ATI RN
Mental Health Nursing Practice Questions Questions
Question 1 of 5
Which drug group requires nursing assessment for the development of abnormal movement disorders in individuals taking therapeutic dosages?
Correct Answer: B
Rationale: Antipsychotics (Choice B) are the correct answer because they are strongly associated with the risk of extrapyramidal symptoms (EPS) and other movement disorders due to their dopamine receptor blockade in the nigrostriatal pathway. These disorders include acute dystonia, akathisia, parkinsonism, and tardive dyskinesia, which can develop even at therapeutic doses. First-generation (typical) antipsychotics like haloperidol have a higher risk, but second-generation (atypical) antipsychotics such as risperidone and aripiprazole can also cause these effects. Nurses must monitor for early signs, such as muscle stiffness, restlessness, or involuntary movements, as tardive dyskinesia can become irreversible. SSRIs (Choice A) primarily affect serotonin reuptake and are not typically linked to movement disorders. While they can cause side effects like agitation or tremors, these are not classified as extrapyramidal symptoms. Rare cases of SSRI-induced akathisia exist, but it is not a hallmark concern like with antipsychotics, making this choice incorrect. Benzodiazepines (Choice C) act on GABA receptors and are used for anxiety, insomnia, or muscle relaxation. They do not cause EPS or tardive dyskinesia. Instead, they may lead to sedation, dizziness, or dependence, but movement disorders are outside their usual adverse effect profile, ruling them out as the correct answer. Tricyclic antidepressants (Choice D) primarily inhibit norepinephrine and serotonin reuptake and have anticholinergic effects. While they can cause side effects like dry mouth, constipation, or orthostatic hypotension, they are not associated with EPS or tardive dyskinesia. Their mechanism does not involve dopamine blockade, so movement disorders are not a clinical concern, making this choice incorrect. The key distinction lies in the pharmacological action: antipsychotics directly interfere with dopamine pathways critical for motor control, while the other drug groups lack this mechanism. Nursing assessments for movement abnormalities are thus essential for antipsychotics but not for SSRIs, benzodiazepines, or tricyclics.
Question 2 of 5
A nurse is reviewing prescriptions for a patient with major depression at the county clinic. Since the patient has a mild intellectual disability, the nurse would question which classification of antidepressant drugs:
Correct Answer: B
Rationale: Monoamine oxidase inhibitors are less suitable for patients with intellectual disabilities due to the need for dietary restrictions and close monitoring. These restrictions can be challenging for patients with mild intellectual disabilities to follow, making this drug class a concern for this patient population.
Question 3 of 5
The mental health team is determining treatment options for a male patient experiencing psychotic symptoms. Which question shouldn't the team answer to determine whether a community outpatient or inpatient setting is most appropriate?
Correct Answer: C
Rationale: Assessing suicidal thoughts, judgment, insight, and the need for a therapeutic environment are crucial factors in determining the appropriate treatment setting for a patient experiencing psychotic symptoms. Past experiences with mental healthcare facilities do not play a direct role in deciding between a community outpatient or inpatient setting.
Question 4 of 5
Pablo is a homeless adult who has no family connection. Pablo passed out on the street, and emergency medical services took him to the hospital where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select one that doesn't apply.
Correct Answer: D
Rationale: The correct answer is D because medication adherence being mandated is not a primary rationale for inpatient treatment. The main reasons for recommending inpatient treatment in this scenario include the need for stabilization of multiple symptoms, addressing nutritional and self-care needs, and ensuring safety due to the imminent danger of self-harm. Inpatient settings provide a more intensive level of care and supervision to address these complex issues effectively.
Question 5 of 5
Which statement made by the nurse demonstrates the best understanding of nonverbal communication?
Correct Answer: B
Rationale: **Rationale:** **Correct Answer (B):** This choice reflects a nuanced and professional understanding of nonverbal communication. The nurse actively assesses for congruence between verbal and nonverbal cues, which is critical in healthcare. Patients may say they are "fine" verbally while displaying nonverbal signs of distress (e.g., clenched fists, avoiding eye contact). By cross-validating these signals, the nurse ensures accurate interpretation and avoids misjudgment. This approach aligns with evidence-based practice, where holistic assessment improves patient care. It also acknowledges the complexity of communication, where nonverbal cues (e.g., tone, posture) often reveal unspoken emotions or needs. --- **Incorrect Answers:** **A:** While this statement acknowledges a discrepancy between verbal and nonverbal communication, it lacks the actionable insight demonstrated in **B**. Simply recognizing a difference is insufficient without further exploration. Nurses must actively investigate incongruence to understand underlying issues (e.g., pain, anxiety). The statement also risks oversimplification—nonverbal and verbal communication aren’t "often" different but may be in specific contexts. Without the nurse’s proactive validation, this observation alone doesn’t improve patient care. **C:** This choice reflects a common pitfall: overinterpreting a single nonverbal cue. Slumped posture could indicate fatigue, pain, or even relaxation—not just anger or depression. Nonverbal communication is context-dependent, and assumptions without further assessment can lead to misdiagnosis or inappropriate interventions. Effective nursing requires gathering additional data (e.g., asking open-ended questions) rather than jumping to conclusions based on isolated behaviors. **D:** This statement undervalues the role of nonverbal communication, which is often more revealing than verbal language. Studies show that nonverbal cues (facial expressions, gestures) convey up to 93% of emotional meaning. In healthcare, patients may struggle to articulate distress verbally, making nonverbal signals vital. Dismissing nonverbal communication as "harder to understand" neglects its importance in building trust and identifying unmet needs. Competent nurses prioritize both forms of communication equally. --- **Key Takeaways:** - **B** stands out because it emphasizes *active validation*, a skill that bridges the gap between observation and clinical judgment. - **A** is passive, **C** is presumptive, and **D** misrepresents the complexity of communication. - Effective nursing integrates verbal and nonverbal cues to form a complete picture of the patient’s state, ensuring accurate and empathetic care.