ATI RN
Population Based Health Care Questions
Question 1 of 5
An expected outcome for a client who hears voices telling him he is evil would be that by discharge, client will:
Correct Answer: C
Rationale: The correct answer is C because it focuses on addressing the underlying causes of the client's experience of hearing voices and feeling evil. By identifying events that increase anxiety and promote hallucinations, the client can work on reducing these triggers and managing his symptoms effectively. This approach is key for long-term improvement and recovery. A: Verbalizing the reason the voices say he is evil does not address the root cause of the hallucinations and may not lead to effective coping strategies. B: Responding verbally to the voices may not be therapeutic and could potentially reinforce the hallucinations. D: Integrating the voices into his personality structure in a positive manner is not a recommended approach as it could lead to further distress and potentially harmful behaviors.
Question 2 of 5
A patient was admitted to the mental health unit after arguing with co-workers and threatening to kill them. He is diagnosed with paranoid schizophrenia. On the unit he is aloof and suspicious. He mentioned that two physicians he saw talking were plotting to kill him. On the basis of data gathered at this point, which two primary nursing diagnoses should the nurse consider?
Correct Answer: A
Rationale: The correct answer is A: Disturbed thought processes and Risk for other-directed violence. 1. Disturbed thought processes: The patient's delusion of being plotted against by the physicians indicates impaired thought processes typical of paranoid schizophrenia. 2. Risk for other-directed violence: The patient's threatening behavior towards co-workers suggests a potential for violent acts towards others due to his paranoid beliefs. Summary of why other choices are incorrect: B: Spiritual distress and Social isolation are not primary concerns given the patient's acute symptoms of paranoia and risk for violence. C: Risk for loneliness and Knowledge deficit are not crucial at this point as the patient's primary issues are related to paranoia and violence. D: Disturbed personal identity and Nonadherence are not relevant to the immediate safety and mental health concerns presented by the patient.
Question 3 of 5
The wife of a patient with schizophrenia is worried about her 17-year-old daughter and asks the nurse what symptoms mark the prodromal stage of schizophrenia. The nurse should respond by listing behaviors such as:
Correct Answer: A
Rationale: The correct answer is A because the symptoms listed: withdrawal, poor concentration, phobic or obsessive behavior, and oddities of speech are characteristic of the prodromal stage of schizophrenia. During this phase, individuals may start to exhibit subtle changes in behavior and thinking, which may signal the onset of the disorder. Choice B includes symptoms of active psychosis, such as auditory hallucinations and delusions, which are not typically seen in the prodromal stage. Choice C describes symptoms of catatonia, which are not specific to the prodromal phase. Choice D includes symptoms of acute psychosis, such as paranoid delusions, which are not typically present during the prodromal stage. In summary, the correct answer is A because it accurately reflects the early, subtle symptoms that may precede the full onset of schizophrenia, while the other choices describe symptoms that are more indicative of later stages of the disorder.
Question 4 of 5
A patient with schizophrenia tells the nurse, 'Everyone must listen to me. I am the redeemer. I will bring peace to the world.' From this the nurse can determine that an appropriate nursing diagnosis is:
Correct Answer: C
Rationale: Step 1: The patient's statement indicates grandiosity and delusions of grandeur, common in schizophrenia. Step 2: Chronic low self-esteem is a common nursing diagnosis for those with grandiose delusions. Step 3: The patient's belief of being the redeemer suggests underlying feelings of inadequacy. Step 4: Addressing self-esteem can help the patient cope with such delusions. Summary: A is incorrect as there is no mention of auditory hallucinations. B is incorrect as there is no immediate threat of violence. D is incorrect as nonadherence to medication is not evident in the scenario.
Question 5 of 5
A useful strategy for helping a patient with schizophrenia manage a potential relapse is to:
Correct Answer: C
Rationale: The correct answer is C because teaching the patient and family about behaviors indicating an impending relapse helps in early detection and intervention. This empowers them to recognize warning signs like changes in behavior or mood, allowing for prompt action. Choice A (group therapy) may be beneficial for support but does not directly address relapse prevention. Choice B (medication adherence) is crucial but not specific to relapse management. Choice D (blood tests) is important for monitoring medication levels but does not focus on recognizing relapse indicators.