C. Providing the patient with coping skills to manage their emotions.
- D. Developing a safety plan with the patient.
Correct answer: D
Rationale: Developing a safety plan with the patient is crucial when addressing self-harm behaviors in individuals with borderline personality disorder. This intervention helps outline steps to take during a crisis, identifies triggers, and provides strategies to prevent self-harm incidents. It involves collaboratively creating a plan between the patient and the healthcare team to ensure a structured and supportive approach to managing potentially dangerous situations.
2. A patient with obsessive-compulsive disorder (OCD) is prescribed fluvoxamine. What is a common side effect of this medication?
- A. Increased appetite
- B. Dry mouth
- C. Weight gain
- D. Nausea
Correct answer: D
Rationale: Nausea is a common side effect of fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) commonly used in the treatment of OCD. Patients should be advised to monitor and report any gastrointestinal disturbances, including nausea, to their healthcare provider.
3. A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, 'You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'
- A. A higher dosage
- B. Once-a-week dosing
- C. A lower dosage
- D. A different drug
Correct answer: C
Rationale: In the maintenance therapy stage for bipolar disorder, a lower dosage of lithium is often prescribed to prevent toxicity and maintain stability while minimizing side effects. Lower doses are typically used once the patient has achieved mood stabilization to reduce the risk of adverse effects associated with long-term lithium use.
4. Which symptom is most indicative of obsessive-compulsive disorder (OCD)?
- A. Flashbacks of traumatic events
- B. Persistent, intrusive thoughts
- C. Frequent mood swings
- D. Auditory hallucinations
Correct answer: B
Rationale: Persistent, intrusive thoughts are a hallmark symptom of obsessive-compulsive disorder. Individuals with OCD experience persistent and unwanted thoughts or obsessions that are intrusive and cause significant distress. These thoughts often lead to repetitive behaviors or compulsions to try to alleviate the anxiety or distress caused by the obsessions. Flashbacks of traumatic events (Choice A), frequent mood swings (Choice C), and auditory hallucinations (Choice D) are not typical symptoms of OCD. Flashbacks are more commonly associated with post-traumatic stress disorder, mood swings can be seen in mood disorders, and auditory hallucinations are more characteristic of psychotic disorders.
5. What is the most appropriate nursing diagnosis for a patient with agoraphobia who reports not having left their house in months?
- A. Social isolation
- B. Ineffective coping
- C. Risk for injury
- D. Impaired social interaction
Correct answer: A
Rationale: The nursing diagnosis 'Social isolation' is most appropriate for a patient with agoraphobia who has not left their house in months. Agoraphobia often leads to the avoidance of situations or places perceived as unsafe, resulting in social isolation. This diagnosis reflects the patient's limited social interactions and confinement to the home environment, which can impact their overall well-being and mental health. The other options are not as relevant in this scenario: 'Ineffective coping' does not directly address the social withdrawal aspect, 'Risk for injury' is not the primary concern presented, and 'Impaired social interaction' does not capture the extent of isolation described.
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