ATI RN
Age Specific Populations Questions
Question 1 of 5
A patient with catatonic schizophrenia exhibits little spontaneous movement and demonstrates waxy flexibility. Which nursing intervention should receive the highest priority?
Correct Answer: A
Rationale: The correct answer is A: Conducting passive range-of-motion exercises. This intervention is the highest priority because it addresses the physical needs of the patient by preventing complications such as muscle stiffness and contractures due to prolonged immobility. Passive range-of-motion exercises also promote circulation and prevent pressure ulcers. Choice B is incorrect because excessive stimuli can overwhelm the patient. Choice C is incorrect as it assumes the patient is responding when they may not be. Choice D is incorrect as the patient may not be ready or able to participate in activities due to their catatonic state.
Question 2 of 5
A client with paranoid schizophrenia has said she feels like throwing a chair. The nurse in the dayroom hears this and wishes to encourage verbalization as a desecalation technique. Which response by the nurse would fulfill this plan?
Correct Answer: A
Rationale: The correct answer is A because it encourages the client to express their feelings verbally, promoting communication and potentially preventing escalation of behavior. By saying "Tell me what's going on," the nurse acknowledges the client's emotions and creates a safe space for them to talk. Option B threatens restraint, likely increasing tension. Option C may come off as confrontational. Option D distracts from the immediate need for the client to process their feelings.
Question 3 of 5
Because of the cognitive disturbances associated with schizophrenia, which technique will be useful as the nurse teaches a client about self-management?
Correct Answer: A
Rationale: The correct answer is A because teaching material in small segments is effective for individuals with cognitive disturbances like schizophrenia, as it helps improve comprehension and retention. Breaking down information into manageable parts reduces cognitive overload and enhances learning. Choice B is incorrect as relying solely on verbal instruction may be challenging for individuals with cognitive deficits. Choice C is incorrect because a stimulated and busy environment may hinder learning for someone with schizophrenia due to difficulty focusing. Choice D is incorrect as offering too many choices can be overwhelming and confusing, especially for those with cognitive disturbances.
Question 4 of 5
When a patient diagnosed with paranoid schizophrenia was discharged from the unit 6 months ago, the plan was for him to take chlorpromazine (Thorazine), a conventional (first generation) antipsychotic medication, 300 mg po daily. He tells the nurse he stopped taking his pills after a few months because they made him feel like a 'zombie.' What other common side effects should the nurse determine if the patient experienced?
Correct Answer: B
Rationale: The correct answer is B: Sedation, tremor, and muscle stiffness. This is because chlorpromazine, being a first-generation antipsychotic, commonly causes sedation, tremors, and muscle stiffness as side effects. Sedation is a common effect due to the drug's ability to block dopamine receptors in the brain. Tremors and muscle stiffness are also common due to the drug's action on the central nervous system. Choices A, C, and D are incorrect as they do not align with the expected side effects of chlorpromazine. Sweating, nausea, weight gain, headache, watery eyes, runny nose, mild fever, sore throat, and skin rash are not typically associated with this medication.
Question 5 of 5
A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient's skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient's recent presentation. The patient is likely experiencing _____, and the nurse should _____.
Correct Answer: A
Rationale: The correct answer is A: anticholinergic toxicity. The patient is displaying symptoms such as restlessness, disorganized behavior, nonsensical verbal responses, disorientation, hot and dry skin, and dilated pupils, which are indicative of anticholinergic toxicity. Step-by-step rationale: 1. Restlessness and disorganized behavior are common symptoms of anticholinergic toxicity. 2. Nonsensical verbal responses and disorientation are also typical signs of anticholinergic toxicity. 3. Hot and dry skin can be caused by decreased sweating due to anticholinergic effects. 4. Dilated pupils are a classic sign of anticholinergic toxicity. 5. Checking vital signs and preparing to use a cooling blanket is the appropriate immediate action to manage anticholinergic toxicity. Summary of other choices: - B: Relapse of psychosis does not explain the physical symptoms like dilated pupils and hot/dry skin. - C: Neuroleptic malignant syndrome presents with