ATI RN
PICO Question Psychiatric Emergency Nursing Questions
Question 1 of 5
A patient diagnosed with major depressive disorder repeatedly tells staff, 'I have cancer. It's my punishment for being a bad person.' Diagnostic tests reveal no cancer. Select the priority nursing diagnosis.
Correct Answer: B
Rationale: The correct answer is B: Risk for suicide. The patient's belief of having cancer as punishment indicates distorted thinking and a high level of hopelessness, which increases the risk for suicide. This is a priority because it addresses the immediate safety of the patient. Powerlessness (A) may be relevant but doesn't address the imminent risk of harm. Stress overload (C) is not as critical as suicide risk in this scenario. Spiritual distress (D) may be present but doesn't address the immediate safety concern of potential suicide.
Question 2 of 5
Transcranial Magnetic Stimulation (TCM) is scheduled for a patient diagnosed with major depressive disorder. Which comment by the patient indicates teaching about the procedure was effective?
Correct Answer: B
Rationale: The correct answer is B. This statement indicates understanding of potential side effects of TMS, which may include dizziness or mild headaches post-procedure. This shows the patient has grasped the information provided during teaching. Choice A is incorrect as TMS does not require anesthesia. Choice C is incorrect as TMS does not typically require extended recovery time. Choice D is unrelated to the procedure and pertains to dietary restrictions for MAOIs.
Question 3 of 5
Select the priority nursing intervention when caring for a patient after an overdose of amphetamines.
Correct Answer: A
Rationale: The correct answer is A: Monitor vital signs. This is the priority nursing intervention because amphetamine overdose can lead to serious cardiovascular complications such as tachycardia, hypertension, and arrhythmias. Monitoring vital signs allows the nurse to assess the patient's cardiovascular status and intervene promptly if any abnormalities are detected. Observing for depression (B) is important but not the priority in the immediate aftermath of an overdose. Awakening the patient every 15 minutes (C) may disrupt rest and recovery, which is not ideal. Using warmers to maintain body temperature (D) is not the priority as cardiovascular stability takes precedence.
Question 4 of 5
An adult in the emergency department states, 'Everything I see appears to be waving. I am outside my body looking at myself. I think I'm losing my mind.' Vital signs are slightly elevated. The nurse should suspect
Correct Answer: B
Rationale: The correct answer is B: hallucinogen ingestion. The individual's symptoms of visual distortions, feelings of detachment from reality, and paranoia are indicative of a hallucinogenic experience. Hallucinogens such as LSD or mushrooms can cause these perceptual disturbances. Vital signs being slightly elevated can also be a sign of hallucinogen use. Schizophrenic episodes (A) typically involve more persistent and complex symptoms over time. Opium intoxication (C) would present with different symptoms such as drowsiness and respiratory depression. Cocaine overdose (D) would exhibit symptoms like agitation, chest pain, and hypertension.
Question 5 of 5
A nurse prepares for an initial interaction with a patient with a long history of methamphetamine abuse. Which is the nurse's best first action?
Correct Answer: C
Rationale: The correct answer is C because self-assessing personal attitudes and beliefs about the health problem is crucial in providing effective care without judgment. This step helps the nurse to approach the patient with empathy and understanding, building trust and rapport. Performing a thorough assessment (choice A) may be premature without establishing a therapeutic relationship first. Verifying security services (choice B) is unnecessary and may escalate the situation. Obtaining a face shield (choice D) is not relevant as it does not address the immediate need for establishing a therapeutic relationship.