ATI RN
Psychiatric Emergencies Questions
Question 1 of 5
Following involvement in a MVC, a middle-aged adult client is admitted to the hospital with multiple facial fractures. The client's blood alcohol level is high on admission. Which PRN prescription should be administered if the client begins to exhibit signs and symptoms of delirium tremens (DTs)?
Correct Answer: D
Rationale: The correct answer is D, Lorazepam (Ativan) 2 mg IM. This is because delirium tremens (DTs) is a severe form of alcohol withdrawal that can be life-threatening. Lorazepam is a benzodiazepine that helps to manage the symptoms of alcohol withdrawal, including agitation, hallucinations, and seizures. It works by calming the central nervous system. Prochlorperazine (A) is an antiemetic, not suitable for managing DTs. Hydromorphone (B) is an opioid analgesic, not indicated for alcohol withdrawal. Chlorpromazine (C) is an antipsychotic used for conditions like schizophrenia, not for alcohol withdrawal. In summary, Lorazepam is the appropriate choice for managing DTs due to its effectiveness in calming the central nervous system and managing alcohol withdrawal symptoms.
Question 2 of 5
A nurse provided medication education for a patient diagnosed with major depressive disorder who began a new prescription for phenelzine (Nardil). Which behavior indicates effective learning? The patient
Correct Answer: D
Rationale: The correct answer is D because conferring with a pharmacist when selecting over-the-counter medications is crucial when taking phenelzine. This is because phenelzine is a monoamine oxidase inhibitor (MAOI) that can interact with various over-the-counter medications, leading to potentially dangerous side effects such as serotonin syndrome. Monitoring sodium intake and weight (choice A) is important for other medications but not specifically for phenelzine. Wearing support stockings and elevating legs (choice B) is not directly related to phenelzine. Identifying foods with high selenium content (choice C) is not relevant as phenelzine does not interact with selenium.
Question 3 of 5
Which documentation for a patient diagnosed with major depressive disorder indicates the treatment plan was effective?
Correct Answer: A
Rationale: The correct answer is A because it indicates positive outcomes in the patient's mood and behavior. Sleeping 6 hours uninterrupted suggests improved sleep patterns, singing with an activity group shows engagement and enjoyment, and looking forward to seeing the grandchild demonstrates positive anticipation and social connection. This documentation aligns with the goals of treating major depressive disorder, which include improving sleep, increasing social interaction, and enhancing mood. Choice B is incorrect because the patient's statement about the project being a failure reflects negative self-perception, which is not indicative of treatment effectiveness. Choice C is incorrect because the patient's weight loss and need for assistance with personal hygiene suggest potential ongoing challenges and lack of improvement in self-care. Choice D is incorrect because the patient feeling tired all the time and being preoccupied with inadequacies indicate persistent symptoms of depression and lack of progress in treatment.
Question 4 of 5
During a psychiatric assessment, the nurse observes a patient's facial expression is without emotion. The patient says, 'Life feels so hopeless to me. I've been feeling sad for several months.' How will the nurse document the patient's affect and mood?
Correct Answer: B
Rationale: The correct answer is B: Affect flat; mood depressed. The patient's facial expression lacking emotion indicates a flat affect, while the verbal expression of feeling sad for several months indicates a depressed mood. Affect refers to the outward expression of emotion, while mood is the internal emotional state. In this scenario, the patient's flat affect and depressed mood align. Choice A is incorrect as the mood is not flat but depressed. Choice C is incorrect as the affect is not labile (fluctuating) but flat. Choice D is incorrect as the affect and mood are congruent in this case.
Question 5 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.