a nurse is developing a care plan for a patient with borderline personality disorder which intervention should be included to address self harm behavi
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Nursing Elites

ATI LPN

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?

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. The school staff has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer ‘locking up’ other children on the playground to the point where the children get scared. The staff recognizes that this behavior is most likely an indication of:

Correct answer: D

Rationale: This behavior of playacting as a police officer and 'locking up' other children to the point of causing fear may suggest that the child is displaying potential symptoms of traumatization. It could indicate that the child has experienced or witnessed traumatic events, leading to the replication of such scenarios as a coping mechanism or way to process the trauma. Choices A, B, and C are incorrect because the behavior described is more indicative of a potential trauma response rather than a need to dominate others, invent traumatic events, or develop close relationships.

3. A healthcare professional is assessing a patient with bipolar disorder. Which finding suggests the patient is experiencing a manic episode?

Correct answer: A

Rationale: During a manic episode in patients with bipolar disorder, they often experience a decreased need for sleep. This symptom is characterized by feeling rested after only a few hours of sleep, or even feeling like they can go without sleep for extended periods without feeling tired. The increased energy levels and racing thoughts during a manic episode contribute to the decreased need for sleep.

4. 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?

Correct answer: C

Rationale: The most therapeutic response acknowledges the patient's emotional state and invites further discussion about their experience. By saying, 'You seem very upset. Please tell me more about what you experienced last night,' the nurse shows empathy and openness, providing a supportive environment for the patient to express their feelings and perceptions.

5. A healthcare provider is educating a patient about the side effects of selective serotonin reuptake inhibitors (SSRIs). Which side effect should the provider emphasize?

Correct answer: C

Rationale: When educating patients about SSRIs, it is crucial to emphasize the common side effect of nausea. Nausea is a frequently reported side effect of SSRIs that can impact adherence to treatment. By highlighting this side effect, patients can be better prepared and informed about what to expect when taking these medications. Choices A, B, and D are incorrect as weight gain, increased libido, and insomnia are not typically associated with SSRIs as common side effects. Nausea is a more relevant and prevalent side effect to address with patients.

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