ATI RN
Multiple Choice Questions on Psychiatric Emergencies Questions
Question 1 of 5
A nurse in an emergency department is assessing a client who has traumatic injuries following an assault. The client sits quietly and calmly in the examination room and states, 'I'm fine.' The nurse should recognize the client's behaviors as which of the following reactions?
Correct Answer: D
Rationale: The correct answer is D: Denial. The client's calm demeanor and statement of being fine despite traumatic injuries indicate denial as a defense mechanism to cope with the distressing situation. Denial involves avoiding the reality of a stressful event or situation. In this case, the client is not acknowledging the severity of their injuries or the emotional impact of the assault. A: Displacement involves transferring emotions from one target to another. B: Projection involves attributing one's own thoughts or feelings to others. C: Undoing involves trying to reverse or negate thoughts, feelings, or actions.
Question 2 of 5
A fourth-grade boy teases and makes jokes about a cute girl in his class. A nurse would recognize this behavior as indicative of which defense mechanism?
Correct Answer: C
Rationale: The correct answer is C: Reaction formation. This defense mechanism involves expressing the opposite of one's true feelings or impulses. In this scenario, the boy may actually have feelings of attraction towards the girl but is teasing her as a way to mask those feelings. Displacement (A) involves redirecting emotions from the original source to a substitute target. Projection (B) is attributing one's own unacceptable feelings onto others. Sublimation (D) is channeling unacceptable impulses into constructive activities. In this case, the boy's behavior aligns most closely with reaction formation as he is displaying the opposite of his true emotions.
Question 3 of 5
According to Maslow's hierarchy of needs, which client action would demonstrate the highest achievement in terms of mental health?
Correct Answer: C
Rationale: According to Maslow's hierarchy of needs, self-fulfillment and realizing full potential are at the top of the hierarchy, representing the highest level of mental health achievement. This is known as self-actualization. It signifies personal growth, creativity, and a sense of purpose beyond fulfilling basic needs. Choices A and D are important for mental health but fall below self-actualization in the hierarchy. Choice B, achieving self-confidence, is a step below self-actualization as it pertains to esteem needs. Therefore, choice C is the correct answer as it aligns with the pinnacle of Maslow's hierarchy, indicating the highest level of mental health achievement.
Question 4 of 5
A 27-year-old woman presents with hypersomnia (sleeps approximately 15 hours per day) and hyperphagia (has gained 6 kg). She is feeling discouraged and disinterested and reports a lack of energy. She has recently been thinking about death. Although she felt able to 'conquer the world' 2 months ago, she now feels lost and confused. Previously, she had 2 jobs and was training for a marathon. She was convinced she would make it to the Olympics, given that she required only 4 hours of sleep to recuperate. What agent would MOST likely stabilize her current condition?
Correct Answer: A
Rationale: The correct answer is A) Quetiapine. Quetiapine, an atypical antipsychotic, is commonly used in the treatment of bipolar depression. The symptoms described in the scenario - hypersomnia, hyperphagia, low energy, feelings of discouragement, disinterest, and suicidal ideation - are indicative of a depressive episode in bipolar disorder. Quetiapine helps stabilize mood, reduce depressive symptoms, and prevent manic episodes. Option B) Divalproex is a mood stabilizer commonly used in bipolar disorder, but it is more effective in treating manic episodes rather than depressive symptoms. Option C) Bupropion is an antidepressant that can exacerbate manic symptoms in bipolar disorder and is not the first-line treatment for bipolar depression. Option D) Pramipexole is a dopamine agonist primarily used in Parkinson's disease and restless leg syndrome, not as a first-line treatment for bipolar depression. Educationally, understanding the rationale behind each option helps students grasp the importance of proper medication selection based on the patient's symptoms and diagnosis. It reinforces the need for accurate assessment and appropriate treatment in psychiatric emergencies to ensure optimal patient outcomes.
Question 5 of 5
Which of the following states is MOST closely related to catatonic excitement?
Correct Answer: D
Rationale: Rationale: The correct answer is D) Mania. Mania is a state characterized by elevated mood, increased energy levels, and sometimes impulsivity. In catatonic excitement, individuals exhibit heightened motor activity, agitation, and may even be violent or destructive, which closely aligns with the symptoms of mania. Option A) Catalepsy is a state of decreased responsiveness and often involves maintaining a rigid posture for an extended period, which is not characteristic of catatonic excitement. Option B) Stereotypies refer to repetitive movements that serve no purpose and are not directly related to the increased motor activity seen in catatonic excitement. Option C) Automatisms are involuntary, unconscious movements that are not typically associated with the purposeless, excessive motor activity seen in catatonic excitement. Educational Context: Understanding the differences between psychiatric states is crucial for healthcare professionals, especially when dealing with psychiatric emergencies. Recognizing the symptoms of catatonic excitement, such as heightened motor activity and agitation, can help in providing appropriate and timely interventions to ensure the safety and well-being of the individual experiencing such a state. Knowledge of different psychiatric states also aids in accurate diagnosis and treatment planning in mental health settings.