ATI RN
ATI Capstone Mental Health Questions
Question 1 of 5
Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?
Correct Answer: A
Rationale: The correct answer is A: Fluoxetine (Prozac). Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that is FDA-approved for both major depressive disorder and bulimia nervosa. It is commonly used in treating patients with co-occurring depression and eating disorders, like bulimia nervosa. Fluoxetine has shown efficacy in reducing binge eating and purging behaviors associated with bulimia nervosa.
Now, let's analyze the other choices:
B: Isocarboxazid (Marplan) is a monoamine oxidase inhibitor (MAOI) that is not commonly used as a first-line treatment for bulimia nervosa. MAOIs have more dietary and drug interaction concerns compared to SSRIs.
C: Amitriptyline is a tricyclic antidepressant (TC
A) that is not typically preferred for bulimia nervosa due to its side effect profile and overdose risk.
D: Duloxetine (Cymbalta)
Question 2 of 5
A client on an inpatient psychiatric unit states,"My mother hates me. My father is a drunk. Right now, I am homeless." The nurse responds,"Let's talk more about your feelings toward your mother." Which is a description of the technique used by the nurse?
Correct Answer: A
Rationale: The correct answer is A because the nurse is using questions or statements to help the client expand on a topic of importance, which in this case is the client's feelings towards their mother. By encouraging the client to talk more about their feelings, the nurse is facilitating a deeper exploration of the client's emotions and thoughts. This technique fosters trust, empathy, and a therapeutic relationship.
Incorrect
Choices:
B: The nurse is not asking the client to select a topic for discussion but rather guiding the conversation based on the client's initial statement.
C: While the nurse is delving further into the client's feelings about their mother, the focus is on the client's emotions rather than a subject or idea.
D: The nurse is not being persistent with questioning but rather offering a supportive and open-ended approach to exploring the client's feelings.
Question 3 of 5
A client comes to the emergency department complaining of a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and his pulse is racing. The client states that he is being treated for depression with selegiline. Which question by the nurse would be most important to ask at this time?
Correct Answer: B
Rationale: The correct answer is B: "What have you had to eat or drink today?" This question is important because the client is taking selegiline, a monoamine oxidase inhibitor (MAOI), which has dietary restrictions. Foods high in tyramine can lead to a hypertensive crisis when combined with MAOIs. The client's symptoms of severe headache, flushing, and diaphoresis are indicative of a potential hypertensive crisis. By asking about the client's recent dietary intake, the nurse can assess for potential tyramine-containing foods that may have triggered the symptoms.
Choice A: "When did you last have blood drawn to check your drug level?" is not as important at this time because the client's symptoms suggest an acute issue that requires immediate intervention, rather than monitoring drug levels.
Choice C: "Are you having any chest pain?" is important for assessing cardiac involvement but is not the most crucial question in this scenario.
Choice D: "Do you use any herbal remedies
Question 4 of 5
The desired outcome for a patient experiencing insomnia is, "Patient will sleep for a minimum of 5 hours nightly within 7 days." At the end of 7 days, review of sleep data shows the patient sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap. The nurse will document the outcome as
Correct Answer: D
Rationale: The correct answer is D: never demonstrate. The rationale is that the desired outcome was for the patient to sleep for a minimum of 5 hours nightly within 7 days. However, the patient only sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap, which does not meet the desired outcome.
Therefore, the nurse would document that the patient has never demonstrated the desired outcome of sleeping for a minimum of 5 hours nightly within 7 days.
Choices A, B, and C are incorrect because the patient did not consistently, often, or sometimes demonstrate meeting the desired outcome.
Question 5 of 5
A patient fearfully runs from chair to chair crying, "They're coming! They're coming!" The patient does not follow the staff's directions or respond to verbal interventions. Which nursing diagnosis has the highest priority?
Correct Answer: B
Rationale: The correct answer is B: Risk for injury. This diagnosis takes priority because the patient's behavior poses an immediate threat to their safety. Running and not responding to staff instructions increases the risk of falls and accidents. Addressing this risk is crucial to ensure the patient's physical well-being.
Choice A (Fear) is important but not as urgent as addressing the immediate risk of injury.
Choice C (Self-care deficit) and D (Disturbed thought processes) are not the priority in this scenario as the patient's safety is the primary concern.