ATI RN
Health Care Utilization by Age Group Questions
Question 1 of 5
A client with antisocial personality disorder yells, 'Shut up about that, or I'll punch you in the nose!' and shakes his fist at another client in a group meeting after the client speaks negatively of illicit drug use. The nurse quickly determines that the client is at risk to act violently against others as evidenced by his aggressive behavior, verbal threats, and a history of impulsivity. Which is the best approach for the nurse to use?
Correct Answer: C
Rationale: The correct answer is C: Explore alternate ways to handle frustrating topics in the group. This approach focuses on addressing the underlying issue of the client's aggressive behavior by finding healthier ways to manage emotions and conflicts. It promotes therapeutic communication and helps the client develop coping strategies. Secluding the client (choice A) may escalate the situation and reinforce negative behavior. Putting the client in restraints (choice B) is a physical intervention that should only be used as a last resort for safety reasons. Telling the client to leave the group (choice D) may not address the root cause of the behavior and could lead to further isolation and resentment. Ultimately, exploring alternate ways to handle frustrating topics is the most therapeutic and effective approach in this scenario.
Question 2 of 5
The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:
Correct Answer: A
Rationale: The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things as all good or all bad, leading to extreme shifts in perception. In this case, the client initially viewed the psychiatrist as the best doctor but now hates him completely due to feeling abandoned. This sudden shift from idealization to devaluation is characteristic of splitting. Choice B: Projective identification involves attributing one's own unacceptable feelings or traits onto another. This is not evident in the client's description. Choice C: Isolation of affect refers to separating emotions from their source. The client is expressing strong emotions towards the psychiatrist, not isolating them. Choice D: Dissociation involves a disruption in consciousness, memory, identity, or perception. The client is not displaying symptoms of dissociation in this scenario.
Question 3 of 5
A patient tells a nurse, 'The others won't give me my pain meds early, but you are more understanding, you know what it's like to be in pain, and you don't want to see your patients suffer. Could you find a way to get me my pill now? I won't tell anyone.' Which response by the nurse would be most therapeutic?
Correct Answer: D
Rationale: Rationale: - Choice D is the correct response because it acknowledges the patient's pain, shows empathy, and educates on the importance of safe medication administration. - Step 1: Acknowledge the patient's pain to validate their feelings. - Step 2: Express understanding but emphasize safety concerns to educate the patient on responsible medication use. - Step 3: Maintain boundaries by emphasizing the importance of safe medication practices. - Other Choices: - A: Ignoring the patient's request can create distrust and may not address the underlying issue of pain management. - B: Delaying the response by involving the doctor may increase the patient's anxiety and does not address the safety concern. - C: Simply stating that it is unsafe without providing further explanation or addressing the patient's concerns lacks empathy and education.
Question 4 of 5
To plan effective interventions, the nurse should understand that the underlying reason a patient with paranoid personality disorder is so critical of others probably lies in the patient's:
Correct Answer: D
Rationale: The correct answer is D because paranoid personality disorder is characterized by distrust and suspicion of others, leading individuals to project their own negative traits onto others (projection). This defense mechanism helps them avoid accepting their own shortcomings. Option A is incorrect because the focus is on control, not blame. Option B is incorrect as intellectualization is a defense mechanism that involves avoiding emotions by focusing on rational aspects. Option C is incorrect as it refers to rigidity and not projection of blame. In summary, projection of blame onto others is the underlying reason for the critical behavior in paranoid personality disorder.
Question 5 of 5
A patient with borderline personality disorder has been hospitalized several times after self-injurious behavior and suicide attempts. The patient has entered dialectical behavior therapy on an outpatient basis. During therapy, the advanced practice nurse has been counseling her regarding self-harm behavior management. Today the patient called the nurse and reported 'feeling empty and anxious' and wants to cut herself. Which response would best help in this situation?
Correct Answer: C
Rationale: The correct response is C: Assist the patient to identify and choose a coping strategy. This choice is the best because it involves helping the patient develop healthy coping mechanisms to manage her distress. This empowers the patient to take control of her emotions and actions in a positive way. Emergency admissions (choices A and B) may not address the underlying issues and could potentially reinforce maladaptive behaviors. Advising medication (choice D) without addressing the emotional distress directly may not provide long-term solutions. In summary, choice C focuses on empowering the patient and addressing the root of the problem, making it the most appropriate response in this scenario.