ATI RN
Age Specific Patient Care Questions
Question 1 of 5
Many persons brought before a criminal court have mental illness, have committed minor offenses, and are off medications. The judge consults the nurse at the local community mental health center for guidance about how to respond when handling such cases. Which advice from the nurse would be most appropriate?
Correct Answer: B
Rationale: Research supports the use of special mental health courts that can sentence mentally ill persons to treatment instead of jail. Jail exposes vulnerable mentally ill persons to criminals, victimization, and high levels of stimulation and stress. Incarceration can also interrupt eligibility for benefits or lead to the loss of housing and often provides lower-quality mental health treatment in other settings. Recidivism rates for both mentally ill and non-mentally ill offenders are relatively high, so it does not appear that incarceration necessarily leads people to behave more appropriately. In addition, a criminal record can leave them more desperate and with fewer options after release. Research indicates that outpatient commitment is less effective at improving the mental health of mentally ill persons than was expected.
Question 2 of 5
A parent who is very concerned about a 3-year-old son says, 'He likes to play with girls' toys. Do you think he is homosexual or mentally ill?' Which response by the nurse most professionally describes the current understanding of gender identity?
Correct Answer: A
Rationale: The correct answer is A because it accurately reflects the current understanding of gender identity. Children's interests in activities typically associated with the opposite gender are not unusual and are not indicative of sexual orientation or mental illness. Most children who exhibit cross-gender interests do not carry these into adulthood. This response emphasizes the normalcy of such behavior and provides reassurance to the parent. Choice B is incorrect because it implies uncertainty based on incomplete research, which goes against the established understanding that cross-gender interests in childhood are common and not predictive of future outcomes. Choice C is incorrect because it focuses on incomplete research and uses the term "normal as adults," which can perpetuate stigmas surrounding gender expression. Choice D is incorrect because it does not address the parent's concerns about the child's behavior and does not provide accurate information about gender identity development.
Question 3 of 5
A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 g sodium diet, restraint as needed, limit fluids to 1800 mL daily, continue antihypertensive medication, milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should
Correct Answer: B
Rationale: The correct answer is B: question the order for restraint. Restraints should only be used as a last resort due to the potential risks and ethical considerations. In this scenario, the prescription of restraint seems unnecessary and should be questioned to ensure the resident's safety and well-being. The other choices are incorrect because questioning the fluid restriction (A) is not necessary as it aligns with the resident's needs, transcribing the prescriptions as written (C) would be inappropriate without considering the necessity of each order, and assessing the resident's bowel elimination (D) is important but not the immediate concern indicated by the order for restraint.
Question 4 of 5
An 18-year-old referred to the mental health center often cooks gourmet meals but eats only tiny portions. The patient wears layers of loose clothing saying, "I like the style." The patient's weight dropped from 130 to 95 pounds. She has amenorrhea. Which diagnosis is most likely?
Correct Answer: B
Rationale: The correct diagnosis is B: Anorexia nervosa. This patient exhibits key symptoms such as restrictive eating leading to significant weight loss, wearing layers of clothing to hide body shape, and amenorrhea. These symptoms align with the diagnostic criteria for anorexia nervosa. The other choices are incorrect because they do not fully capture the combination of symptoms present in this case. Choice A (Eating disorder not otherwise specified) is too broad and does not specify the severity of the symptoms. Choice C (Bulimia nervosa) typically involves binge eating followed by compensatory behaviors, which is not indicated in this case. Choice D (Binge eating) focuses solely on overeating without the restrictive eating and weight loss seen in anorexia nervosa.
Question 5 of 5
A patient admitted to the eating disorders unit has yellow skin, the extremities are cold, and the heart rate is 42 bpm. The patient weighs 70 pounds; height is 5 feet 4 inches. The patient is quiet during the assessment saying only, "I will not eat until I lose enough weight to look thin." Select the best initial nursing diagnosis.
Correct Answer: D
Rationale: The correct initial nursing diagnosis is D: Imbalanced nutrition: less than body requirements related to self-starvation. The patient's symptoms indicate severe malnutrition from self-starvation, leading to the yellow skin, cold extremities, low heart rate, and underweight status. The patient's statement reflects their distorted perception of body image and the extreme measures taken to achieve thinness. Choice A (Anxiety related to fear of weight gain) is not the best initial diagnosis as it focuses on anxiety rather than the critical issue of malnutrition. Choice B (Disturbed body image related to weight loss) is not the best initial diagnosis as it does not address the immediate risk of severe malnutrition. Choice C (Ineffective coping related to lack of conflict resolution skills) is not the best initial diagnosis as it does not prioritize the life-threatening malnutrition present in this case.