ATI RN
Age Specific Considerations in Patient Care Questions
Question 1 of 5
A patient with anorexia nervosa is at risk for refeeding syndrome. The nurse should be most concerned with:
Correct Answer: B
Rationale: The correct answer is B: Electrolyte imbalances, particularly hypophosphatemia. Refeeding syndrome occurs when a malnourished individual receives nutrition too quickly, leading to shifts in electrolytes like phosphate, potassium, and magnesium. Hypophosphatemia is a key concern due to its potential to cause cardiac and respiratory failure. Hyperglycemia (A) may occur but is not the primary concern. Increased hunger and overeating (C) are common symptoms of anorexia nervosa but not directly related to refeeding syndrome. Rapid weight gain and hypertension (D) are potential consequences of refeeding but are not the immediate concern compared to electrolyte imbalances.
Question 2 of 5
A client with borderline personality disorder is having difficulty with memories of sexual abuse. She has a history of suicidal gestures, self-mutilation, sexual addiction, and substance addiction. She complains of vague pains, menstrual problems, and headaches. She entered the partial hospital program to prevent another suicide gesture or self-mutilation. The nurse recognizes that collaborative therapy may be helpful for this client and knows that the most useful collaboration in this case would be the client, the nurse, and the:
Correct Answer: A
Rationale: The correct answer is A: Occupational therapist exploring ways to reduce stress. In this case, the client's symptoms and history suggest complex emotional issues related to trauma and addiction. Occupational therapy can help the client develop coping skills, manage stress, and improve functioning in daily activities. The therapist can work collaboratively with the client and nurse to address the client's emotional, physical, and social needs. Choice B: Physical therapist exploring ways to reduce back pain focuses only on physical symptoms and does not address the underlying emotional issues. Choice C: Acupuncturist exploring ways to reduce pain also only addresses physical symptoms and does not provide comprehensive support for the client's mental health. Choice D: Sexologist exploring healthy sexuality and safe sex is not the most immediate need for the client, as her primary concerns are related to trauma, self-harm, and addiction.
Question 3 of 5
Which is a hallmark characteristic of bulimia nervosa?
Correct Answer: B
Rationale: The correct answer is B because bulimia nervosa is characterized by recurrent episodes of binge eating followed by compensatory behaviors such as purging. Binge eating involves consuming a large amount of food in a short period, followed by feelings of loss of control. Purging behaviors like self-induced vomiting or misuse of laxatives are used to prevent weight gain. Choices A, C, and D are incorrect because bulimia nervosa typically involves normal or fluctuating weight, not severe weight loss or excessive exercise to burn calories. Persistent restriction of caloric intake is more indicative of anorexia nervosa, not bulimia nervosa.
Question 4 of 5
The client tells the nurse, 'My husband left to go bowling with his buddies, so I had to cut myself.' The nurse using the SET method of communication will use as the initial response:
Correct Answer: B
Rationale: The correct answer is B: "It concerns me to hear that you took that action." The rationale for this is that this response demonstrates empathy and concern for the client's well-being, which is essential in building a therapeutic relationship. It acknowledges the client's statement without judgment and opens the door for further exploration of the client's feelings and reasoning behind the self-harm. Choice A: "Tell me what made you think of that action" may come across as too direct and could be perceived as insensitive or confrontational, potentially shutting down communication. Choice C: "You should have called your psychiatrist" is dismissive and fails to address the client's emotional needs or offer support. Choice D: "What can I do to help you now that you're here?" is forward-thinking and assumes the client is seeking help, which may not be the case. It also does not directly address the concerning behavior of self-harm.
Question 5 of 5
Which nursing strategy leads patients to respond more positivity to limit setting?
Correct Answer: C
Rationale: The correct answer is C because reflecting back to the patient an understanding of their distress shows empathy and validation, which can help build rapport and trust. By acknowledging the patient's feelings, it can help them feel heard and understood, leading to a more positive response to limit setting. Choice A is incorrect because confrontation can lead to defensiveness and resistance. Choice B focuses on exploring underlying dynamics without addressing the immediate behavior. Choice D may come off as judgmental and punitive, potentially escalating the situation.