ATI RN
Age Specific Care Questions
Question 1 of 5
Police bring a 63-year-old woman to the emergency room, reporting that her behavior is disorganized and disruptive, that her speech makes little sense, and that she does not seem able to take care of herself. The woman has had elective surgeries at the hospital previously and was seen in the ER last week after a fall; records show no history of similar symptoms or mental illness. The ER physician speaks with the patient but does not examine her medically, diagnoses her with schizophrenia, and orders admission to the inpatient psychiatric unit. Which response by the nurse would be most appropriate?
Correct Answer: C
Rationale: The correct answer is C because it demonstrates critical thinking and patient advocacy. By reminding the physician that schizophrenia typically develops earlier in life and suggesting a medical work-up, the nurse is advocating for a comprehensive approach to ruling out potential medical causes for the patient's symptoms before jumping to a psychiatric diagnosis. This approach aligns with best practices in patient care and ensures that all possible underlying causes are considered and addressed appropriately. Choice A is incorrect because it does not address the need for a medical work-up to rule out physical causes of the symptoms. Choice B is incorrect as it focuses on validating the diagnosis and initiating medication rather than investigating potential medical issues. Choice D is incorrect as it only addresses the patient's vital signs, overlooking the need for a thorough medical evaluation.
Question 2 of 5
Several children a day are seen in the emergency department for treatment of illnesses and injuries. The situation that would create a high index of suspicion of child abuse is a child who:
Correct Answer: C
Rationale: The correct answer is C because perineal bruises and urinary tract infections are physical signs that are highly suspicious for child abuse, particularly sexual abuse. Perineal bruises are not commonly seen in children due to accidental injuries, and urinary tract infections in young children are rare and may indicate sexual abuse. Repeated middle ear infections (choice A) and complaints of abdominal cramps and upset stomach (choice B) are common childhood illnesses that do not necessarily indicate child abuse. Displaying reduced functioning at school (choice D) may suggest various issues such as learning disabilities or emotional distress, but is not specific to child abuse.
Question 3 of 5
The nursing diagnosis Rape-trauma syndrome is established for a rape victim in the emergency department. Select the most important outcome to achieve before discharging the patient!
Correct Answer: D
Rationale: The correct answer is D. Establishing a follow-up appointment with a rape victim advocate is crucial for ongoing support and recovery. It ensures the patient has access to necessary resources and assistance in coping with the trauma. Choice A focuses on emotional well-being but doesn't address long-term support. Choice B addresses memory but doesn't ensure ongoing care. Choice C only addresses physical symptoms, neglecting the emotional and psychological impact of the trauma. Thus, choice D is the most important outcome to achieve before discharging the patient to promote comprehensive care and support.
Question 4 of 5
A child, age 9, is being evaluated in the Emergency Department at the hospital. Her mother reports that the child fell down the stairs in her home. Her mother is with her and describes her as a 'clumsy kid.' The nurse practitioner suspects child abuse. Which of these findings indicates that physical abuse may be a chronic problem for the child?
Correct Answer: B
Rationale: The correct answer is B - Unhealed fractures revealed on x-ray. This finding indicates chronic physical abuse as unhealed fractures suggest repeated trauma over time. This is concerning because chronic abuse can lead to severe physical and emotional consequences for the child. A: Bloody nose and blackened eyes may indicate acute physical abuse, but not necessarily chronic abuse. C: Clinging to her mother as she attempted to leave is a behavior often seen in children who are anxious or scared in a medical setting, but it does not specifically indicate chronic physical abuse. D: Struggling with the staff that attempts to obtain a blood specimen could be a response to fear or discomfort with medical procedures, which does not definitively point to chronic abuse.
Question 5 of 5
A client, age 34, has been physically abused by her husband five times during the past 2 years. During her last discussion with the nurse, the client stated, 'I probably should not keep going back to my husband, since he continues to abuse me.' The nurse is aware that the final decision to leave a batterer:
Correct Answer: B
Rationale: The correct answer is B: Is usually a gradual process that occurs over time. Rationale: 1. Leaving an abusive partner is a complex and difficult decision that often requires careful planning and support. 2. Victims may face various barriers such as financial dependence, emotional attachment, and fear of further violence. 3. It is rare for victims to abruptly leave without considering their safety and well-being. 4. The statement 'I probably should not keep going back' indicates a gradual realization and contemplation of leaving. Summary: A: The decision to leave is not solely based on serious injury; victims may leave before any significant harm occurs. C: Approval from the church may influence the victim's decision but is not a determining factor. D: Leaving an abusive partner should not require the batterer's permission; it is a personal choice made by the victim.