ATI RN
psychiatric nurse certification Questions
Question 1 of 5
A nurse is caring for a patient diagnosed with bipolar disorder who is in the manic phase. The nurse notices the patient is exhibiting risky behaviors, such as driving recklessly. What is the priority nursing intervention?
Correct Answer: D
Rationale: In this scenario, the priority nursing intervention for a patient diagnosed with bipolar disorder in the manic phase exhibiting risky behaviors like reckless driving is option D: Ensure the patient is supervised and prevent access to situations where they could harm themselves. This intervention is crucial because during the manic phase of bipolar disorder, individuals may engage in impulsive and dangerous behaviors that can result in harm to themselves or others. By providing supervision and preventing access to situations where harm could occur, the nurse is prioritizing the safety and well-being of the patient. Option A, administering antipsychotic medications, may be necessary for managing symptoms of bipolar disorder, but in this urgent situation where the patient is engaging in risky behaviors, ensuring their safety takes precedence over medication administration. Option B, encouraging the patient to talk about their feelings and the consequences of their actions, may not be effective in immediately preventing harm due to the impulsivity and lack of insight often seen in the manic phase of bipolar disorder. Option C, providing a calm and structured environment, is important for overall management of bipolar disorder but may not be sufficient to address the immediate risk posed by the patient's reckless behaviors. In an educational context, understanding the priority of interventions in managing acute situations in psychiatric nursing is crucial for ensuring patient safety and preventing harm. Nurses need to be able to quickly assess and prioritize interventions based on the immediate needs of the patient to provide effective care in psychiatric emergencies.
Question 2 of 5
A patient diagnosed with emphysema has severe shortness of breath and needs portable oxygen when leaving home. Recently the patient has reduced activity because of fear that breathing difficulty will occur. A nurse suggests using guided imagery. Which image should the patient be encouraged to visualize?
Correct Answer: C
Rationale: The patient has dysfunctional images of dyspnea. Guided imagery can help replace the dysfunctional image with a positive coping image. Athletes have found that picturing successful images can enhance performance. Encouraging the patient to imagine a regular breathing depth and rate will help improve oxygen-carbon dioxide exchange and help achieve further relaxation. Other options focus on unrealistic goals (being younger, not needing supplemental oxygen) or restrict her quality of life.
Question 3 of 5
A patient who had been experiencing significant stress learned to use progressive muscle relaxation and deep breathing exercises. When the patient returns to the clinic 2 weeks later, which finding most clearly shows the patient is coping more effectively with stress?
Correct Answer: A
Rationale: Objective measures tend to be the most reliable means of gauging progress. In this case, the patient's elevated blood pressure, an indication of the body's physiological response to stress, has diminished. The patient's report regarding activity level is subjective; sitting quietly could reflect depression rather than improvement. Appetite, mood, and energy levels are also subjective reports that do not necessarily reflect physiological changes from stress and may not reflect improved coping with stress. The patient's weight change could be a positive or negative indicator; the blood pressure change is the best answer.
Question 4 of 5
A patient undergoing diagnostic tests says, 'Nothing is wrong with me except a stubborn chest cold.' The spouse reports the patient smokes, coughs daily, lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?
Correct Answer: D
Rationale: Denial is an unconscious blocking of threatening or painful information or feelings. Regression involves using behaviors appropriate at an earlier stage of psychosexual development. Displacement shifts feelings to a more neutral person or object. Projection attributes one's own unacceptable thoughts or feelings to another.
Question 5 of 5
A person who feels unattractive repeatedly says, 'Although I'm not beautiful, I am smart.' This is an example of
Correct Answer: D
Rationale: Compensation is an unconscious process that allows us to make up for deficits in one area by excelling in another area to raise self-esteem. Repression unconsciously puts an idea, event, or feeling out of awareness. Identification is an unconscious mechanism calling for imitation of mannerisms or behaviors of another. Devaluation occurs when the individual attributes negative qualities to self or others.