ATI RN
psychiatric nurse certification Questions
Question 1 of 5
A nurse is caring for a patient diagnosed with major depressive disorder. The patient states, 'I don't feel anything anymore. Nothing matters.' What is the priority nursing intervention?
Correct Answer: A
Rationale: In this scenario, the priority nursing intervention is option A) Ask the patient about their suicidal thoughts and plans. This is the correct choice because the patient's statement, "I don't feel anything anymore. Nothing matters," indicates a sense of hopelessness and emotional numbness, which are common in individuals with major depressive disorder and could be associated with suicidal ideation. By addressing suicidal ideation directly, the nurse can assess the patient's risk of harm to themselves and initiate appropriate interventions to ensure their safety. Suicidal ideation is a critical concern in individuals with major depressive disorder and requires immediate attention to prevent self-harm or suicide attempts. Options B, C, and D are incorrect in this context. Encouraging the patient to participate in activities or reassuring them that their feelings will improve overlook the seriousness of the patient's statement and do not address the potential risk of suicide. Providing support and allowing the patient to express their feelings are important aspects of care but should not take precedence over assessing and addressing suicidal ideation, which is the most urgent concern in this situation. From an educational perspective, this question highlights the essential role of nurses in assessing and managing suicidal ideation in patients with major depressive disorder. It emphasizes the importance of prioritizing safety and implementing appropriate interventions to address the immediate risk of harm. This scenario underscores the critical need for nurses to be vigilant in recognizing warning signs of suicide and taking proactive steps to ensure patient safety and well-being.
Question 2 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 3 of 5
While talking with a patient diagnosed with major depressive disorder, a nurse notices the patient is unable to maintain eye contact. The patient's chin lowers to the chest. The patient looks at the floor. Which aspect of communication has the nurse assessed?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Nonverbal communication. Nonverbal communication refers to the transmission of messages or information without the use of words. In the context of the patient with major depressive disorder, the inability to maintain eye contact, lowering the chin to the chest, and looking at the floor are all nonverbal cues that indicate the patient's emotional state and level of engagement. Option B) A message filter is incorrect because it does not relate to the observed behaviors of the patient. A message filter typically refers to factors that interfere with the accurate transmission or reception of a message, such as noise or distractions. Option C) A cultural barrier is also incorrect in this context because the observed behaviors are more indicative of emotional distress rather than a cultural difference. Cultural barriers typically involve differences in beliefs, values, or communication styles between individuals from different cultural backgrounds. Option D) Social skills is not the correct answer as well because the observed behaviors are not related to the patient's ability to interact or engage with others in a social setting. Social skills encompass a broader range of abilities related to communication, problem-solving, and relationship-building. Understanding nonverbal communication cues is essential for healthcare providers, especially in psychiatric nursing, as these cues can provide valuable insights into a patient's emotional state, needs, and responses to treatment. By recognizing and interpreting nonverbal cues, nurses can enhance their communication with patients, build rapport, and provide more effective care.
Question 4 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 5 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.