ATI RN
Age Specific Populations Questions
Question 1 of 5
A client with paranoid schizophrenia has said she feels like throwing a chair. The nurse in the dayroom hears this and wishes to encourage verbalization as a desecalation technique. Which response by the nurse would fulfill this plan?
Correct Answer: A
Rationale: The correct answer is A because it encourages the client to express their feelings verbally, promoting communication and potentially preventing escalation of behavior. By saying "Tell me what's going on," the nurse acknowledges the client's emotions and creates a safe space for them to talk. Option B threatens restraint, likely increasing tension. Option C may come off as confrontational. Option D distracts from the immediate need for the client to process their feelings.
Question 2 of 5
When a patient diagnosed with paranoid schizophrenia was discharged from the unit 6 months ago, the plan was for him to take chlorpromazine (Thorazine), a conventional (first generation) antipsychotic medication, 300 mg po daily. He tells the nurse he stopped taking his pills after a few months because they made him feel like a 'zombie.' What other common side effects should the nurse determine if the patient experienced?
Correct Answer: B
Rationale: The correct answer is B: Sedation, tremor, and muscle stiffness. This is because chlorpromazine, being a first-generation antipsychotic, commonly causes sedation, tremors, and muscle stiffness as side effects. Sedation is a common effect due to the drug's ability to block dopamine receptors in the brain. Tremors and muscle stiffness are also common due to the drug's action on the central nervous system. Choices A, C, and D are incorrect as they do not align with the expected side effects of chlorpromazine. Sweating, nausea, weight gain, headache, watery eyes, runny nose, mild fever, sore throat, and skin rash are not typically associated with this medication.
Question 3 of 5
A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient's skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient's recent presentation. The patient is likely experiencing _____, and the nurse should _____.
Correct Answer: A
Rationale: The correct answer is A: anticholinergic toxicity. The patient is displaying symptoms such as restlessness, disorganized behavior, nonsensical verbal responses, disorientation, hot and dry skin, and dilated pupils, which are indicative of anticholinergic toxicity. Step-by-step rationale: 1. Restlessness and disorganized behavior are common symptoms of anticholinergic toxicity. 2. Nonsensical verbal responses and disorientation are also typical signs of anticholinergic toxicity. 3. Hot and dry skin can be caused by decreased sweating due to anticholinergic effects. 4. Dilated pupils are a classic sign of anticholinergic toxicity. 5. Checking vital signs and preparing to use a cooling blanket is the appropriate immediate action to manage anticholinergic toxicity. Summary of other choices: - B: Relapse of psychosis does not explain the physical symptoms like dilated pupils and hot/dry skin. - C: Neuroleptic malignant syndrome presents with
Question 4 of 5
A patient with many positive symptoms of schizophrenia, whose behavior is disorganized and who is highly anxious, tells the nurse in the psychiatric emergency department, 'You have got to help me. I do not know what is going on. I think someone is trying to wipe me out. I have to get a gun.' The patient, a college student, lives alone and has no family or support system in the immediate area. He has not left his room in 2 weeks, has not eaten in several days, and is unkempt. Of the available treatment settings, the nurse should recommend:
Correct Answer: B
Rationale: The correct answer is B: inpatient hospitalization on a locked unit. This option is the most appropriate given the patient's presentation. The patient is experiencing severe positive symptoms of schizophrenia, such as delusions and disorganized behavior, posing a risk to himself and others by expressing intent to obtain a gun. Additionally, the patient is neglecting basic needs, indicating a need for close monitoring and intervention. Inpatient hospitalization on a locked unit provides a structured and secure environment for intensive treatment, ensuring safety and stabilization. Incorrect choices: A: Admission to an unlocked residential crisis unit may not provide the level of monitoring and security needed for a patient with active psychotic symptoms and self-harm potential. C: Attending a day treatment program for 4 weeks does not address the acute safety concerns and level of impairment displayed by the patient. D: Admission to a partial hospital program may not offer the round-the-clock supervision and immediate intervention required for someone at risk of harming themselves or others.
Question 5 of 5
Which point should be included in teaching patients and families about relapse?
Correct Answer: B
Rationale: Step-by-step rationale for why answer B is correct: 1. Caffeine and nicotine are known to reduce the effectiveness of antipsychotic drugs. 2. Teaching patients and families about this can help them understand the importance of avoiding these substances. 3. By avoiding caffeine and nicotine, patients can improve the effectiveness of their treatment and reduce the risk of relapse. 4. This information empowers patients and families to make informed decisions to support treatment outcomes. Summary of why other choices are incorrect: A: Incorrect because relapse can occur due to various factors, not just medication non-adherence. C: Incorrect because relapse is a complex issue that may not be entirely prevented even with support, education, and adherence. D: Incorrect because education about medication side effects is still valuable, even if it may not entirely prevent relapse.