ATI RN
Age Specific Care Quiz Questions
Question 1 of 5
A 28-year-old female client was admitted 3 days ago after she ran nude through the streets, shouting that she was the 'Queen of Hearts.' The client has remained delusional since admission. An initial expected outcome would be that the client will:
Correct Answer: C
Rationale: The correct answer is C: Engage in reality-oriented conversation. This is the most appropriate initial expected outcome because it focuses on helping the client ground herself in reality. Engaging in reality-oriented conversation can help the client understand and acknowledge her delusions, leading to potential insight and eventual treatment. A: Allowing the nurse to logically dispute the delusion may not be effective initially as the client may not be receptive to this approach during the acute phase of her delusion. B: Distinguishing external boundaries may not address the underlying delusional beliefs and may not be the most immediate concern. D: Explaining why she thinks she is the 'Queen of Hearts' may reinforce the delusion rather than challenging it.
Question 2 of 5
A client with undifferentiated schizophrenia is readmitted for an acute exacerbation of the disorder. The goal of hospitalization is symptom stabilization. The nurse has documented that, in addition to experiencing auditory hallucinations, the client seems uninterested in activities, has difficulty completing tasks, seems forgetful, and seems puzzled by information and directions given by staff. The nurse's plans for intervention will be effective if these behaviors are attributed to:
Correct Answer: D
Rationale: The correct answer is D: Problems in cognitive functioning. In undifferentiated schizophrenia, cognitive deficits are common, leading to difficulties in memory, attention, problem-solving, and executive functioning. The client's symptoms of forgetfulness, difficulty completing tasks, being puzzled by information, and auditory hallucinations are indicative of cognitive impairment. Interventions should focus on addressing these cognitive deficits to improve the client's ability to function. Incorrect choices: A: Social isolation - This choice does not address the cognitive deficits and symptoms described by the client, such as forgetfulness and difficulty completing tasks. B: Deficient knowledge - While cognitive deficits may contribute to deficient knowledge, the primary concern in this scenario is the client's cognitive functioning impairments. C: Situational low self-esteem - This choice does not explain the cognitive deficits and symptoms experienced by the client, which are more indicative of problems in cognitive functioning.
Question 3 of 5
A catatonic patient admitted in a stuporous condition begins to demonstrate increased motor activity. During his assessment, the psychiatrist raises the patient's arm above his head and releases it. The patient maintains the position his arm was placed in, immobile in that position for 15 minutes, moving only when the nurse gently lowers his arm. What symptom is demonstrated by this assessment technique?
Correct Answer: B
Rationale: Waxy flexibility involves maintaining a posture imposed by another person, as seen in the patient's arm staying raised. This behavior is indicative of catatonia, a symptom of severe mental illness. Echopraxia involves mimicking movements of others, not maintaining a position. Depersonalization is a feeling of detachment from oneself, not related to physical movements. Thought withdrawal pertains to a symptom in schizophrenia where thoughts are removed by an external force, not related to physical posture.
Question 4 of 5
A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:
Correct Answer: B
Rationale: The correct answer is B: olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that is known to be effective in treating negative symptoms of schizophrenia, such as apathy, poverty of thought, and social withdrawal. These symptoms are often resistant to typical antipsychotics like haloperidol (A) and chlorpromazine (D), which are more effective for positive symptoms like hallucinations. Diphenhydramine (C) is an antihistamine and not used to treat schizophrenia symptoms. In summary, olanzapine is the best choice to address the specific symptoms described in the scenario.
Question 5 of 5
A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?
Correct Answer: D
Rationale: The correct answer is D because the patient's accusation of the nurse being homosexual and implying that other men do not trust him or want to be around him suggests projection of the patient's own homosexual urges onto the nurse. This defense mechanism of projection helps the patient avoid acknowledging and dealing with his own uncomfortable feelings by attributing them to someone else. Option A is incorrect because the patient's behavior is more about projecting feelings onto the nurse rather than unconscious hostility. Option B is incorrect as it focuses on the patient's fear of rejection rather than projecting his own feelings onto the nurse. Option C is incorrect as it does not address the specific dynamic of projecting homosexual urges onto the nurse.