ATI RN
Age Specific Patient Care Questions
Question 1 of 5
A community mental health nurse receives a new client for his caseload. The diagnosis of the client is residual schizophrenia. Documentation states that the client has a number of negative symptoms. Which symptom would the nurse expect to assess in the client?
Correct Answer: D
Rationale: The correct answer is D: Emotional blunting. In residual schizophrenia, negative symptoms involve deficits in normal emotional responses and behaviors. Emotional blunting refers to a reduction in the intensity of emotional expression, which is commonly seen in clients with residual schizophrenia. This symptom can include a lack of facial expressions, reduced vocal inflections, and overall flat affect. Choice A (Bizarre, somatic delusions) is incorrect as it refers to a positive symptom of schizophrenia involving distorted beliefs about the body. Choice B (Disorganized speech pattern) is incorrect as it is characteristic of disorganized schizophrenia, not residual schizophrenia. Choice C (Catatonic posturing) is incorrect as it is a symptom of catatonic schizophrenia, not residual schizophrenia.
Question 2 of 5
A newly admitted patient diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment. He states that he saw two doctors talking in the hall and knows they were plotting to kill him. When charting, how should the nurse identify this behavior?
Correct Answer: A
Rationale: The correct identification for the behavior described is "A: Idea of reference." This term refers to the belief that neutral events are directed at oneself. In this case, the patient's belief that the doctors were plotting to kill him is an example of a false idea of reference. Delusion of infidelity (choice B) involves false beliefs about a partner's unfaithfulness, not relevant here. Auditory hallucination (choice C) pertains to false perceptions of hearing sounds, not applicable. Echolalia (choice D) is the repetition of words spoken by others, not seen in this scenario. Identifying the behavior as an idea of reference helps the nurse understand the patient's distorted perception of reality.
Question 3 of 5
The nurse is told that a patient with disorganized schizophrenia is being admitted to the unit. The nurse should expect the patient to demonstrate:
Correct Answer: C
Rationale: The correct answer is C because disorganized schizophrenia is characterized by social withdrawal and ineffective communication. This subtype of schizophrenia involves disorganized speech and behavior, flat or inappropriate affect, and disorganized thinking. Patients with this type may display bizarre or nonsensical behavior and have difficulty with daily activities. Choice A is incorrect as suspiciousness and delusions are more commonly associated with paranoid schizophrenia. Choice B is incorrect as extremes of motor activity and excitement to stupor are characteristic of catatonic schizophrenia. Choice D is incorrect as severe anxiety and ritualistic behavior are not typical features of disorganized schizophrenia.
Question 4 of 5
A patient receiving risperidone (Risperdal) reports severe muscle stiffness midmorning. During lunch he has difficulty swallowing food and speaking, and when vital signs are taken 30 minutes later, he is noted to be stuporous and diaphoretic, with a temperature of 38.8° C, pulse of 110 beats/min, and blood pressure of 150/90 mm Hg. The nurse should suspect _____ and should _____.
Correct Answer: A
Rationale: The correct answer is A: neuroleptic malignant syndrome (NMS). NMS is a rare but serious adverse reaction to antipsychotic medications like risperidone. The patient's symptoms of severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, and elevated temperature, pulse, and blood pressure are all consistent with NMS. The nurse should suspect NMS due to the constellation of symptoms and vital sign changes. Placing the patient in a cooling blanket and transferring to the ICU is appropriate as NMS is a medical emergency requiring prompt intervention to lower the body temperature and provide supportive care. Choices B, C, and D are incorrect: B: Anticholinergic toxicity does not typically present with the specific symptoms described, such as muscle stiffness and stupor. C: Relapse of psychosis would not explain the acute onset of symptoms and vital sign changes seen in the scenario. D: Agranulocytosis is a rare side effect of some ant
Question 5 of 5
A patient who has been hospitalized for 2 days remains delusional and anxious and does not yet appear to be ready to give up the delusions. What intervention will best help the patient focus less on the delusion?
Correct Answer: B
Rationale: The correct answer is B because engaging in activities that require physical skills and constructive use of time can help the patient shift their focus away from the delusions. Physical activities can help reduce anxiety and provide a sense of accomplishment, which can help distract the patient from the delusions. It also promotes a sense of normalcy and routine, which can aid in grounding the patient in reality. Choice A is incorrect because reading and listening to music may not actively engage the patient in a way that helps them shift their focus from the delusions. Choice C is incorrect because planning for discharge may be premature and may not address the immediate need to distract the patient from the delusions. Choice D is incorrect because discussing personal goals related to improved socialization may not be effective in helping the patient focus less on the delusions at this stage.