ATI RN
ATI Capstone Mental Health Questions
Question 1 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 2 of 5
Guadalupe is the matriarch of a large family. She is terminally ill and none of her family members know her end-of-life wishes. The best action for the nurse is to:
Correct Answer: B
Rationale: The correct answer is B because organizing a family meeting with Guadalupe's permission allows for open communication about her end-of-life wishes. This approach respects her autonomy and ensures her preferences are known. Discussing durable power of attorney (A) may be premature without knowing Guadalupe's wishes. Having a family meeting without her (C) disregards her right to be involved in decision-making. Asking the doctor to inform Guadalupe about her terminal illness (D) should be done by a healthcare provider, not a nurse, and may cause distress without addressing her specific wishes.
Question 3 of 5
A female patient was admitted to the hospital with pneumonia, and in the course of her treatment, it was determined that she was experiencing alcohol dependence because she began experiencing alcohol withdrawal while she was in the hospital. When the psychiatrist who was called in as a consultant documented the patient's mental disorder, he identified her alcohol dependence on which axis?
Correct Answer: A
Rationale: The correct answer is A: Axis I. In the DSM-IV-TR, mental disorders, including substance-related disorders like alcohol dependence, are classified under Axis I. This axis is for clinical disorders and other conditions that may be a focus of clinical attention. Alcohol dependence is a primary psychiatric disorder that affects the patient's mental and behavioral functioning, which is why it is categorized under Axis I. Choice B: Axis II is incorrect because Axis II is for personality disorders and mental retardation, not for substance-related disorders like alcohol dependence. Choice C: Axis III is incorrect because Axis III is for general medical conditions that may be relevant to the individual's mental health, not for mental disorders like alcohol dependence. Choice D: Axis IV is incorrect because Axis IV is for psychosocial and environmental problems that may influence the diagnosis, treatment, and prognosis of mental disorders, not for the mental disorders themselves.
Question 4 of 5
A nurse is preparing to reinforce the use of cognitive behavior therapy with a patient. When interacting with the patient, which of the following would be appropriate?
Correct Answer: C
Rationale: The correct answer is C: Using a future-oriented goal focus. In cognitive behavior therapy, focusing on future-oriented goals helps the patient set achievable objectives and work towards positive outcomes. This approach encourages the patient to look forward and make changes that align with their desired future. Establishing the agenda (A) can be helpful but may not be as effective as focusing on goal setting. Focusing primarily on behavior (B) is too narrow and may not address the underlying thoughts and emotions. Identifying the problem from the nurse's perspective (D) is not client-centered and may not promote active participation in the therapy process.
Question 5 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 (TCA) that is not typically preferred for bulimia nervosa due to its side effect profile and overdose risk. D: Duloxetine (Cymbalta)