ATI RN
Use of Psychotropic Medications Questions
Question 1 of 5
The nurse is testing the deep tendon reflexes of a 30-year-old woman who is in the clinic for an annual physical examination. When striking the Achilles heel and quadriceps muscle, the nurse is unable to elicit a reflex. The nurse's next response should be to:
Correct Answer: A
Rationale: The correct answer is A because asking the patient to lock her fingers and pull engages the upper motor neurons, potentially facilitating the reflex response. This technique, known as Jendrassik maneuver, can help in eliciting reflexes that were initially absent. It is important to try this before proceeding with further testing or documenting reflexes as 0. Choice B is incorrect as retesting immediately after the maneuver may yield a different result. Choice C is premature as further testing may not be necessary after trying the Jendrassik maneuver. Choice D is incorrect as documenting reflexes as 0 without attempting the Jendrassik maneuver could lead to an inaccurate assessment.
Question 2 of 5
A 59-year-old patient has a herniated intervertebral disk. Which of the following findings should the nurse expect to see on physical assessment of this individual?
Correct Answer: A
Rationale: The correct answer is A: Hyporeflexia. In a patient with a herniated intervertebral disk, compression of the spinal nerve can lead to decreased reflexes (hyporeflexia) due to nerve root involvement. This is because the nerve transmission is impaired, resulting in decreased reflex responses. Increased muscle tone (B) is less likely as the herniation typically leads to muscle weakness or atrophy. Positive Babinski sign (C) and presence of pathologic reflexes (D) are associated with upper motor neuron lesions, not typically seen in herniated disk cases.
Question 3 of 5
A 69-year-old patient has been admitted to an adult psychiatric unit because his wife thinks he is getting more and more confused. He laughs when he is found to be forgetful, saying 'I'm just getting old!' After the nurse completes a thorough neurologic assessment, which findings would be indicative of Alzheimer disease? Select all that apply.
Correct Answer: C
Rationale: The correct answer is C. Misplacing items, such as putting dish soap in the refrigerator, is indicative of Alzheimer's disease as it reflects difficulties with executive functioning and memory. This behavior goes beyond occasional forgetfulness (choice A) and having trouble finding the right word (choice D). Difficulty performing familiar tasks (choice B) can also be a sign of Alzheimer's, but misplacing items is more specific to memory and executive function impairment. In this case, the patient's behavior suggests a pattern of cognitive decline rather than just normal aging.
Question 4 of 5
A patient has delusions and hallucinations. Before beginning treatment with a psychotropic medication, the health care provider wants to rule out the presence of a brain tumor. For which test will a nurse need to prepare the patient?
Correct Answer: B
Rationale: The correct answer is B: Computed tomography (CT) scan or magnetic resonance imaging (MRI). To rule out a brain tumor, a CT scan or MRI is essential because they provide detailed images of the brain structure, allowing healthcare providers to visualize any abnormalities such as tumors. Step-by-step rationale: 1. CT scan and MRI are common imaging tests used to detect structural abnormalities in the brain, including tumors. 2. These tests provide detailed cross-sectional images of the brain, enabling healthcare providers to assess the presence of any masses or lesions. 3. By evaluating the images from a CT scan or MRI, healthcare providers can determine if a brain tumor is present before initiating treatment with psychotropic medication. Summary of other choices: - A: Cerebral arteriogram is used to visualize blood vessels in the brain and is not specifically for detecting brain tumors. - C: PET or SPECT scans are more useful in assessing brain function and blood flow, rather than detecting structural abnormalities like tumors.
Question 5 of 5
A patient has anxiety, increased heart rate, and fear. The nurse would suspect the presence of a high concentration of which neurotransmitter?
Correct Answer: D
Rationale: The correct answer is D: Norepinephrine. In anxiety and fear, the body's "fight or flight" response is activated, leading to increased heart rate and heightened arousal. Norepinephrine is a neurotransmitter that plays a key role in this response by increasing heart rate, blood pressure, and alertness. A high concentration of norepinephrine is associated with these symptoms. A: GABA is an inhibitory neurotransmitter that typically has a calming effect, so a high concentration of GABA would not produce symptoms of anxiety and increased heart rate. B: Histamine is involved in allergic reactions and regulates sleep-wake cycles, not typically associated with anxiety and increased heart rate. C: Acetylcholine is involved in muscle control and memory, not directly related to anxiety symptoms such as increased heart rate and fear. In summary, the presence of anxiety, increased heart rate, and fear points towards a high concentration of norepinephrine due to