ATI RN
ATI Mental Health Proctored Exam 2019
1. A healthcare provider is evaluating a client who is taking selective serotonin reuptake inhibitors (SSRIs) for depression. Which symptom should the healthcare provider identify as an adverse effect that requires immediate attention?
- A. Increased appetite
- B. Weight gain
- C. Blurred vision
- D. Suicidal thoughts
Correct answer: D
Rationale: Suicidal thoughts are a serious adverse effect associated with SSRIs and require immediate attention. This symptom is critical as it can increase the risk of self-harm or suicide in individuals taking these medications. Increased appetite and weight gain are common side effects of SSRIs but do not require immediate attention. Blurred vision is not a typical adverse effect of SSRIs, making it an incorrect choice. Healthcare providers must promptly recognize and address suicidal thoughts to ensure the safety and well-being of the client.
2. When starting on oral contraceptives, what should the nurse emphasize about the potential interactions with other medications?
- A. Oral contraceptives can be less effective when taken with certain antibiotics.
- B. Oral contraceptives are less effective when taken with food.
- C. Oral contraceptives are effective immediately after starting.
- D. Oral contraceptives have no interactions with other medications.
Correct answer: A
Rationale: The correct answer is A. Oral contraceptives can be less effective when taken with certain antibiotics, so patients should be informed about the potential need for additional contraception. Choice B is incorrect because taking oral contraceptives with food does not affect their effectiveness. Choice C is incorrect because oral contraceptives may take some time to become fully effective. Choice D is incorrect because oral contraceptives can interact with other medications, especially certain antibiotics, affecting their efficacy.
3. When planning care for a 77-year-old male admitted with suspected acute myeloid leukemia (AML), what epidemiologic fact should the nurse be aware of?
- A. Early diagnosis is associated with good outcomes.
- B. Five-year survival for older adults is approximately 50%.
- C. Five-year survival for patients over 75 years old is less than 2%.
- D. Survival rates are wholly dependent on the patient's pre-illness level of health.
Correct answer: C
Rationale: In the context of AML, the 5-year survival rate significantly decreases with age. The 5-year survival rate for patients over 75 years old is less than 2% compared to 43% for those 50 years or younger, and 19% for those between 50 and 64 years. Choice A is incorrect as early diagnosis does not necessarily guarantee good outcomes in AML. Choice B is inaccurate as the 5-year survival rate is not approximately 50% for older adults with AML. Choice D is incorrect as survival rates for AML patients are influenced by various factors beyond just the pre-illness level of health.
4. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?
- A. Hemoglobin A1C level is 7.9%.
- B. Last eye exam was 18 months ago.
- C. Glomerular filtration rate is decreased.
- D. Patient has questions about the prescribed diet.
Correct answer: C
Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.
5. During the first 24 hours of burn, nursing measures should focus on which of the following?
- A. I and O hourly
- B. Strict aseptic technique
- C. Forced oral fluids
- D. Isolate the patient
Correct answer: A
Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.
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