ATI RN
Age Specific Considerations in Patient Care Questions
Question 1 of 5
A client with schizophrenia tells the nurse that he is the President of the United States, and no logical reasoning with the client convinces him otherwise. This client is experiencing a:
Correct Answer: B
Rationale: The correct answer is B: Delusion. A delusion is a fixed false belief that is not based on reality, such as believing one is a famous figure like the President. In this scenario, the client's belief is firmly held despite evidence to the contrary, indicating a delusion. Mutism (A) is a lack of verbal communication, not applicable here. Neologism (C) is creating new words or phrases, not seen in this example. Flight of ideas (D) is a rapid, continuous flow of speech with abrupt topic changes, which is not demonstrated in the client's behavior described.
Question 2 of 5
A child, aged 11 years, has to stay home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The father appears to be emotionally abusive. Which intervention could be used for the primary prevention of problems such as these?
Correct Answer: B
Rationale: The correct answer is B because lobbying for subsidized childcare and increasing the minimum wage addresses the root causes of the family's situation, such as financial insecurity and lack of affordable childcare. This intervention aims to prevent similar situations from occurring by advocating for systemic changes that can support families in need. Choice A focuses on providing support to the parents, which may not address the underlying issues of financial instability and emotional abuse. Choice C addresses detection and treatment after the abuse has occurred, rather than preventing it from happening in the first place. Choice D focuses on providing counseling services after abuse or neglect has already taken place, rather than preventing it through systemic changes like subsidized childcare and increased minimum wage.
Question 3 of 5
A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. The client occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The best response for the nurse to make would be:
Correct Answer: B
Rationale: The correct answer is B: "Who do you mean when you say 'everybody'?" Rationale: 1. Clarifying the client's statement helps to understand his perception. 2. Asking specifically about 'everybody' encourages the client to express his feelings and thoughts. 3. It promotes therapeutic communication by showing empathy and active listening. Incorrect choices: A: "That's really too bad." - This response does not address the client's specific concerns or promote further exploration. C: "What difference does frobitzing make?" - This response is dismissive and lacks empathy or understanding of the client's experience. D: "Why do they frobitz?" - This response is confrontational and may come across as accusatory, potentially shutting down communication.
Question 4 of 5
A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales. Today, he argued with several office mates and threatened to kill one of them. The police were called, and he was brought to the mental health center for evaluation. He has had previous admissions to the unit for stabilization of paranoid schizophrenia. When the nurse meets him, he points at staff in the nursing station and states loudly, 'They're all plotting to destroy me. Isn't that true?' Which would be the most appropriate response?
Correct Answer: C
Rationale: The correct answer is C: Thinking that people want to destroy you must be very frightening. Rationale: 1. Acknowledges the patient's feelings: By stating that thinking people want to destroy him is frightening, the nurse shows empathy and validates his experience. 2. Validates the patient's emotions: This response does not directly agree or disagree but acknowledges the emotions behind the patient's statement. 3. Builds rapport: By showing understanding and empathy, the nurse can establish trust and rapport with the patient, leading to better communication and therapeutic relationship. Summary of other options: A: This response denies the patient's feelings and could potentially escalate the situation by invalidating his experiences. B: This response may come off as confrontational and does not address the patient's underlying fears. D: This response is dismissive and does not address the patient's emotional distress, potentially leading to further agitation.
Question 5 of 5
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
Correct Answer: D
Rationale: The correct answer is D: relapse of his schizophrenia. The patient's symptoms of feeling tense, difficulty concentrating, poor sleep, and delusional beliefs about creatures at work indicate a worsening of his psychotic symptoms. This suggests a relapse of schizophrenia, a chronic mental illness characterized by periods of stability and exacerbation of symptoms. The patient's previous stability for a year makes medication nonadherence less likely. While psychoeducation may be beneficial, the patient's current symptoms require more immediate intervention for relapse management. The information provided does not directly indicate the chronic nature of his illness, but rather an acute exacerbation. Therefore, D is the most appropriate choice based on the presented symptoms and clinical understanding of schizophrenia.