ATI RN
Age Specific Populations Questions
Question 1 of 5
A client is admitted to a day hospital following an episode in which he purchased a gun to use while standing guard over his property to prevent a neighbor from erecting a boundary fence. His wife describes him as distrustful of the motives of others and often interpreting others' motives as threats. She mentions that one time he accused her of having an affair with a neighbor with whom she chatted occasionally. The care plan will list the priority outcome as 'Client will:
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct: 1. Building trust is essential in therapeutic relationships. 2. The client's distrustful nature and misinterpretation of others' motives indicate a lack of trust. 3. By demonstrating trust in the nurse, the client can begin to address his issues with mistrust. 4. Trust in the nurse can lead to better communication and engagement in therapy. 5. Trust in the nurse is foundational for therapeutic progress and successful outcomes. Summary of why other choices are incorrect: - Choice A: Admitting his action was excessive is important but does not address the underlying issue of trust. - Choice B: Writing a letter of apology to the neighbor does not directly address the client's trust issues. - Choice D: Identifying positive role models may be helpful, but building trust with the nurse is more immediate and directly related to the client's current issues.
Question 2 of 5
A 72-year-old female patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. A nurse planning discharge care must consider the need to teach the family to be alert for maladaptive cognitive symptoms because:
Correct Answer: D
Rationale: The correct answer is D because slower metabolism in the elderly can lead to medication toxicity, including anticholinergic toxicity causing delirium. As people age, their metabolism slows down, making them more susceptible to drug accumulation and toxicity. This can result in cognitive symptoms like delirium. A: Delirium is not a hypersensitivity reaction; it is an acute state of confusion. B: Denial of cognitive changes is not directly related to the risk of medication toxicity in the elderly. C: Gender is not a significant factor in medication toxicity leading to delirium; it is more related to individual metabolism and drug interactions.
Question 3 of 5
An 18-year-old referred to the mental health center often cooks gourmet meals but eats only tiny portions. The patient wears layers of loose clothing saying, "I like the style." The patient's weight dropped from 130 to 95 pounds. She has amenorrhea. Which diagnosis is most likely?
Correct Answer: B
Rationale: The correct answer is B: Anorexia nervosa. This diagnosis fits the patient's symptoms of restrictive eating, significant weight loss, amenorrhea, and denial of the severity of the situation. The patient's behavior of cooking gourmet meals but eating tiny portions and wearing layers of clothes to hide weight loss are classic signs of anorexia nervosa. The other choices are incorrect because: A: Eating disorder not otherwise specified does not fully capture the severity and specific symptoms exhibited by the patient. C: Bulimia nervosa involves binge-eating followed by compensatory behaviors, which are not described in the scenario. D: Binge eating disorder involves recurrent episodes of binge eating without compensatory behaviors, which is not indicated.
Question 4 of 5
A 16-year-old client has anorexia nervosa. She has lost 50 pounds during the past 3 months and is about 20 pounds under the weight that is normal for her height. She has dry skin with poor turgor, hair breakage, and brittle nails. The nurse can anticipate that when giving information about her menstrual history, the client is likely to report:
Correct Answer: B
Rationale: The correct answer is B: amenorrhea. In anorexia nervosa, severe weight loss can disrupt the hormonal balance, leading to the cessation of menstruation, known as amenorrhea. This is due to the body conserving energy and prioritizing essential functions over reproductive processes. The client's significant weight loss and physical symptoms indicate a state of malnutrition, further supporting the likelihood of amenorrhea. The other choices (heavy menstrual flow, premenstrual syndrome, dysmenorrhea) are less likely because they are not typically associated with anorexia nervosa and severe weight loss. Amenorrhea is a common manifestation of anorexia nervosa and reflects the impact of malnutrition on reproductive health.
Question 5 of 5
A pediatric nurse at the clinic interviews a 14-year-old client who is dressed in baggy clothes and two sweaters on a warm day. The client admits to not having had her period for 4 months. The nurse notes fine downy hair along the client's cheeks. Vital signs are T, 36.6; P, 64; and BP, 84/50. Which additional objective sign would best support the nurse's assessment that the client has anorexia nervosa?
Correct Answer: A
Rationale: The correct answer is A: Weight 15% below normal for her height. In anorexia nervosa, individuals have a fear of gaining weight leading to severe weight loss. A weight 15% below normal for her height indicates significant weight loss, a hallmark feature of anorexia nervosa. This is supported by the client's baggy clothes, two sweaters on a warm day, and absence of menstrual periods, which are common signs of anorexia nervosa. Choice B: Eroded dental enamel is a sign of bulimia nervosa, not anorexia nervosa. Choice C: Parotid gland enlargement is seen in bulimia nervosa due to frequent vomiting, not anorexia nervosa. Choice D: Dehydration is a general sign and not specific to anorexia nervosa.