ATI RN
Health Care Utilization by Age Group Questions
Question 1 of 5
A patient reports, 'My brain is tapped. The government has implanted a device in my head.' What outcome would the nurse identify as being appropriate for the patient to achieve within 1 week of admission?
Correct Answer: C
Rationale: The correct answer is C because it reflects the goal of promoting reality testing and challenging the patient's delusional beliefs. By helping the patient interpret reality correctly and recognize that the implanted device is not real, the nurse can support the patient in overcoming their delusions and improving their mental health. Choice A is incorrect as simply taking medication does not address the underlying delusional belief. Choice B is incorrect as it validates and reinforces the patient's delusion, which is not therapeutic. Choice D is incorrect as it does not address the core issue of the patient's delusional belief and may not lead to long-term improvement in mental health.
Question 2 of 5
A female client with a psychotic disorder is experiencing olfactory hallucinations. Most likely, she would be complaining of:
Correct Answer: C
Rationale: The correct answer is C because olfactory hallucinations involve perceiving smells that are not actually present. In a psychotic disorder, such hallucinations are common and can be disturbing to the individual. This is due to the sensory perception of smells that others cannot detect. Choices A, B, and D do not align with the experience of olfactory hallucinations. Vision (A) and sound (B) are not related to olfactory hallucinations, and a sense of touch (D) is not typically associated with this type of sensory distortion in psychotic disorders.
Question 3 of 5
When a nurse overhears the spouse of a patient threaten to 'smack you good if you don't shut up' while sitting in the unit's dayroom, which action reflects the most immediate, therapeutic nursing intervention?
Correct Answer: A
Rationale: The correct answer is A: Notify hospital security immediately that the situation exists. This is the most immediate, therapeutic nursing intervention because the safety of the nurse, patient, and others in the unit is the top priority. By involving hospital security, the nurse can ensure a swift and appropriate response to the threatening behavior. This action helps to de-escalate the situation and protect everyone involved. The other choices are incorrect because: B: Asking the spouse to leave the unit could escalate the situation further and put the nurse at risk. C: Asking the patient about the spouse's behavior may not be immediate enough to address the threat. D: Threatening to call the police could escalate the situation and may not be the best approach to ensure safety for all parties involved.
Question 4 of 5
A child, aged 11 years, stays home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The home is cluttered and dirty when the community mental health nurse visits to investigate the child's school absences. The nurse's legal responsibility if child abuse or neglect is suspected is to:
Correct Answer: C
Rationale: Correct Answer: C Rationale: 1. **Legal Obligation**: The nurse has a legal duty to report suspicions of child abuse or neglect. 2. **Protecting the Child**: Reporting ensures the child's safety and well-being. 3. **State Regulations**: State laws mandate reporting suspected abuse or neglect. 4. **Immediate Action**: Waiting for proof delays intervention and puts the child at risk. Summary: - Choice A: Consulting with school staff doesn't fulfill the legal obligation to report. - Choice B: Documenting is important but not sufficient; reporting is crucial. - Choice D: Waiting for proof is dangerous; immediate reporting is necessary to protect the child.
Question 5 of 5
A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He 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 nurse would assess 'frobitz' as:
Correct Answer: D
Rationale: The correct answer is D: A neologism. A neologism is a newly created word or phrase that is unique to the individual and not understandable to others. In this scenario, the client's use of the word 'frobitz' is an example of a neologism. This demonstrates disorganized thinking and language typical of schizophrenia. A: Circumstantial speech involves providing unnecessary details before reaching the main point, which is not evident in the client's response. B: Loose associations involve a lack of logical connection between thoughts, which is not demonstrated by the client's use of 'frobitz.' C: Delusional thinking involves fixed false beliefs, which are not explicitly present in the client's response. In summary, the client's use of 'frobitz' indicates a neologism, reflecting disorganized thinking in schizophrenia, making it the correct assessment.