ATI RN
Population Based Care Questions
Question 1 of 5
An Arab student new to an elementary school reports, 'I just don't want to go to gym class.' Which factor would be of primary concern for a school nurse?
Correct Answer: B
Rationale: The correct answer is B because the primary concern for the school nurse would be addressing any potential bullying the Arab student is experiencing in gym class. This is important for the student's well-being and mental health. Choice A is not the primary concern as it does not directly address the student's reluctance to attend gym class. Choice C focuses on general adjustment issues, while choice D pertains to a logistical issue rather than the student's emotional or social well-being. Addressing bullying is crucial to creating a safe and inclusive environment for the student.
Question 2 of 5
A client who has been diagnosed as having paranoid schizophrenia is highly suspicious and delusional. He hears voices telling him terrorists are plotting to assassinate him. He refuses to eat, saying the food is poisoned. The nursing action that best addresses his needs is to:
Correct Answer: B
Rationale: The correct answer is B: Allow client to select food from vending machines. This option respects the client's autonomy and addresses his delusion about the food being poisoned. By allowing the client to choose food from vending machines, it acknowledges his concerns and promotes a sense of control over his environment. This approach can help build trust and rapport with the client, as forcing him to eat regular hospital food might exacerbate his paranoia and resistance. A: Explaining that others eat the food and are not harmed may not be effective as it disregards the client's beliefs and could further alienate him. C: Assisting with personal hygiene and grooming is important but does not directly address the client's primary concern of refusing to eat due to delusional beliefs. D: Not allowing the client to verbalize delusional thoughts is counterproductive as it suppresses communication and does not address the underlying issue of the client's fear of being poisoned.
Question 3 of 5
A patient received maintenance doses of fluphenazine decanoate (Prolixin Decanoate) 25 mg IM every 2 weeks for 2 years. The clinic nurse notes the patient is grimacing and seems to be constantly smacking her lips. On the next clinic visit, the patient's neck and shoulders twist in a slow, snakelike motion. The nurse should suspect the presence of ______ and should ______.
Correct Answer: B
Rationale: Step 1: The patient is showing signs of abnormal movements like lip smacking, grimacing, and snakelike motions, which are indicative of tardive dyskinesia (TD). Step 2: TD is a side effect of long-term antipsychotic use, such as fluphenazine decanoate. Step 3: The Abnormal Involuntary Movement Scale is a validated tool to assess the severity of TD. Step 4: Administering the Abnormal Involuntary Movement Scale will help confirm the diagnosis of TD. Step 5: Prompt recognition of TD is crucial as it may be irreversible and can worsen over time if not addressed. Summary: - A: Agranulocytosis is a condition characterized by low white blood cell count, not related to the patient's symptoms. - C: Tourette's syndrome presents with different symptoms and requires specialized evaluation. - D: Anticholinergic effects do not typically manifest as the described
Question 4 of 5
A nurse observes a patient who is sitting alone in a room put hands over both ears and vigorously shake her head as though saying, 'No.' Later the patient cries and mutters, 'You don't know what you're talking about! Leave me alone.' What assessment should the nurse attempt to validate?
Correct Answer: C
Rationale: The correct answer is C because the patient's behavior indicates a possible experience of auditory hallucinations. The patient covering both ears and shaking her head could be an attempt to block out voices or sounds she is hearing. The subsequent crying and muttering could be a response to these hallucinations. Choice A is incorrect because the patient's behavior does not necessarily indicate a desire for attention. Choice B is incorrect because the patient's emotional expression is not the primary focus of the behavior. Choice D is incorrect because negative symptoms of schizophrenia typically involve a decrease in emotional expression or motivation, which is not evident in this scenario.
Question 5 of 5
A woman has concerns about a man she recently began to date. She confides to her friend, a nurse in the clinic, that she recently discovered that he had been charged with domestic violence in a previous relationship. She asks if this means he will also hurt her and what signs would indicate that he is likely to be abusive. What should the nurse tell her friend?
Correct Answer: C
Rationale: The correct answer is C because it provides specific warning signs of potential abuse, such as pathological jealousy and controlling behavior. These behaviors are often early indicators of an abusive relationship. Option A is incorrect as past behavior can indicate future behavior. Option B is not correct as abuse can occur in any type of relationship. Option D is also incorrect as it implies that abuse is the fault of the victim, which is not true. It is important to educate the woman on recognizing red flags and seeking help if needed.