ATI RN
Age Specific Populations Questions
Question 1 of 5
A client tells the nurse he has just finished an important business meeting, when in fact he has been napping. Upon what rationale should the nurse's response be based?
Correct Answer: C
Rationale: The correct answer is C because reinforcing reality helps the client maintain maximum functioning. By gently guiding the client back to reality, the nurse can support their cognitive abilities and prevent further confusion or disorientation. Choice A is incorrect because ignoring memory deficits does not address the issue at hand. Choice B is incorrect as confronting delusions may lead to increased distress. Choice D is incorrect as it does not address the situation effectively and may not help the client maintain cognitive functioning.
Question 2 of 5
A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disoriented and confused. His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse's first action should be to:
Correct Answer: A
Rationale: The correct answer is A: Take the client's vital signs. The first step in assessing any client in the emergency department is to ensure their physiological stability. Vital signs provide essential information about the client's current physical condition, such as heart rate, blood pressure, respiratory rate, and temperature. In this case, the client's alternating states of hyperalertness and difficulty in arousal, disorientation, confusion, agitation, memory impairment, delusions, and misinterpretations of surroundings indicate a potential medical emergency. Therefore, taking the client's vital signs is crucial to determine if there are any immediate life-threatening conditions that need to be addressed promptly. Summary of other choices: B: Restrain the client to prevent injury - Restraint should only be used as a last resort for safety concerns and after assessing the client's physical condition. C: Obtain a PRN order for a psychotropic medication - Administering psychotropic medication should not be the first action without assessing the client's physical condition and
Question 3 of 5
The nurse is aware, when developing a care plan, that the three major goals of care for the client in whom Alzheimer's disease has been diagnosed include providing for the client's safety and well-being, therapeutically managing the client's behaviors, and:
Correct Answer: B
Rationale: The correct answer is B: Providing support for family, relatives, and caregivers. This is because Alzheimer's disease not only affects the individual but also has a significant impact on their family and caregivers. Providing support to them is crucial for maintaining the overall well-being of the client. Choice A is incorrect as Alzheimer's disease does not have a curative treatment. Choice C is incorrect as nursing home placement is not always necessary and should be considered as a last resort. Choice D is incorrect as tracking medical, legal, and financial records is important but not a major goal in the care plan for Alzheimer's clients. Supporting the family and caregivers helps in creating a supportive environment for the client and ensures holistic care.
Question 4 of 5
A nurse caring for a patient with bulimia nervosa should teach the patient about:
Correct Answer: C
Rationale: Rationale for Correct Answer (C): 1. Patients with bulimia nervosa often engage in purging behaviors, leading to electrolyte imbalances. 2. Hypokalemia is a common complication due to vomiting, which can have serious consequences. 3. Educating the patient about hypokalemia symptoms is crucial for early detection and intervention to prevent complications. Summary of Incorrect Choices: A. Self-monitoring of food intake is important but not the priority as addressing electrolyte imbalances. B. Weight gain is not a recommended goal for patients with bulimia nervosa. D. While self-esteem maintenance is important, addressing acute physical health risks takes precedence.
Question 5 of 5
A rape victim asks a nurse, 'How do I know whether this attack was my fault?' Which response by the nurse is therapeutic?
Correct Answer: A
Rationale: The correct answer is A because it focuses on supporting the victim in understanding that vulnerability does not equate to blame. This response helps the victim separate self-blame from the responsibility of the perpetrator. Choice B is incorrect as it undermines the victim's autonomy. Choice C is incorrect as it offers false reassurance and ignores the complexity of the situation. Choice D is incorrect as option A provides a therapeutic response that addresses the victim's emotional needs.