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ATI Mental Health Practice B
1. A patient with obsessive-compulsive disorder (OCD) frequently washes their hands. Which nursing intervention is most appropriate?
- A. Allow the patient to wash their hands, then gradually limit the time spent on this behavior.
- B. Discourage the patient from discussing their obsessions.
- C. Encourage the patient to suppress their compulsive behaviors.
- D. Avoid setting limits on the patient's compulsive behaviors.
Correct answer: A
Rationale: In managing a patient with OCD who frequently washes their hands, it is important to understand that compulsive behaviors provide temporary relief from anxiety. Allowing the patient to engage in their rituals initially and then gradually setting limits on the time spent can help them gain control over their compulsions. This approach supports the patient without causing undue distress, ultimately assisting in managing OCD symptoms effectively. Choice B is incorrect as discouraging the patient from discussing their obsessions can hinder therapeutic communication and understanding of their condition. Choice C is wrong because encouraging the patient to suppress their compulsive behaviors may increase their anxiety and lead to worsening symptoms. Choice D is also incorrect as avoiding setting limits on the patient's compulsive behaviors does not help the patient in gaining control over their OCD symptoms.
2. When assessing a patient with major depressive disorder, which of the following is a common cognitive symptom?
- A. Hallucinations
- B. Delusions
- C. Lack of appetite
- D. Negative self-talk
Correct answer: D
Rationale: Negative self-talk is a common cognitive symptom of major depressive disorder. It involves a pattern of negative thoughts and beliefs about oneself, which can significantly impact a patient's self-esteem and overall outlook on life. Hallucinations and delusions are more commonly associated with other mental health conditions like schizophrenia, while lack of appetite is typically considered a physical symptom of depression rather than a cognitive one.
3. When a patient with schizophrenia is taking haloperidol, what is a priority assessment for the nurse?
- A. Assessing for signs of tardive dyskinesia
- B. Monitoring for signs of neuroleptic malignant syndrome
- C. Checking for signs of depression
- D. Monitoring for changes in appetite
Correct answer: B
Rationale: Monitoring for signs of neuroleptic malignant syndrome is crucial for patients taking haloperidol. Neuroleptic malignant syndrome is a rare but serious side effect that can occur with antipsychotic medications like haloperidol. It presents with symptoms such as high fever, unstable blood pressure, confusion, muscle rigidity, and autonomic dysfunction. Early detection and intervention are essential to prevent serious complications.
4. A patient with social anxiety disorder is learning cognitive-behavioral therapy (CBT) techniques. Which skill is most likely being taught?
- A. Avoiding social situations that cause anxiety
- B. Challenging and changing negative thoughts
- C. Using deep breathing exercises during social interactions
- D. Taking anti-anxiety medication before social events
Correct answer: B
Rationale: The correct answer is B. In cognitive-behavioral therapy (CBT) for social anxiety disorder, the focus is on challenging and changing negative thoughts that contribute to anxiety. This process involves identifying distorted thought patterns and replacing them with more balanced and realistic thoughts, helping individuals develop healthier perspectives on social situations. Choices A, C, and D are incorrect because avoiding social situations, using deep breathing exercises, and taking medication are not the primary skills taught in CBT for social anxiety disorder. CBT aims to address the underlying thought patterns and behaviors that maintain anxiety, rather than avoidance or temporary relief.
5. A nurse is planning care for several clients attending community-based mental health programs. Which of the following clients should the nurse visit first?
- A. A client who received a burn on the arm while using a hot iron at home
- B. A client who requests a change of antipsychotic medication due to new adverse effects
- C. A client who reports hearing a voice saying that life is not worth living anymore
- D. A client who tells the nurse about experiencing manifestations of severe anxiety before and during a job interview
Correct answer: C
Rationale: The nurse should visit the client who reports hearing a voice saying that life is not worth living anymore first. This statement indicates potential suicidal ideation, which requires immediate intervention to ensure the client's safety. Choices A, B, and D do not present an immediate threat to the client's life. While burns, adverse effects of medication, and severe anxiety are important concerns, they do not pose an immediate risk of self-harm or suicide.
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