ATI RN
Psychiatric Emergencies Questions
Question 1 of 5
What is the most important goal for a client with major depression who has been receiving an antidepressant medication for two weeks?
Correct Answer: D
Rationale: The correct answer is D because the most crucial goal for a client with major depression on antidepressants is to ensure their safety and prevent self-harm. Monitoring for suicidal ideation and behavior is a top priority. Ventilating feelings of sadness (A) is important but not as critical as ensuring safety. Eating three meals a day (B) and participating in group meetings (C) are important for overall well-being but do not directly address the immediate safety concern of potential suicide attempts.
Question 2 of 5
Defense mechanism question: for projection.
Correct Answer: A
Rationale: The correct answer is A because it exemplifies the defense mechanism of projection, where one attributes their unacceptable thoughts or feelings to others. In this case, the individual is shifting blame onto the police for being in the psychiatric facility. Choice B is incorrect as it demonstrates rationalization rather than projection. Choice C is incorrect as it reflects denial rather than projection. Choice D is incorrect as it represents displacement rather than projection.
Question 3 of 5
During one-to-one session with the nurse, a female client who has been admitted for chronic depression and attempted suicide discloses her experience of sexual promiscuity and prostitution. When the nurse asks the client if she was ever sexually abused as a child, the client says, 'I don't remember, but my mother ran my father off when I was five.' The nurse should recognize that the client may be using which defense mechanism?
Correct Answer: A
Rationale: The correct answer is A: Repression. Repression is a defense mechanism where painful or unacceptable memories are pushed into the unconscious mind to avoid conscious awareness. In this scenario, the client's inability to remember potential childhood sexual abuse could be a result of repressing those memories due to the distress they may cause. The client's response of not remembering but mentioning a significant event from childhood (mother running off father) suggests the possibility of repressed memories. Summary: - Choice B: Denial involves refusing to acknowledge reality, which is not evident in this scenario. - Choice C: Projection involves attributing one's own thoughts or feelings to others, which is not applicable in this context. - Choice D: Rationalization involves creating logical explanations to justify behaviors, which is not demonstrated in the client's response.
Question 4 of 5
A client with bulimia and depression who is taking Phenelzine (Nardil) 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. What dietary choice should the nurse instruct the client to avoid?
Correct Answer: A
Rationale: The correct answer is A: Pepperoni pizza. Phenelzine is a monoamine oxidase inhibitor (MAOI) which interacts with tyramine-rich foods, like aged, fermented, or spoiled foods, leading to hypertensive crisis. Pepperoni is high in tyramine due to its fermentation process. Grilled chicken salad, steamed vegetables, and fresh fruit are low in tyramine and safe to consume with Phenelzine.
Question 5 of 5
A 14-year-old client with anorexia is allowed to select which activity?
Correct Answer: A
Rationale: The correct answer is A: Arts and crafts activity. For a 14-year-old with anorexia, engaging in arts and crafts can provide a therapeutic outlet for self-expression, relaxation, and distraction from negative thoughts about body image or food. It promotes creativity and allows the client to explore emotions in a non-threatening way. Physical exercise (B) may exacerbate the client's condition by reinforcing unhealthy behaviors. Cooking class (C) may trigger anxiety around food. Group therapy (D) can be beneficial, but the client may not be ready to openly discuss their struggles with others. Therefore, the arts and crafts activity is the most suitable choice for this client.