ATI RN
Age Specific Care Competency Questions
Question 1 of 5
A client with catatonic schizophrenia has been posturing, standing with his left arm upraised and his right foot off the floor. For the most part, he ignores attempts at nursing intervention but will occasionally walk, sit, or lie down for a few minutes. The client eats standing up if the nurse brings a tray to the room. The priority nursing order would be to:
Correct Answer: B
Rationale: The correct answer is B. Assess for lower extremity edema bid. Rationale: 1. Priority is to assess for lower extremity edema as the client is standing for extended periods, which can lead to edema. 2. Edema assessment is crucial for preventing complications like blood clots or skin breakdown. 3. Insisting on sitting or lying down may aggravate the client and worsen the situation. 4. Providing high-calorie drinks or activities therapy are not the immediate priority in this case. In summary, assessing for lower extremity edema is crucial due to the client's prolonged standing, which can lead to potential health risks, making it the priority nursing order.
Question 2 of 5
The nurse is sitting with a patient diagnosed as having schizophrenia, disorganized type, who starts to laugh uncontrollably, although nothing funny has occurred. The nurse should say:
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's behavior in a non-confrontational manner and invites the patient to share their experience. By saying "You're laughing. Tell me what's happening," the nurse shows empathy and encourages open communication. Choice A may unintentionally minimize the patient's experience. Choice B may come off as accusatory. Choice C doesn't actively engage the patient in conversation. Encouraging the patient to express their feelings can help establish trust and facilitate therapeutic communication.
Question 3 of 5
A patient has schizophrenia and is troubled by negative symptoms, muscle stiffness, and motor restlessness. His Advanced Practice Nurse (APN) is considering changing the patient's antipsychotic medication, haloperidol (Haldol, a typical or first generation antipsychotic drug). For planning purposes, which medication can the nurse assume that the APN will probably choose?
Correct Answer: C
Rationale: The correct answer is C: Olanzapine (Zyprexa). Olanzapine is an atypical or second-generation antipsychotic that is effective in treating both positive and negative symptoms of schizophrenia. It also has a lower risk of causing extrapyramidal symptoms like muscle stiffness and motor restlessness compared to typical antipsychotics like haloperidol. Chlorpromazine (A) is a typical antipsychotic with similar side effects as haloperidol. Clozapine (B) is an atypical antipsychotic that is effective for treatment-resistant schizophrenia but is usually considered as a last resort due to its potential for serious side effects. Fluoxetine (D) is an antidepressant and not typically used as a first-line treatment for schizophrenia.
Question 4 of 5
A novice nurse tells the assigned mentor, 'I admitted a patient today who has several bizarre delusions. I wanted to tell the patient that the ideas and conclusions simply are not logical. What do you think will happen if I do?' Which reply by the mentor is best?
Correct Answer: C
Rationale: The correct answer is C because it emphasizes the importance of developing trust and rapport with the patient before addressing their delusions. By using empathy and calmness, the nurse can create a safe environment for the patient to feel understood and supported. This approach can help the patient be more receptive to feedback about the discrepancies in their thinking. Choice A is incorrect because simply giving the patient something to think about may not address the underlying issues causing the delusions. Choice B is incorrect as it assumes the patient will view the nurse negatively, which may not always be the case. Choice D is incorrect as it suggests going along with the patient's delusions, which can potentially reinforce and perpetuate their false beliefs.
Question 5 of 5
The nurse has been working with a patient diagnosed with schizophrenia who experiences auditory hallucinations. The patient relates, 'When I first heard the voices they said nice things about me. Lately, they've changed and they say bad things.' What information has the least impact on therapeutic patient care at this point in the hospitalization?
Correct Answer: A
Rationale: Correct Answer: A Rationale: A: Asking about trust in the nurse is not immediately relevant as the patient's primary concern is the change in voice content. Building trust is important but addressing the content of hallucinations takes priority. B: This is relevant as commanding voices could pose a safety risk. C: Monitoring frequency helps assess severity and response to treatment. D: Understanding triggers for hallucinations is important for managing symptoms.