ATI RN
Psychiatric Emergencies Questions
Question 1 of 5
A patient diagnosed with major depressive disorder received six ECT sessions and aggressive doses of antidepressant medication. The patient owns a small business and was counseled not to make major decisions for a month. Select the correct rationale for this counseling.
Correct Answer: C
Rationale: The correct answer is C because ECT (electroconvulsive therapy) can cause temporary memory impairments and confusion. The patient needs time to recover and readjust after undergoing ECT sessions, which may affect their ability to make sound decisions. This counseling is given to ensure the patient's safety and well-being during the recovery period. Choice A is incorrect because antidepressant medications primarily affect neurotransmitters like serotonin and norepinephrine, not catecholamines. Choice B is incorrect as limitations on tyramine in the diet are related to certain antidepressants like MAOIs, not ECT. Choice D is incorrect since the patient's need to avoid major decisions is more related to the cognitive effects of ECT rather than readjusting to a work schedule.
Question 2 of 5
A patient has smoked two packs of cigarettes daily for many years. When the patient tries to reduce smoking, anxiety, craving, poor concentration, and headache occur. This scenario describes
Correct Answer: C
Rationale: The correct answer is C: substance addiction. This scenario describes a patient experiencing withdrawal symptoms when trying to reduce smoking, which is a key characteristic of substance addiction. Addiction involves compulsive drug-seeking behavior despite negative consequences, and withdrawal symptoms are common when the substance is not consumed. Cross-tolerance (A) refers to the development of tolerance to one substance due to exposure to another, which is not applicable here. Substance abuse (B) refers to harmful use of a substance without dependence, which does not explain the withdrawal symptoms in the scenario. Substance intoxication (D) refers to the physiological effects of a substance when taken in excess, which is also not relevant to the patient's situation.
Question 3 of 5
A patient is thin, tense, jittery, and has dilated pupils. The patient says, 'My heart is pounding in my chest. I need help.' The patient allows vital signs to be taken but then becomes suspicious and says, 'You could be trying to kill me.' The patient refuses further examination. Abuse of which substance is most likely?
Correct Answer: D
Rationale: The correct answer is D: Amphetamines. The patient's symptoms of agitation, dilated pupils, paranoia, and refusal of further examination are consistent with amphetamine intoxication. Amphetamines can cause increased heart rate, jitteriness, and paranoia. PCP (A) can also cause paranoia and hallucinations but typically presents with more dissociative symptoms. Heroin (B) typically causes sedation and respiratory depression, not agitation. Barbiturates (C) would likely cause sedation and impaired consciousness, not the symptoms described.
Question 4 of 5
A patient with fluctuating levels of awareness, confusion, and disturbed orientation shouts, 'Bugs are crawling on my legs.' Which problem is the patient experiencing?
Correct Answer: C
Rationale: The correct answer is C: Tactile hallucinations. The patient's complaint of bugs crawling on their legs indicates a sensory perception disturbance, which is characteristic of tactile hallucinations. This symptom is commonly associated with conditions like schizophrenia or substance use. Aphasia (A) is a language disorder, not related to sensory perceptions. Dystonia (B) is a movement disorder, not associated with hallucinations. Mnemonic disturbance (D) refers to memory issues, not sensory hallucinations. In this case, the patient's symptom points to a sensory perception distortion, making tactile hallucinations the most appropriate choice.
Question 5 of 5
A patient previously hospitalized for 2 weeks committed suicide the day after discharge. Which initial nursing measure will be most important regarding this event?
Correct Answer: B
Rationale: The correct answer is B because holding a meeting for staff to provide support, express feelings, and identify overlooked clues or faulty judgments is crucial in addressing the emotional impact of the patient's suicide and identifying any potential errors in care. This measure promotes teamwork, communication, and a culture of learning from adverse events to prevent future occurrences. Option A is incorrect because verifying the security of the patient's medical record does not directly address the emotional impact on staff or the need for reflection on care provided. Option C is incorrect as consulting the legal department focuses on potential legal consequences rather than immediate emotional and clinical considerations. Option D is incorrect because documenting a report of a sentinel event is necessary but does not address the immediate need for staff support and reflection on care provided.