ATI RN
Age Specific Patient Care Quizlet Questions
Question 1 of 5
A patient whose boyfriend raped her during an argument tells the nurse, 'It's no use reporting it. No one will ever believe me, because everyone knows I've been sexually intimate with him many times before.' Which response by the nurse would have the greatest therapeutic value initially?
Correct Answer: D
Rationale: Rationale for Correct Answer D: 1. Acknowledges the patient's agency and emphasizes consent. 2. Validates the patient's experience and emphasizes boundaries. 3. Encourages the patient to prioritize her safety and well-being. 4. Addresses the need for intervention and prevention of future harm. Summary: A: Does not address the issue of consent or the need for intervention. B: Shifts focus from perpetrator to victim, potentially placing blame. C: Focuses on legal action without addressing the patient's emotional needs. D: Empowers the patient, emphasizes consent, and prioritizes safety and prevention.
Question 2 of 5
A 19-year-old client is admitted for the second time in 9 months and is acutely psychotic with a diagnosis of undifferentiated schizophrenia. The client sits alone rubbing her arms and smiling. She tells the nurse her thoughts cause earthquakes and that the world is burning. The nurse assesses the primary deficit associated with the client's condition as:
Correct Answer: B
Rationale: The correct answer is B: Disturbed thinking. In this scenario, the client's belief that her thoughts cause earthquakes and the world is burning are examples of delusions, which are a key symptom of schizophrenia. This demonstrates a disturbance in the client's thought process, indicating a primary deficit in thinking. Altered mood states (A) may be present as well but are not the primary deficit in this case. Social isolation (C) is a consequence of the client's symptoms rather than the primary deficit. Poor impulse control (D) is not the primary issue presented in the scenario.
Question 3 of 5
A client with undifferentiated schizophrenia is readmitted for an acute exacerbation of the disorder. The goal of hospitalization is symptom stabilization. The nurse has documented that, in addition to experiencing auditory hallucinations, the client seems uninterested in activities, has difficulty completing tasks, seems forgetful, and seems puzzled by information and directions given by staff. The nurse's plans for intervention will be effective if these behaviors are attributed to:
Correct Answer: D
Rationale: The correct answer is D: Problems in cognitive functioning. In undifferentiated schizophrenia, cognitive deficits such as difficulty completing tasks, forgetfulness, and confusion are common symptoms. These behaviors are indicative of cognitive impairment rather than social isolation, deficient knowledge, or low self-esteem. Cognitive deficits in schizophrenia can affect memory, attention, and problem-solving abilities, leading to difficulties in daily functioning. Therefore, the nurse's interventions should focus on addressing these cognitive impairments to stabilize the client's symptoms.
Question 4 of 5
A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:
Correct Answer: B
Rationale: The correct answer is B: olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that addresses both positive and negative symptoms of schizophrenia. In this case, the patient still experiences negative symptoms like apathy, poverty of thought, and social withdrawal. Olanzapine has been shown to be effective in improving negative symptoms and overall functioning in patients with schizophrenia. A: haloperidol is a typical (first-generation) antipsychotic that primarily targets positive symptoms like hallucinations, not negative symptoms. C: diphenhydramine is an antihistamine with no known efficacy for treating schizophrenia symptoms. D: chlorpromazine is a typical antipsychotic like haloperidol and is not typically used for addressing negative symptoms.
Question 5 of 5
The nurse notes that a male client, who is taking an antipsychotic medication, is constantly moving from chair to chair during a group activity, and he complains that he feels 'nervous and jittery inside.' The nurse is aware that this client most likely is experiencing:
Correct Answer: D
Rationale: The correct answer is D: Akathisia. Akathisia is a common side effect of antipsychotic medications characterized by an inner feeling of restlessness and an inability to sit still. In this case, the client's constant movement and complaints of feeling 'nervous and jittery inside' align with the symptoms of akathisia. A: Akinesia refers to a lack of movement or muscle weakness, which is not consistent with the client's presentation. B: Dystonia is a movement disorder characterized by involuntary muscle contractions, typically presenting as sustained muscle contractions or abnormal postures. C: Dyskinesia refers to abnormal, involuntary movements, which are not reflective of the client's symptoms in this scenario. In summary, the client's symptoms of restlessness and inability to sit still indicate that he is likely experiencing akathisia, making option D the correct choice.