ATI RN
PICO Question Psychiatric Emergency Nursing Questions
Question 1 of 5
A psychiatric nurse intern states, “This client's use of defense mechanisms should be eliminated.†Which is a correct evaluation of this nurse's statement?
Correct Answer: A
Rationale: The correct answer is A because defense mechanisms can be adaptive responses to stress, helping individuals cope and manage anxiety. It is important to understand that defense mechanisms serve a purpose in protecting the individual's psychological well-being. Eliminating them completely can be harmful as they may be necessary for emotional regulation. Choice B is incorrect as defense mechanisms can sometimes be adaptive. Choice C is incorrect as defense mechanisms are utilized by everyone, not just those with weak ego integrity. Choice D is incorrect as fostering defense mechanisms excessively can lead to maladaptive coping strategies.
Question 2 of 5
According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?
Correct Answer: B
Rationale: The correct answer is B because Maslow's hierarchy of needs prioritizes safety and security needs. Aggressive behavior jeopardizes the safety of others, requiring immediate intervention to prevent harm. Choices A, C, and D relate more to social and esteem needs, which are of lower priority according to Maslow's theory. Addressing them would be important but not as urgent as ensuring physical safety in the case of aggressive behavior.
Question 3 of 5
A 28-year-old paramedic presents for an independent medical examination. He has been on long-term disability for 2 years following an emergency response to a motor vehicle collision that involved fatalities. There is no previous psychiatric or substance use history. He states that he is improving. His wife agrees but notes that he has 'a very quick temper and breaks stuff when he is frustrated.' He reports feeling anxious about returning to work and feeling that 'people are out to get me.' He admits that he sometimes hears 'voices and people screaming.' What is the MOST likely diagnosis?
Correct Answer: D
Rationale: The most likely diagnosis for the 28-year-old paramedic described in the scenario is D) Posttraumatic stress disorder (PTSD). This diagnosis is supported by his history of being involved in a traumatic event with fatalities during his work as a paramedic, his reported anxiety about returning to work, his auditory hallucinations ("voices and people screaming"), and his hypervigilance ("people are out to get me"). Option A) Persistent depressive disorder with mood-congruent psychotic features is less likely because the primary symptoms described are related to anxiety, paranoia, and auditory hallucinations, which are more indicative of PTSD than depressive disorder with psychotic features. Option B) Malingering is unlikely as there is no evidence or motive provided in the scenario to suggest that the paramedic is intentionally faking or exaggerating his symptoms for secondary gain. Option C) Unspecified schizophrenia spectrum and other psychotic disorder is less likely as the symptoms described are more consistent with a trauma-related disorder like PTSD rather than a primary psychotic disorder like schizophrenia. Educationally, understanding the differentiation between these diagnoses is crucial for healthcare professionals, especially in emergency and psychiatric settings, to provide accurate assessments, interventions, and referrals for individuals experiencing mental health challenges following traumatic events. Recognizing the symptoms and diagnostic criteria for PTSD can lead to appropriate treatment and support for individuals like the paramedic in this scenario.
Question 4 of 5
An adult outpatient diagnosed with major depression has a history of several suicide attempts by overdose. Given this patient's history and diagnosis, which antidepressant medication would the nurse expect to be prescribed?
Correct Answer: B
Rationale: Selective serotonin reuptake inhibitor antidepressants are very safe in overdosage situations, which is not true of the other medications listed. Given this patient's history of overdosing, it is important that the medication be as safe as possible in case she takes an overdose of her prescribed medication.
Question 5 of 5
A college student who failed two tests cried for hours and then tried to telephone a parent but got no answer. The student then gave several expensive sweaters to a roommate and asked to be left alone for a few hours. Which behavior provides the strongest clue of an impending suicide attempt?
Correct Answer: C
Rationale: In a psychiatric emergency nursing context, identifying warning signs of suicide is crucial for timely intervention. The correct answer, giving away sweaters, provides the strongest clue of an impending suicide attempt. This behavior can indicate a sense of finality and detachment from possessions, common in individuals contemplating suicide. Excessive crying (Option B) is a common emotional response to stress and failure, but it is not as specific to suicide risk as giving away belongings. Calling parents (Option A) shows a desire for connection and support, which may actually serve as a protective factor against suicide. Staying alone in a dorm room (Option D) is concerning but not as indicative of imminent risk as giving away personal items. Educationally, discussing these warning signs can help nurses and healthcare professionals in psychiatric settings to develop a keen awareness of subtle cues that may signal an impending suicide attempt. By understanding these behaviors, they can intervene early and provide necessary support and interventions to prevent harm.