ATI RN
Psychiatric Emergency Questions
Question 1 of 5
A client is receiving benztropine mesylate (Cogentin) for drug-induced extrapyramidal syndrome (EPS). Which finding indicates that the RN should further evaluate the client?
Correct Answer: D
Rationale: The correct answer is D: Increased mouth movements. Benztropine mesylate is used to treat EPS, which includes symptoms like tremors and muscle stiffness. Increased mouth movements, such as lip smacking or puckering, can indicate a serious side effect called tardive dyskinesia. This condition can be irreversible and requires immediate evaluation. A: Decreased bowel movements is not directly related to EPS or benztropine mesylate. B: Dry mouth is a common side effect of benztropine mesylate and does not generally require immediate evaluation. C: Decreasing hand tremors is actually a positive sign that the medication is working, so further evaluation is not immediately necessary.
Question 2 of 5
Which client statement suggests to the RN that the client is using a defense mechanism of projection to deal with anxiety related to admission to a psychiatric unit?
Correct Answer: B
Rationale: The correct answer is B because the client is attributing their presence in the psychiatric unit to external factors (police involvement) rather than acknowledging their own internal struggles. This aligns with the defense mechanism of projection, where individuals attribute their own thoughts or feelings onto others. Choice A demonstrates displacement, choice C shows rationalization, and choice D reflects denial, making them incorrect options.
Question 3 of 5
During the initial nursing interview, a client tells the nurse, 'Sometimes my thoughts go so fast. Wonder if I can sell my fast car. Work is so boring. I wonder if I can get a transfer. Is it time to eat yet?' Which documentation should the nurse use to describe the client's statements?
Correct Answer: C
Rationale: The correct answer is C: Exhibits tangential thinking. In this scenario, the client's statements lack logical connection and go off on tangents, such as thoughts about selling a car, work, and eating. This is characteristic of tangential thinking, where the individual struggles to maintain focus and coherence in their thoughts. Thought-blocking (A) refers to sudden interruption in the train of thought, incoherent speech (B) involves disorganized and unintelligible language, and word salad (D) is a severe form of incoherence where words are jumbled and meaningless. These choices do not accurately describe the client's statements in this context.
Question 4 of 5
The nurse in the day shift receives report about a client with depression who was in bed most of the weekend. The nurse walks into the client's room in the morning and finds the client in bed. What intervention is best for the nurse to implement?
Correct Answer: A
Rationale: Correct Answer: A: Assist the client to get out of bed and involved in an activity. Rationale: 1. Depression often leads to social withdrawal and lack of motivation. 2. Encouraging activity helps combat physical and emotional stagnation. 3. Engaging in activity can boost mood and energy levels. 4. It promotes social interaction and prevents isolation. 5. Resting excessively may exacerbate depressive symptoms. In summary, Choice A is the best intervention as it addresses the client's need for activity, social interaction, and mood improvement, while the other choices do not actively address these aspects of care.
Question 5 of 5
A nurse is planning care for a depressed client. Which approach is most therapeutic?
Correct Answer: A
Rationale: The correct answer is A, allowing the client time to complete activities. This approach is therapeutic as it promotes autonomy and self-efficacy, which are crucial in managing depression. By giving the client the freedom to complete activities at their own pace, it fosters a sense of control and empowerment. Encouraging participation in group therapy (B) can also be beneficial, but it may not be as effective if the client is not ready or willing. Setting strict deadlines (C) can increase stress and worsen depressive symptoms. Providing constant supervision (D) may feel intrusive and undermine the client's independence. Ultimately, choice A aligns with the principles of client-centered care and empowerment, making it the most therapeutic approach in this scenario.