ATI RN
Age Specific Nursing Care Questions
Question 1 of 5
When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?
Correct Answer: C
Rationale: The correct answer is C: Medications the patient has recently taken. This information is crucial because certain medications can cause delirium in elderly patients. By reviewing the patient's recent medications, healthcare providers can identify potential drug-induced delirium and adjust treatment accordingly. Spasticity or flaccidity (choice A) is more indicative of neurologic conditions, not delirium. The patient's level of motor activity (choice B) may provide some insight but is not as specific to delirium as medication history. The level of preoccupation with somatic symptoms (choice D) is more relevant to other psychiatric conditions and does not directly help in distinguishing delirium.
Question 2 of 5
A nurse finds a patient with anorexia nervosa vigorously exercising before gaining the agreed-upon weekly weight. Select the nurse's best comment.
Correct Answer: D
Rationale: The correct answer is D because it directly addresses the behavior in relation to the agreed-upon plan and sets clear boundaries. By stating that exercising is not permitted until the patient has gained a specific amount of weight, the nurse reinforces the importance of following the treatment plan to ensure the patient's health and well-being. A: This response does not address the behavior in a constructive manner and may come across as judgmental. B: While discussing the problem is important, it does not provide clear guidance on addressing the immediate issue of exercising before reaching the weight goal. C: While discussing the relationship between exercise and weight loss can be helpful, it does not provide a clear directive on what action should be taken in this specific situation.
Question 3 of 5
A depressed patient who is taking a tricyclic antidepressant tells the nurse, "I don't think I can keep taking these pills. They make me very dizzy, especially when I stand up." The best nursing response is:
Correct Answer: B
Rationale: The correct answer is B because tricyclic antidepressants can cause orthostatic hypotension leading to dizziness upon standing. Advising the patient to drink more fluids and change positions slowly can help alleviate this symptom. Choice A minimizes the patient's concern, which is not therapeutic. Choice C diminishes the patient's experience and feelings. Choice D dismisses the patient's symptoms and attributes them solely to the patient's negative thinking, which is not appropriate.
Question 4 of 5
A patient with bipolar disorder, mania, relapsed after discontinuing lithium. The health care provider prescribes lithium 600 mg BID and olanzapine (Zyprexa) 10 mg BID. What is the rationale for addition of olanzapine to the lithium regime? It will:
Correct Answer: B
Rationale: The correct answer is B: Bring hyperactivity under rapid control. Rationale: 1. Olanzapine is an atypical antipsychotic known for its rapid onset of action in controlling manic symptoms, including hyperactivity. 2. Lithium alone may take time to reach therapeutic levels and show efficacy, while olanzapine can provide more immediate relief. 3. Combining olanzapine with lithium can address acute manic symptoms effectively and quickly. 4. Choice A is incorrect because olanzapine does not specifically minimize lithium's side effects. 5. Choice C is incorrect as olanzapine does not directly potentiate lithium's antimanic action. 6. Choice D is incorrect because olanzapine is typically used for acute symptom management rather than long-term control.
Question 5 of 5
A patient receiving risperidone (Risperdal) reports severe muscle stiffness midmorning. During lunch he has difficulty swallowing food and speaking, and when vital signs are taken 30 minutes later, he is noted to be stuporous and diaphoretic, with a temperature of 38.8° C, pulse of 110 beats/min, and blood pressure of 150/90 mm Hg. The nurse should suspect _____ and should _____.
Correct Answer: A
Rationale: The correct answer is A: Neuroleptic malignant syndrome. The patient is exhibiting symptoms consistent with NMS, a rare but serious side effect of antipsychotic medications like risperidone. The severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, elevated temperature, and vital sign changes are classic signs of NMS. Treatment includes immediate cooling to lower the body temperature and transfer to the intensive care unit for close monitoring and supportive care. Choice B: Anticholinergic toxicity does not fit the patient's presentation as there are no specific signs of anticholinergic toxicity such as dry mucous membranes, dilated pupils, or tachycardia. Choice C: Relapse of psychosis is unlikely to present with the same constellation of symptoms, including altered mental status, fever, and vital sign changes. Choice D: Agranulocytosis is characterized by a severe drop in white blood cells, leading to increased risk of infection, but it does