ATI RN
Age Specific Care Competency Questions
Question 1 of 5
A patient with an eating disorder states, 'I heard people laughing behind me in the check-out line at the department store. I bet they thought it was hysterically funny that I gained a pound in the last few days.' The nurse documents that the patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?
Correct Answer: B
Rationale: The correct answer is B: Personalization. Personalization is a cognitive distortion where an individual takes responsibility for events that are not entirely their fault. In this scenario, the patient is attributing the laughter of people in the check-out line to being about them and their weight gain, when in reality, the laughter may have had nothing to do with them. This distortion can contribute to feelings of guilt, shame, and self-blame. A: Magnification involves exaggerating the importance or meaning of an event, which is not evident in the scenario. C: Overgeneralization involves making broad negative conclusions based on a single event, which is not demonstrated here. D: Dichotomous thinking is the tendency to view situations in black and white terms, with no middle ground, which is not present in the patient's statement.
Question 2 of 5
What is a common consequence of repeated purging behaviors in bulimia nervosa?
Correct Answer: A
Rationale: The correct answer is A: Cardiovascular instability due to electrolyte imbalances. Repeated purging in bulimia nervosa leads to electrolyte imbalances, particularly hypokalemia, which can result in cardiovascular instability like arrhythmias and cardiac arrest. Other choices are incorrect. B is false as purging behaviors do not improve body image or self-esteem. C is incorrect as purging does not lead to increased appetite and healthy weight gain, rather it disrupts normal metabolism. D is also incorrect as purging behaviors actually increase the risk of gastrointestinal complications.
Question 3 of 5
A client with a borderline personality disorder tells the nurse, 'My doctor tells me there's something wrong with the hard wiring of my brain, and that's why I'm so impulsive and get so many mood swings. He said he's going to prescribe some medication.' Being aware of current practice guidelines, the nurse will prepare a teaching plan for:
Correct Answer: B
Rationale: The correct answer is B: Fluoxetine. In the context of borderline personality disorder, fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is often used to manage symptoms such as mood swings and impulsivity. SSRIs help regulate serotonin levels in the brain, which can improve mood stability and reduce impulsive behaviors. - A: Lithium is typically used for bipolar disorder, not borderline personality disorder. - C: Lorazepam is a benzodiazepine used for anxiety or panic disorders, not specific to treating symptoms of borderline personality disorder. - D: Haloperidol is an antipsychotic medication used for psychosis, not typically indicated for managing impulsivity or mood swings in borderline personality disorder.
Question 4 of 5
An appropriate outcome for a patient with a personality disorder and a nursing diagnosis of Ineffective coping as evidenced by use of manipulation would be that the patient will:
Correct Answer: C
Rationale: Rationale: Choice C is correct as it focuses on the patient acknowledging manipulative behavior when pointed out. This is important for growth and self-awareness in handling emotions and behaviors effectively. Choices A and B are extreme and unrealistic expectations, as complete cessation or selective use of manipulation may not be achievable. Choice D is irrelevant to the nursing diagnosis and does not address the core issue of ineffective coping through manipulation.
Question 5 of 5
A patient with borderline personality disorder cut her wrists while out on a pass. For future planning, staff should consider that the reason for the self-mutilation is probably related to:
Correct Answer: B
Rationale: Correct Answer: B Rationale: 1. Borderline personality disorder is characterized by fear of abandonment. 2. Self-mutilation can be a maladaptive coping mechanism to alleviate this fear. 3. The behavior is often triggered by perceived threats to relationships or autonomy. 4. Therefore, considering fear of abandonment in future planning is crucial. Summary of other choices: A: Inherited disorder is not the primary reason for self-mutilation in borderline personality disorder. C: Projective identification and splitting are defense mechanisms, not primary reasons for self-mutilation. D: Constitutional inability to regulate affect may contribute, but fear of abandonment is more central in borderline personality disorder.