ATI RN
Age Specific Care Questions
Question 1 of 5
An acutely psychotic individual diagnosed with schizophreniaform disorder at admission is immediately placed on daily doses of risperidone. A hospitalization of 8 days' duration has been authorized by the HMO. By what hospital day would the nurse expect to note that client was demonstrating beginning trust in the nurse and reduction in hallucinations and delusions?
Correct Answer: B
Rationale: The correct answer is B: Day 3 of hospitalization. At this point, the risperidone medication would have had sufficient time to begin exerting its therapeutic effects on the individual's symptoms of hallucinations and delusions. It typically takes a few days for antipsychotic medications like risperidone to reach therapeutic levels in the body and start alleviating psychotic symptoms. By day 3, the individual may start to demonstrate improved trust in the nurse due to the reduction in distressing symptoms. Incorrect options: A: Day of admission - It is unlikely to see significant improvement in symptoms and trust on the same day of admission. C: Day 5 of hospitalization - By this time, the medication would have likely already started showing some effects, and the individual would have had some time to build trust with the nurse. D: Day 7 of hospitalization - Waiting until day 7 might be too late to note beginning trust and significant reduction in symptoms, as the
Question 2 of 5
A patient with the diagnosis of schizophrenia, disorganized type, approaches the nurse and says, 'It's beat, it's eat. No room for doom.' The nurse can correctly assess this verbalization as:
Correct Answer: B
Rationale: The correct answer is B: clanging. Clanging refers to the pattern of speech characterized by the association of words based on sound rather than meaning. In this case, the patient's verbalization, "It's beat, it's eat. No room for doom," demonstrates a connection based on rhyming sounds rather than coherent meaning. This is a classic example of clanging commonly seen in individuals with disorganized schizophrenia. Neologisms (choice A) refer to new words created by the individual, ideas of reference (choice C) involve believing that external events have special significance for oneself, and associative looseness (choice D) pertains to a lack of logical connection between thoughts. These choices are incorrect as they do not accurately describe the patient's speech pattern in this scenario.
Question 3 of 5
The physician and advanced practice nurse are considering which antipsychotic medication to prescribe for a patient with schizophrenia who demonstrates auditory hallucinations, apathy, anhedonia, and poor social functioning. The patient is overweight and has hypertension. Bearing these facts in mind, the drug the nurse should advocate would be:
Correct Answer: D
Rationale: The correct answer is D: aripiprazole (Abilify). Aripiprazole is a second-generation antipsychotic that is less likely to cause weight gain and metabolic side effects compared to other antipsychotics. This is important since the patient is already overweight and has hypertension. Aripiprazole also has a lower risk of causing sedation, which can be beneficial for addressing apathy and anhedonia without worsening social functioning. A: Clozapine is effective for treatment-resistant schizophrenia but is associated with significant weight gain and metabolic side effects. B: Haloperidol is a first-generation antipsychotic with a high risk of extrapyramidal side effects and is not ideal for a patient with hypertension. C: Olanzapine is known for causing significant weight gain and metabolic effects, making it a less suitable choice for an overweight patient with hypertension.
Question 4 of 5
The nursing diagnosis most likely to be used for a person who has a diagnosis of schizophrenia, paranoid type, is:
Correct Answer: A
Rationale: Step-by-step rationale for choice A: 1. Schizophrenia, paranoid type, involves mistrust and suspicion. 2. Impaired ability to trust can lead to social isolation. 3. "Impaired ability to trust" directly relates to social isolation. 4. Therefore, "social isolation related to impaired ability to trust" is the most likely nursing diagnosis. Summary of other choices: - B: Not directly related to mistrust in paranoid schizophrenia. - C: Lack of confidence in significant others is not a defining characteristic of paranoid schizophrenia. - D: Impaired memory is not a primary feature of paranoid schizophrenia.
Question 5 of 5
A patient diagnosed with schizophrenia approaches the nurse and says, 'Cats eat birds. East now. Job is new. You father.' This speech pattern can be assessed as:
Correct Answer: C
Rationale: The correct answer is C: loose associations. This speech pattern is characteristic of loose associations seen in schizophrenia, where thoughts are disorganized and lack logical connections. The patient's statements lack coherence and jump from one topic to another without a clear link. Hyperverbosity (A) refers to excessive speech without a clear point, which is not evident in this scenario. Circumstantiality (B) involves excessive detail before reaching the main point, which is not present here. Expressing delusions (D) would involve holding false beliefs, which are not explicitly stated in the patient's speech.