ATI RN
Psychobiologic Disorders Questions
Question 1 of 5
A newly admitted patient diagnosed with schizophrenia says, The voices are bothering me. They yell and tell me I am bad. I have got to get away from them. Select the nurses most helpful reply.
Correct Answer: C
Rationale: Staying with a distraught patient who is bearing voices serves several purposes: ongoing observation, the opportunity to provide reality orientation, a means of helping dismiss the voices, the opportunity of forestalling an action that would result in self-injury, and general support to reduce anxiety. Asking if the patient hears voices is not particularly relevant at this point. Asking if the patient plans to get away from the voices is relevant for assessment purposes but is less helpful than offering to stay with the patient while encouraging a focus on their discussion. Suggesting playing cards with other patients shifts responsibility for intervention from the nurse to the patient and other patients.
Question 2 of 5
When counseling patients diagnosed with major depression, an advanced practice nurse will address the negative thought patterns by using:
Correct Answer: C
Rationale: Cognitive behavioral therapy attempts to alter the patients dysfunctional beliefs by focusing on positive outcomes rather than negative attributions. The patient is also taught the connection between thoughts and resultant feelings. Research shows that cognitive behavioral therapy involves the formation of new connections between nerve cells in the brain and that it is at least as effective as medication. Evidence is not present to support superior outcomes for the other psychotherapeutic modalities mentioned.
Question 3 of 5
A patient diagnosed with major depression tells the nurse, Bad things that happen are always my fault. Which response by the nurse will best assist the patient to reframe this overgeneralization?
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 4 of 5
What is the focus of priority nursing interventions for the period immediately after electroconvulsive therapy treatment?
Correct Answer: B
Rationale: During the immediate post-treatment period, the patient is recovering from general anesthesia; hence, the priority need is to establish and support physiological stability. Reducing disorientation and confusion is an acceptable intervention but not the priority. Assisting the patient in identifying and testing negative thoughts is inappropriate in the immediate post-treatment period because the patient may be confused.
Question 5 of 5
A patient being treated for depression has taken 300 mg amitriptyline (Elavil) daily for a year. The patient calls the case manager at the clinic and says, I stopped taking my antidepressant 2 days ago. Now I am having cold sweats, nausea, a rapid heartbeat, and nightmares. The nurse will advise the patient to:
Correct Answer: C
Rationale: The patient has symptoms associated with abrupt withdrawal of the tricyclic antidepressant. Taking a dose of the drug will ameliorate the symptoms. Seeing the health care provider will allow the patient to discuss the advisability of going off the medication and to be given a gradual withdrawal schedule if discontinuation is the decision. This situation is not a medical emergency, although it calls for medical advice. Resuming taking the antidepressant for 2 more weeks and then discontinuing again would produce the same symptoms the patient is experiencing.