ATI RN
Behavioral Health Nursing Questions
Question 1 of 5
A nurse is assessing a patient diagnosed with anorexia nervosa. Which of the following signs should the nurse monitor for in this patient?
Correct Answer: C
Rationale: The correct answer is C: Severe weight loss and restriction of food intake. In anorexia nervosa, patients typically exhibit extreme fear of gaining weight, leading to severe restriction of food intake resulting in significant weight loss. Monitoring for this sign is crucial to assess the severity of the disorder and plan appropriate interventions. Incorrect choices: A: Extreme weight gain and bloating - This is not indicative of anorexia nervosa as patients with this disorder typically experience significant weight loss. B: Excessive exercise and compulsive eating - While excessive exercise can be a symptom of anorexia nervosa, compulsive eating is more commonly associated with binge eating disorder. D: Binge eating followed by purging behaviors - This pattern of behavior is characteristic of bulimia nervosa, not anorexia nervosa.
Question 2 of 5
A newly admitted patient diagnosed with major depressive disorder has gained 20 pounds over a few months and has suicidal ideation. The patient has taken antidepressant medication for 1 week without remission of symptoms. Select the priority nursing diagnosis.
Correct Answer: C
Rationale: The correct nursing diagnosis is C: Risk for suicide. This is the priority because the patient is experiencing suicidal ideation, indicating an immediate threat to their safety. Addressing this risk is crucial to ensure the patient's safety and well-being. Option A is incorrect as weight gain is not the priority when compared to suicidal ideation. Option B is incorrect as low self-esteem, while important, is not as urgent as the risk of suicide. Option D, hopelessness, is also important but addressing the immediate risk of suicide takes precedence.
Question 3 of 5
An adolescent asks a nurse conducting an assessment interview, 'Why should I tell you anything? You'll just tell my parents whatever you find out.' Which response by the nurse is appropriate?
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the importance of confidentiality regarding the adolescent's feelings while also highlighting the necessity of reporting certain critical issues like suicidal thoughts to ensure the adolescent's safety. This response respects the adolescent's privacy while prioritizing their well-being. Choice A is incorrect because it inaccurately states that everything is held in strict confidence, which may not be the case for issues like suicidal thoughts. Choice B is incorrect as it dismisses the adolescent's concerns about privacy and may deter them from being open during the assessment. Choice D is incorrect as it makes assumptions about the adolescent's readiness without addressing their specific concerns about confidentiality.
Question 4 of 5
A nurse is caring for a patient diagnosed with bipolar disorder during the manic phase. The nurse understands that during this phase, the patient is most likely to exhibit which behavior?
Correct Answer: B
Rationale: The correct answer is B (Rapid speech, inflated self-esteem, and impulsivity). During the manic phase of bipolar disorder, individuals typically experience elevated mood, increased energy, and engage in impulsive behaviors. Rapid speech, inflated self-esteem, and impulsivity are commonly observed behaviors during this phase. Excessive sleep and withdrawal (choice A) are more indicative of the depressive phase. Depressed mood and low energy levels (choice C) are also characteristic of the depressive phase. Social withdrawal and feelings of hopelessness (choice D) are symptoms of depression, not mania. Therefore, choice B is the most appropriate behavior exhibited during the manic phase of bipolar disorder.
Question 5 of 5
Select the most appropriate label to complete this nursing diagnosis: _____ related to feelings of shyness and poorly developed social skills as evidenced by watching television alone at home every evening.
Correct Answer: C
Rationale: The correct answer is C: Social isolation. This nursing diagnosis best fits the situation described because the individual is experiencing feelings of shyness and poorly developed social skills, leading to isolation by watching television alone every evening. Social isolation refers to a lack of social interactions and connections, which aligns with the symptoms presented. A: Deficient knowledge does not address the social aspect of the situation. B: Ineffective coping does not directly address the social withdrawal behavior. D: Powerlessness does not capture the essence of the individual's situation involving social skills and shyness. In summary, social isolation is the most appropriate label as it directly reflects the individual's behavior and feelings of loneliness and lack of social engagement.