ATI RN
Age Specific Considerations in Patient Care Questions
Question 1 of 5
The client tells the nurse, 'My husband left to go bowling with his buddies, so I had to cut myself.' The nurse using the SET method of communication will use as the initial response:
Correct Answer: B
Rationale: The correct answer is B: "It concerns me to hear that you took that action." The rationale for this is that this response demonstrates empathy and concern for the client's well-being, which is essential in building a therapeutic relationship. It acknowledges the client's statement without judgment and opens the door for further exploration of the client's feelings and reasoning behind the self-harm. Choice A: "Tell me what made you think of that action" may come across as too direct and could be perceived as insensitive or confrontational, potentially shutting down communication. Choice C: "You should have called your psychiatrist" is dismissive and fails to address the client's emotional needs or offer support. Choice D: "What can I do to help you now that you're here?" is forward-thinking and assumes the client is seeking help, which may not be the case. It also does not directly address the concerning behavior of self-harm.
Question 2 of 5
A patient with paranoid personality disorder is noted to sit alone in a corner of the unit living room. When anyone approaches, the patient is haughty or simply ignores the other person. When staff invite her to join an activity, she tells them, 'I do not care to be with people who do not like me.' A nursing diagnosis that should be considered is:
Correct Answer: D
Rationale: The correct answer is D: impaired social interaction. This patient's behavior of sitting alone, being haughty, and refusing to engage with others indicates difficulty in social interactions. The patient's belief that others do not like her also suggests social challenges. Impaired social interaction relates to difficulty in establishing or maintaining relationships. A: Splitting is a defense mechanism where the patient views people as all good or all bad, which is not evident in this scenario. B: Activity intolerance refers to insufficient physiological or psychological energy to endure or complete required or desired daily activities. This does not apply here. C: Powerlessness refers to the perception of lack of control over a situation, which is not the primary issue in this case.
Question 3 of 5
A teacher comes to the mental health clinic saying a co-worker recently confronted her about behaviors that are annoying to other co-workers. She is now experiencing moderate to severe levels of anxiety. The co-worker told the patient that others find her very difficult because she is a perfectionist and micromanages the tasks of others on the teaching team, always demanding that things should be done according to her plans. The co-worker mentioned that the patient made everyone feel as though everything they tried was inadequate, and they feel frustrated and angry. The patient states she likes her co-workers and only wanted to help them be successful. The nurse realizes the patient's behaviors are most consistent with:
Correct Answer: A
Rationale: The correct answer is A: obsessive-compulsive personality disorder. This is because the patient's behaviors of being a perfectionist, micromanaging tasks, demanding things be done according to her plans, and making others feel inadequate align with the diagnostic criteria for obsessive-compulsive personality disorder. Individuals with this disorder are preoccupied with orderliness, perfectionism, and control. Choice B: narcissistic personality disorder, is incorrect because the patient's behaviors are not characterized by a sense of grandiosity, a lack of empathy, or a need for admiration, which are hallmark features of narcissistic personality disorder. Choice C: histrionic personality disorder, is incorrect as individuals with this disorder typically display attention-seeking behavior, emotional instability, and excessive emotionality, none of which are evident in the patient's presentation. Choice D: schizoid personality disorder, is incorrect as individuals with this disorder tend to be socially detached, have limited emotional expression, and prefer solitary activities, which do not align with the
Question 4 of 5
Which complication is most likely in a patient with bulimia nervosa who purges frequently?
Correct Answer: A
Rationale: The correct answer is A: Dehydration and electrolyte imbalances. Purging in bulimia nervosa involves self-induced vomiting or misuse of laxatives, leading to fluid and electrolyte loss. This can result in dehydration, electrolyte imbalances, and potentially life-threatening complications like cardiac arrhythmias. Increased appetite and weight gain (B) are less likely due to purging. Improved digestion and nutrient absorption (C) are not associated with frequent purging. High blood pressure and rapid heart rate (D) may occur in severe cases but are not the most likely complication.
Question 5 of 5
Which of the following is a common physical sign in patients with bulimia nervosa?
Correct Answer: B
Rationale: The correct answer is B: Dental erosion and swollen parotid glands are common physical signs in patients with bulimia nervosa. Dental erosion is caused by repeated exposure of teeth to stomach acid during purging. Swollen parotid glands result from repeated vomiting. Hypotension and bradycardia (A) are more common in anorexia nervosa. Rapid weight gain and increased appetite (C) are not typical in bulimia nervosa; rather, patients often maintain a normal weight. Severe muscle wasting and low body temperature (D) are not commonly associated with bulimia nervosa.