ATI RN
Psychiatric Emergencies Questions
Question 1 of 5
When developing a plan of care for a client admitted to the psychiatric unit following aspiration of a caustic material related to a suicide attempt, which nursing problem has the highest priority?
Correct Answer: C
Rationale: The correct answer is C: Ineffective breathing pattern. This is the highest priority because aspiration of a caustic material can lead to respiratory distress or compromise. Priority is given to airway and breathing concerns for immediate stabilization. Impaired comfort (A) is important but not life-threatening. Risk for injury (B) may be a concern, but airway takes precedence. Ineffective coping (D) is significant for long-term care but not immediate priority.
Question 2 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 3 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 4 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.
Question 5 of 5
Which goal for treatment of alcohol use disorder should the nurse address first?
Correct Answer: D
Rationale: The correct answer is D: Achieve physiological stability. This is the most crucial goal to address first because individuals with alcohol use disorder often experience physical health complications due to alcohol consumption. Achieving physiological stability involves addressing withdrawal symptoms, managing any medical issues related to alcohol use, and ensuring the individual's physical health is stable before moving on to other treatment goals. Learning about addiction and recovery (A), developing coping strategies (B), and establishing a peer support system (C) are important aspects of treatment but should come after ensuring the individual's physiological stability to prevent any medical emergencies or complications.