ATI RN
Age Specific Care Competency Questions
Question 1 of 5
A patient who has been taking fluoxetine (Prozac) 60 mg daily for the past 6 months tells the nurse at the medication follow-up clinic that he is considering stopping the Prozac. He states his mood is fine, and now that he is living normally, his wife is concerned that he has no sex drive. Which response would be best?
Correct Answer: D
Rationale: Step-by-step rationale for why answer D is correct: 1. Correctly acknowledges the patient's concern about sexual side effects. 2. Highlights the importance of managing depression to prevent recurrence. 3. Offers a solution by mentioning alternative medications with less impact on sex drive. 4. Empowers the patient by providing information and options for treatment. 5. Addresses both the patient's current situation and long-term mental health needs. Summary of why other choices are incorrect: A: Overlooks the patient's valid concern about sexual side effects and lacks a proactive solution. B: Focuses on timing of medication without addressing the underlying issue of sexual side effects. C: Dismisses the patient's concern and fails to provide a solution or alternative options.
Question 2 of 5
Which assessment findings would be expected for a patient diagnosed with bipolar I disorder?
Correct Answer: B
Rationale: Step 1: Bipolar I disorder involves episodes of acute mania, which is characterized by elevated mood, increased energy, and impulsivity. Step 2: Major depression can also occur in bipolar I, as patients may experience depressive episodes. Step 3: Therefore, choice B (Major depression and acute mania) is the correct answer. Summary: Choice A is incorrect because rapid cycling refers to frequent mood shifts, not specific to bipolar I. Choice C is incorrect as hypomania is characteristic of bipolar II, not bipolar I. Choice D is incorrect as minor depression is not a typical feature of bipolar I disorder.
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'?" This response is the best because it acknowledges the client's feelings and seeks clarification. By asking for specifics, the nurse can gain a better understanding of the client's perceptions and experiences, which can help in providing appropriate care and support. Choice A: "That's really too bad." This response lacks empathy and does not address the client's concerns directly. Choice C: "What difference does frobitzing make?" This response is dismissive and does not focus on the client's feelings or experiences. Choice D: "Why do they frobitz?" This response is confrontational and may make the client feel defensive, hindering effective communication and rapport-building.
Question 4 of 5
A client with catatonic schizophrenia has been posturing, standing with his left arm upraised and his right foot off the floor. For the most part, he ignores attempts at nursing intervention but will occasionally walk, sit, or lie down for a few minutes. The client eats standing up if the nurse brings a tray to the room. The priority nursing order would be to:
Correct Answer: B
Rationale: The correct answer is B. Assess for lower extremity edema bid. Rationale: 1. Priority is to assess for lower extremity edema as the client is standing for extended periods, which can lead to edema. 2. Edema assessment is crucial for preventing complications like blood clots or skin breakdown. 3. Insisting on sitting or lying down may aggravate the client and worsen the situation. 4. Providing high-calorie drinks or activities therapy are not the immediate priority in this case. In summary, assessing for lower extremity edema is crucial due to the client's prolonged standing, which can lead to potential health risks, making it the priority nursing order.
Question 5 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 because it demonstrates empathy and validates the patient's feelings without agreeing with the delusion. By acknowledging the patient's fear, the nurse can establish trust and rapport, which are crucial in therapeutic communication. This response shows understanding and compassion, helping to de-escalate the situation and provide a supportive environment for the patient. Choice A is incorrect as it denies the patient's belief and may lead to increased agitation. Choice B is incorrect as it challenges the patient's delusion, which can worsen the situation and lead to further confrontation. Choice D is incorrect as it dismisses the patient's feelings and may cause the patient to become defensive or feel misunderstood.