ATI RN
Psychiatric Nurse Certification Questions
Question 1 of 5
A patient is known to express tangential thinking. The nurse would assess for which of the following when interacting with the patient?
Correct Answer: C
Rationale: Tangential thinking is wandering off the topic and never providing the information requested. Thought blocking is stopping abruptly in the middle of a sentence or train of thoughts, sometimes unable to continue the idea. Loose associations are disorganized thinking that jumps from one idea to another with little or no evident relation between the thoughts. Flight of ideas is excessive amount and rate of speech composed of fragmented or unrelated ideas.
Question 2 of 5
Which of the following would be circumstances when a client could be subjected to involuntary hospitalization?Select one that does not apply.
Correct Answer: D
Rationale: Health-care professionals respect the wishes of a client who does not wish to be hospitalized and treated unless clients are a danger to themselves or others (i.e., they are threatening or have attempted suicide or represent a danger to others). When a client states that he or she intends to commit suicide and is making plans to do so, the client is threatening suicide and could be subjected to involuntary hospitalization. When a client does not bathe regularly or change clothes often, the client is neglecting his or her hygiene, but it is unlikely that this could be construed as an imminent risk of harm to self. When a client states that he or she intends to harm others by a deliberate act, the client could be considered representing a danger to others. When a client who has diabetes refuses to follow the prescribed diet, the client is acting within his or her own right to comply with the recommendations of their health-care provider. When a client is unable to control his or her rage and is assaulting everyone around him or her, the client would be considered a danger to others.
Question 3 of 5
A client was brought to the emergency department by police after neighbors complained that he was loud and disruptive. The client is paranoid and upset and states, 'No one can be trusted.' Which of the criteria for involuntary admission does this client meet?
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 4 of 5
A client being served in a busy inpatient psychiatric unit becomes very noisy and combative. The other clients are complaining about the noise and are afraid that they will be hurt by the client. The nurse determines that the best course of action for all involved is to seclude the client until the client is able to regain control of his behavior. On which ethical principle did the nurse base this decision?
Correct Answer: A
Rationale: Utilitarianism is a theory that bases decisions on the 'greatest good for the greatest number.' While the client may experience a temporary loss of freedom, all of the clients on the nursing unit and their visitors will benefit by not being at risk for harm from this client. Deontology is a theory that says decisions should be based on whether or not an action is morally right with no regard for the result or consequences. It may not be considered morally right to deny this client his freedom for any amount of time, irrespective of the consequences (harm to others). Nonmaleficence is the requirement to do no harm to others either intentionally or unintentionally. In this circumstance, it could be argued that secluding the client could be maleficence, but it also could be argued that the other clients' rights to not be harmed would be violated by not secluding this client until he is able to regain control of his behavior. Justice refers to fairness, that is, treating all people fairly and equally without regard for social or economic status, race, sex, marital status, religion, ethnicity, or cultural beliefs. It could be argued that the client was not treated fairly when he was secluded, but it also could be argued that the others were not treated fairly if the client was allowed to continue to freely engage in the disrupting behavior.
Question 5 of 5
A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent most of the session. Another patient comes to the door of the room, interrupts, and says to the nurse, I really need to talk to you. The nurse should:
Correct Answer: D
Rationale: Adhering to the agreed session time respects the therapeutic contract and builds trust with the current patient. Option D sets a boundary with the interrupting patient while honoring the commitment to the silent patient. Option A violates privacy, Option B is abrupt and dismissive, and Option C abandons the current patient, undermining trust.