ATI RN
Age Specific Populations Questions
Question 1 of 5
When a patient diagnosed with paranoid schizophrenia was discharged from the unit 6 months ago, the plan was for him to take chlorpromazine (Thorazine), a conventional (first generation) antipsychotic medication, 300 mg po daily. He tells the nurse he stopped taking his pills after a few months because they made him feel like a 'zombie.' What other common side effects should the nurse determine if the patient experienced?
Correct Answer: B
Rationale: The correct answer is B: Sedation, tremor, and muscle stiffness. This is because chlorpromazine, being a first-generation antipsychotic, commonly causes sedation, tremors, and muscle stiffness as side effects. Sedation is a common effect due to the drug's ability to block dopamine receptors in the brain. Tremors and muscle stiffness are also common due to the drug's action on the central nervous system. Choices A, C, and D are incorrect as they do not align with the expected side effects of chlorpromazine. Sweating, nausea, weight gain, headache, watery eyes, runny nose, mild fever, sore throat, and skin rash are not typically associated with this medication.
Question 2 of 5
A patient with many positive symptoms of schizophrenia, whose behavior is disorganized and who is highly anxious, tells the nurse in the psychiatric emergency department, 'You have got to help me. I do not know what is going on. I think someone is trying to wipe me out. I have to get a gun.' The patient, a college student, lives alone and has no family or support system in the immediate area. He has not left his room in 2 weeks, has not eaten in several days, and is unkempt. Of the available treatment settings, the nurse should recommend:
Correct Answer: B
Rationale: The correct answer is B: inpatient hospitalization on a locked unit. This option is the most appropriate given the patient's presentation. The patient is experiencing severe positive symptoms of schizophrenia, such as delusions and disorganized behavior, posing a risk to himself and others by expressing intent to obtain a gun. Additionally, the patient is neglecting basic needs, indicating a need for close monitoring and intervention. Inpatient hospitalization on a locked unit provides a structured and secure environment for intensive treatment, ensuring safety and stabilization. Incorrect choices: A: Admission to an unlocked residential crisis unit may not provide the level of monitoring and security needed for a patient with active psychotic symptoms and self-harm potential. C: Attending a day treatment program for 4 weeks does not address the acute safety concerns and level of impairment displayed by the patient. D: Admission to a partial hospital program may not offer the round-the-clock supervision and immediate intervention required for someone at risk of harming themselves or others.
Question 3 of 5
Which point should be included in teaching patients and families about relapse?
Correct Answer: B
Rationale: Step-by-step rationale for why answer B is correct: 1. Caffeine and nicotine are known to reduce the effectiveness of antipsychotic drugs. 2. Teaching patients and families about this can help them understand the importance of avoiding these substances. 3. By avoiding caffeine and nicotine, patients can improve the effectiveness of their treatment and reduce the risk of relapse. 4. This information empowers patients and families to make informed decisions to support treatment outcomes. Summary of why other choices are incorrect: A: Incorrect because relapse can occur due to various factors, not just medication non-adherence. C: Incorrect because relapse is a complex issue that may not be entirely prevented even with support, education, and adherence. D: Incorrect because education about medication side effects is still valuable, even if it may not entirely prevent relapse.
Question 4 of 5
A patient was admitted in a semistuporous catatonic state. Family states that the patient has neither left the apartment nor attended to personal hygiene for several weeks. The patient's last 48 hours have been spent lying in bed, mute and motionless. The nursing diagnosis that should be considered the priority is:
Correct Answer: A
Rationale: The correct answer is A: self-care deficit. This nursing diagnosis should be considered the priority because the patient is unable to attend to personal hygiene and has been lying in bed motionless and mute for 48 hours, indicating a significant impairment in self-care abilities. This is a critical issue that needs immediate attention to prevent further deterioration in the patient's physical and mental health. Choice B: situational low self-esteem is not the priority as the patient's current state is more indicative of physical neglect rather than a self-esteem issue. Choice C: disturbed thought processes may be a contributing factor to the patient's presentation, but the priority at this moment is addressing the self-care deficit to ensure the patient's safety and well-being. Choice D: impaired verbal communication, while important, is not the priority in this scenario as the patient's inability to communicate verbally is secondary to the urgent need for assistance with self-care.
Question 5 of 5
The signs and symptoms of schizophrenia must be present for at least _____ months before a diagnostic label is assigned.
Correct Answer: C
Rationale: The correct answer is C (12 months) because the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires symptoms to be present for at least 6 months before a diagnosis of schizophrenia can be made. This prolonged duration helps ensure that the symptoms are not due to temporary factors. Therefore, option C is the most appropriate choice. Options A (3 months), B (6 months), and D (18 months) do not align with the established diagnostic criteria for schizophrenia.