ATI RN
Population Based Care Questions
Question 1 of 5
A woman became severely depressed when the last of her six children moved out of the home 4 months ago. Since then she has neglected to care for herself, sleeps poorly, lost weight, and repeatedly states, "No one cares about me anymore. I'm worthless." After hospitalization, the nursing diagnosis of situational low self-esteem related to feelings of abandonment was identified. The nurse wishes to reinforce the patient's self-esteem by acknowledging the improvement in her personal appearance. She's wearing a new dress and has combed her hair. The most appropriate remark would be:
Correct Answer: A
Rationale: The correct answer is A because it directly compliments Mrs. J's personal appearance, reinforcing her self-esteem. By stating "You look very nice this morning, Mrs. J," the nurse acknowledges and validates Mrs. J's efforts to improve her appearance, which can help boost her self-esteem. Choice B focuses solely on the dress, not directly addressing Mrs. J's overall appearance. Choice C may come across as insincere or too focused on the transformation rather than Mrs. J herself. Choice D, while acknowledging the hair and dress, lacks the personal and direct compliment needed to reinforce self-esteem effectively. In summary, choice A is the best option as it provides a genuine and direct compliment that can positively impact Mrs. J's self-esteem.
Question 2 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 has been shown to effectively target negative symptoms of schizophrenia, such as apathy, poverty of thought, and social isolation. It also helps with mood stabilization and cognitive function, which can improve the patient's ability to work and engage in social interactions. Choice A: Haloperidol (Haldol) is a typical (first-generation) antipsychotic like the current medication, which is less effective in treating negative symptoms and can potentially worsen them. Choice C: Diphenhydramine (Benadryl) is an antihistamine and not indicated for treating schizophrenia symptoms. Choice D: Chlorpromazine (Thorazine) is another typical (first-generation) antipsychotic, similar to the current medication, and may not adequately address the negative symptoms the patient is experiencing.
Question 3 of 5
Which of the following interventions should the nurse plan to use to reduce client focus on delusional thinking?
Correct Answer: B
Rationale: The correct answer is B: Focusing on feelings suggested by the delusion. By addressing the underlying emotions associated with the delusion, the nurse can help the client process and cope with their feelings, ultimately reducing the intensity of the delusional thinking. Confronting the delusion (A) may lead to resistance and escalation. Refuting the delusion with logic (C) can be ineffective as it may reinforce the client's belief. Exploring reasons for the delusion (D) may not directly address the client's focus on delusional thinking.
Question 4 of 5
The wife of a client diagnosed with paranoid schizophrenia asks, 'I've been told that my husband's illness is probably related to imbalanced brain chemicals. Can you be more specific?' The response based on the dopamine hypothesis is:
Correct Answer: A
Rationale: Step-By-Step Rationale: 1. The dopamine hypothesis states that an increase in dopamine is linked to delusions and hallucinations in schizophrenia. 2. Delusions and hallucinations are common positive symptoms of schizophrenia. 3. Therefore, choice A is correct as it directly aligns with the dopamine hypothesis and the symptoms observed in paranoid schizophrenia. Summary of Incorrect Choices: B. Incorrect because an increase in dopamine is not typically associated with lack of motivation and disordered affect in schizophrenia. C. Incorrect because decreased amounts of dopamine are not linked to delusions and hallucinations in schizophrenia. D. Incorrect because the breakdown of dopamine producing LSD and causing psychosis is not supported by the dopamine hypothesis in schizophrenia.
Question 5 of 5
A client experiences intrusive, insulting auditory hallucinations. Which independent behavioral technique can the nurse teach the client to employ when the voices are troublesome?
Correct Answer: C
Rationale: The correct answer is C: Sing or whistle to compete with the voices. This technique is effective as it can help distract the client from the intrusive auditory hallucinations. By engaging in singing or whistling, the client can shift their focus away from the voices, making them less bothersome. This method can also empower the client by giving them a sense of control over the situation. Other choices are incorrect: A: Taking additional antipsychotic medication may not be necessary in this situation and should be prescribed by a healthcare provider. B: Lying down and trying to sleep may not address the immediate distress caused by the hallucinations. D: Eating a large portion of chocolate is not a valid behavioral technique for managing auditory hallucinations.