ATI RN
Age Specific Care Competency Questions
Question 1 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 known for effectively treating negative symptoms, muscle stiffness, and motor restlessness in schizophrenia. It has a lower risk of extrapyramidal side effects compared to typical antipsychotics like haloperidol. Chlorpromazine (A) is a typical antipsychotic with similar side effect profiles as haloperidol. Clozapine (B) is an atypical antipsychotic but is typically reserved for treatment-resistant cases due to its potential for serious side effects. Fluoxetine (D) is an antidepressant and not typically used for treating the symptoms described in the question. Therefore, the APN will likely choose Olanzapine to address the patient's symptoms effectively with a lower risk of side effects.
Question 2 of 5
A nurse interviews a patient abducted and raped at gunpoint by an unknown assailant. The patient says, "I can't talk about it. Nothing happened. I have to forget." What is the patient's present coping strategy?
Correct Answer: D
Rationale: The correct answer is D: Denial. The patient's statement of "I can't talk about it. Nothing happened. I have to forget" indicates a denial coping strategy. Denial is a defense mechanism where individuals refuse to acknowledge a stressful situation or event. In this case, the patient is attempting to block out the traumatic experience of being abducted and raped by denying its existence. This coping mechanism helps the individual temporarily avoid the emotional distress associated with the event. A: Somatization involves expressing emotional distress through physical symptoms, which is not evident in the patient's statement. B: Repression is the unconscious blocking of unpleasant memories, whereas the patient is consciously trying to forget the event. C: Projection involves attributing one's own thoughts or feelings to others, which is not demonstrated in the patient's statement. In summary, the patient's use of denial as a coping strategy is evident in their attempt to minimize the traumatic experience by refusing to acknowledge it.
Question 3 of 5
A patient in the long-term phase of the rape-trauma syndrome had intrusive thoughts of the attack and developed fears of being alone. Which finding best demonstrates the patient has improved? The patient!
Correct Answer: B
Rationale: The correct answer is B because planning coping strategies for fearful situations indicates the patient is actively working on managing their fears and trauma, showing progress and improvement. Choice A is incorrect as increased activity may be a maladaptive coping mechanism. Choice C suggests social withdrawal, which is a sign of regression. Choice D may indicate premature attempts to engage in sexual activity without addressing the underlying trauma. Overall, choice B demonstrates proactive steps towards healing and recovery.
Question 4 of 5
The nurse caring for a school-age child who has been sexually abused by a close family member realizes that the child may resist disclosing the experience of being sexually abused because the child:
Correct Answer: B
Rationale: The correct answer is B: Fears being blamed or disbelieved. This is because children who have been sexually abused often fear that they will not be believed or may be blamed for what happened. This fear can prevent them from disclosing the abuse. Choice A is incorrect because repeated questioning may not be the primary reason for the child's resistance. Choice C is incorrect because the child's fear of being pitied at school is not typically a main concern when disclosing sexual abuse. Choice D is incorrect because embarrassment about facing family members may be a factor, but the fear of blame or disbelief is usually a more significant barrier to disclosure in cases of sexual abuse.
Question 5 of 5
The nurse is interviewing a client who presents with a dislocated shoulder. She demonstrates signs of anxiety and poor eye contact and turns to her partner for answers, allowing him to answer for her. Bruises on her breast and upper arm are visible. The nurse asks the partner to go to the admitting office to give insurance information. While the partner is out of the room, which question is most important to ask?
Correct Answer: B
Rationale: The correct answer is B: "Have you ever been physically or emotionally hurt by someone?" This question is important as it directly addresses the potential abuse the client may be experiencing. It allows the nurse to assess for any history of abuse, which could be contributing to the client's anxiety and behavior. It also opens up an opportunity for the client to disclose any abuse they may be facing. Choice A is incorrect because the length of the relationship with the partner is not as crucial as addressing the potential abuse. Choice C is also incorrect because it is too direct and may not encourage the client to open up about their experiences. Choice D is incorrect as it assumes the client wants to press charges without first assessing the situation and the client's wishes.