ATI RN
psychiatric nurse certification Questions
Question 1 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 2 of 5
A patient diagnosed with obsessive-compulsive disorder has this nursing diagnosis: Anxiety related to _____ as evidenced by inability to control compulsive cleaning. Which phrase correctly completes the etiological portion of the diagnosis?
Correct Answer: C
Rationale: In this scenario, the correct completion to the etiological portion of the nursing diagnosis for a patient with obsessive-compulsive disorder is Option C: persistent thoughts about bacteria, germs, and dirt. This is the most appropriate choice because it directly relates to the core feature of OCD, which is the presence of obsessions (persistent, intrusive thoughts) and compulsions (repetitive behaviors aimed at reducing anxiety or preventing a feared outcome). Option A (feelings of responsibility for the health of family members) may be a common feature in individuals with high levels of anxiety, but it does not specifically address the nature of OCD symptoms seen in this patient. Option B (approval-seeking behavior from friends and family) is more characteristic of dependent personality traits rather than OCD. Option D (needs to avoid interactions with others) is more indicative of social anxiety disorder rather than OCD. Educationally, understanding the rationale behind selecting the correct etiological factor in a nursing diagnosis for a patient with OCD is crucial for providing effective care. By recognizing the key symptoms and triggers associated with OCD, nurses can tailor interventions to help patients manage their anxiety and compulsive behaviors effectively. This knowledge aids in promoting therapeutic relationships and fostering positive outcomes in psychiatric nursing practice.
Question 3 of 5
A store clerk was killed during a robbery 2 weeks ago. His widow, who has a long history of schizoaffective disorder, cries spontaneously when talking about his death. Select the nurse's most therapeutic response.
Correct Answer: D
Rationale: The patient is expressing feelings related to the loss, and this is an expected and healthy behavior. This patient is at risk for a maladaptive response because of the history of a serious mental illness, but the nurse's priority intervention is to form a therapeutic alliance and support the patient's expression of feelings. Crying at 2 weeks after his death is expected and normal.
Question 4 of 5
A soldier returned 3 months ago from a combat zone and was diagnosed with PTSD. Which social event would be most disturbing for this soldier?
Correct Answer: D
Rationale: In the context of PTSD, the correct answer is D) Fireworks display on July 4th. Fireworks can trigger traumatic memories, causing distress and anxiety in individuals with PTSD, especially combat veterans. The loud noises, sudden flashes of light, and the unpredictability of fireworks can resemble combat situations, potentially leading to a heightened stress response. Option A) Halloween festival with neighborhood children may not be as disturbing because it is a more controlled and predictable environment compared to sudden loud noises like fireworks. Option B) Singing carols around a Christmas tree and Option C) A family outing to the seashore are also less likely to be distressing as they are typically calm and joyful events that do not involve triggers commonly associated with PTSD. Educationally, understanding the impact of triggers on individuals with PTSD is crucial for healthcare professionals, especially psychiatric nurses. By recognizing potential triggers and learning how to support individuals experiencing PTSD, nurses can provide more effective care and create safe environments for their patients. It is important to approach PTSD with sensitivity, awareness, and evidence-based strategies to promote healing and recovery.
Question 5 of 5
The nurse interviewing a patient with suspected PTSD should be alert to findings indicating the patient (Select all that apply)
Correct Answer: A
Rationale: In assessing a patient for PTSD, it is crucial for the nurse to be attentive to various signs and symptoms. Option A, "avoids people and places that arouse painful memories," is correct because avoidance is a common coping mechanism in PTSD. Patients may actively avoid triggers to prevent distress or anxiety associated with past traumatic events. This behavior can significantly impact their daily functioning and quality of life. Options B, C, and D are incorrect. Option B, "experiences flashbacks or re-experiences the trauma," is a symptom commonly associated with PTSD but is not the only indicator. Not all patients with PTSD experience flashbacks; some may have other predominant symptoms. Option C, "experiences symptoms suggestive of a heart attack," is not typically a hallmark symptom of PTSD. Finally, option D, "feels compelled to repeat selected ritualistic behaviors," is more indicative of conditions like obsessive-compulsive disorder (OCD) rather than PTSD. Educationally, understanding the nuanced presentations of PTSD is essential for psychiatric nurses. By recognizing the diverse manifestations of PTSD, nurses can provide tailored care and support for patients. It is important to differentiate between symptoms of PTSD and other mental health conditions to ensure accurate assessment and appropriate intervention. Effective communication and a thorough understanding of PTSD symptoms are critical skills for nurses working with individuals who have experienced trauma.