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ATI Mental Health Practice A 2023
1. Which symptom is most characteristic of generalized anxiety disorder (GAD)?
- A. Fear of social situations
- B. Excessive worrying about various aspects of life
- C. Hallucinations
- D. Impulsive behaviors
Correct answer: B
Rationale: Excessive worrying about various aspects of life is a hallmark symptom of generalized anxiety disorder (GAD). In GAD, individuals experience excessive and uncontrollable worry about a wide range of everyday problems. This persistent worrying can lead to physical and emotional symptoms, impacting their daily functioning and quality of life. Fear of social situations, hallucinations, and impulsive behaviors are not typically associated with GAD.
2. What principle about patient communication should guide a nurse's fear of 'saying the wrong thing' to a patient?
- A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
- B. Patients are more interested in talking to you than listening to what you have to say, so they are not likely to be offended.
- C. Considering the patient's history, there is little chance that the comment will do any actual harm.
- D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.
Correct answer: A
Rationale: Effective patient communication is guided by the principle that patients value genuine acceptance, respect, and concern from their caregivers. This approach helps to build trust and fosters effective communication, enhancing the nurse-patient relationship. Choice B is incorrect because patients value both talking and listening in effective communication. Choice C is incorrect because a nurse should always consider the impact of their words on the patient, regardless of the patient's history. Choice D is incorrect as it generalizes about people with mental illness and forgiveness, which is not directly relevant to patient communication.
3. During the working phase of a therapeutic relationship, a client with methamphetamine use disorder displays transference behavior. Which action by the client indicates transference behavior?
- A. The client asks the nurse if they will go out to dinner together
- B. The client accuses the nurse of being controlling just like an ex-partner
- C. The client reminds the nurse of a friend who died from substance toxicity
- D. The client becomes angry and threatens to engage in self-harm
Correct answer: B
Rationale: Transference occurs when a client projects feelings, often unconscious, onto the nurse that are associated with significant figures in their past or present life. In this scenario, the client accusing the nurse of being controlling like an ex-partner demonstrates transference behavior by attributing characteristics of someone from their past onto the nurse. Choices A, C, and D do not reflect transference behavior. Choice A involves a social invitation, which is not necessarily transference. Choice C is more related to countertransference as it triggers memories in the nurse, not the client. Choice D describes aggressive behavior and self-harm threats, which are not indicative of transference.
4. When communicating with a client admitted for treatment of a substance use disorder, which of the following communication techniques should be identified as a barrier to therapeutic communication?
- A. Offering advice
- B. Reflecting
- C. Listening attentively
- D. Giving information
Correct answer: A
Rationale: Offering advice is a barrier to therapeutic communication because it can hinder the client's ability to explore their own solutions and feelings. It may come across as judgmental or dismissive of the client's experience, leading to a breakdown in trust and hindering the therapeutic relationship. Reflecting (choice B) is a helpful technique that involves paraphrasing or restating the client's words to show understanding. Listening attentively (choice C) is crucial for building rapport and demonstrating empathy. Giving information (choice D) is also important but should be done in a way that supports the client's understanding and autonomy, rather than directing their choices.
5. Which therapeutic approach is most effective for a patient with generalized anxiety disorder (GAD)?
- A. Psychoanalytic therapy
- B. Cognitive-behavioral therapy (CBT)
- C. Humanistic therapy
- D. Gestalt therapy
Correct answer: B
Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic approach for generalized anxiety disorder (GAD). CBT helps individuals identify and modify negative thought patterns and behaviors that contribute to anxiety. It focuses on changing cognitive distortions and maladaptive behaviors, providing practical strategies to manage anxiety symptoms effectively. Numerous studies have shown the effectiveness of CBT in treating GAD by helping patients develop coping mechanisms and skills to address their anxiety. Choice A, Psychoanalytic therapy, is not the most effective for GAD as it primarily focuses on exploring unconscious conflicts and childhood experiences rather than providing immediate coping strategies. Choice C, Humanistic therapy, emphasizes personal growth and self-improvement, which may not directly target the specific symptoms of GAD. Choice D, Gestalt therapy, focuses on increasing self-awareness and personal responsibility, which might not address the cognitive distortions and behavioral patterns associated with GAD as directly as CBT does.
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