ATI RN
ATI Mental Health Proctored Exam 2019 Questions
Question 1 of 5
A client has been prescribed bupropion (Wellbutrin) for depression. Which instruction should the nurse provide during discharge?
Correct Answer: C
Rationale: The correct instruction for the nurse to provide is to advise the client to avoid drinking alcohol while taking bupropion (Wellbutrin) due to the increased risk of side effects like seizures. Alcohol can interact with bupropion and worsen its side effects, making it important to abstain from alcohol consumption during the treatment. Option A is incorrect because taking the medication with a full glass of water is a general instruction for medications and not specific to bupropion. Option B is incorrect as abruptly stopping bupropion can lead to withdrawal symptoms and should only be done under medical supervision. Option D is incorrect as doubling the dose of bupropion is dangerous and should not be done, even if a dose is missed.
Question 2 of 5
A nurse is assessing a client who has been diagnosed with persistent depressive disorder (dysthymia). Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: The correct finding the nurse should expect in a client diagnosed with persistent depressive disorder (dysthymia) is a lack of interest in activities. This disorder is characterized by a chronic depressive mood lasting for at least two years, alongside symptoms such as changes in appetite, fatigue, low self-esteem, and difficulty concentrating. Clients with dysthymia do not typically experience hypomania, periods of elevated mood, or feelings of detachment from one's body, which are more commonly associated with other mood disorders. Therefore, options A, B, and D are incorrect findings for a client with persistent depressive disorder.
Question 3 of 5
After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, 'You are incompetent!' Which is the nurse's best response?
Correct Answer: B
Rationale: In this scenario, the most appropriate response for the nurse is option B. By acknowledging the client's feelings and setting a boundary regarding inappropriate behavior, the nurse addresses the situation with empathy. This response demonstrates understanding of the client's emotions while also maintaining a professional standard by expressing discomfort with swearing. Option A could come off as defensive and may escalate the situation. Option C may be perceived as condescending and not immediately address the client's behavior. Option D, although offering space, does not directly address the inappropriate behavior and misses an opportunity to set a professional boundary.
Question 4 of 5
A client diagnosed with paranoid schizophrenia states, 'The FBI is watching me. I see their agents everywhere.' Which is the nurse's most appropriate response?
Correct Answer: B
Rationale: The most appropriate response is **B: "I don't see any FBI agents, but it sounds like you're feeling frightened."** **Rationale for Correct Answer (B):** This response validates the patient's emotional experience without reinforcing the delusion, which is crucial in therapeutic communication for paranoid schizophrenia. By acknowledging the patient’s fear ("it sounds like you're feeling frightened"), the nurse demonstrates empathy and builds trust. Simultaneously, the nurse avoids reinforcing the delusion by stating, "I don’t see any FBI agents," which gently introduces reality without confrontation. This approach aligns with evidence-based psychiatric nursing practices, which emphasize reducing distress while avoiding arguments that could escalate paranoia or damage rapport. **Rationale for Incorrect Answers:** **A: "You shouldn't worry about that. It's not real."** This response dismisses the patient's experience, which can increase distress and reinforce feelings of isolation. Telling a delusional patient that their beliefs "aren’t real" is counterproductive—it doesn’t address the underlying fear and may provoke defensiveness. Effective psychiatric care focuses on managing distress, not challenging delusions outright. **C: "Let's talk about something else to take your mind off of it."** While distraction can sometimes be useful, this response avoids addressing the patient’s immediate emotional state. Ignoring the delusion may leave the patient feeling unheard, worsening their anxiety. Therapeutic communication requires engagement with the patient’s concerns, even if the content of the delusion isn’t validated. **D: "Why do you think the FBI is watching you?"** Asking for justification of a delusion can reinforce paranoid ideation by encouraging the patient to elaborate on false beliefs. Probing questions may also increase agitation, as the patient might perceive the nurse as doubting or investigating them. This approach risks deepening the delusion rather than alleviating distress. The correct response (B) balances empathy with gentle reality orientation, which is essential in managing paranoid schizophrenia. The incorrect choices either dismiss emotions, avoid the issue, or inadvertently worsen delusional thinking. Understanding these distinctions is critical for effective mental health nursing interventions.
Question 5 of 5
A client with depression is experiencing anhedonia. Which statement by the client reflects this symptom?
Correct Answer: B
Rationale: Anhedonia is the inability to experience pleasure from activities usually found enjoyable. The statement 'I don't enjoy the things I used to love' directly reflects this symptom as the client is expressing a lack of pleasure from previously enjoyable activities. Choices A, C, and D do not specifically relate to anhedonia but rather indicate symptoms of anxiety, concentration difficulties, and sleep disturbances, respectively.