ATI RN
Age Specific Care Competency Questions
Question 1 of 5
Which assessment findings would be expected for a patient diagnosed with bipolar I disorder?
Correct Answer: B
Rationale: Step 1: Bipolar I disorder involves episodes of acute mania, which is characterized by elevated mood, increased energy, and impulsivity. Step 2: Major depression can also occur in bipolar I, as patients may experience depressive episodes. Step 3: Therefore, choice B (Major depression and acute mania) is the correct answer. Summary: Choice A is incorrect because rapid cycling refers to frequent mood shifts, not specific to bipolar I. Choice C is incorrect as hypomania is characteristic of bipolar II, not bipolar I. Choice D is incorrect as minor depression is not a typical feature of bipolar I disorder.
Question 2 of 5
A client with catatonic schizophrenia has been posturing, standing with his left arm upraised and his right foot off the floor. For the most part, he ignores attempts at nursing intervention but will occasionally walk, sit, or lie down for a few minutes. The client eats standing up if the nurse brings a tray to the room. The priority nursing order would be to:
Correct Answer: B
Rationale: The correct answer is B. Assess for lower extremity edema bid. Rationale: 1. Priority is to assess for lower extremity edema as the client is standing for extended periods, which can lead to edema. 2. Edema assessment is crucial for preventing complications like blood clots or skin breakdown. 3. Insisting on sitting or lying down may aggravate the client and worsen the situation. 4. Providing high-calorie drinks or activities therapy are not the immediate priority in this case. In summary, assessing for lower extremity edema is crucial due to the client's prolonged standing, which can lead to potential health risks, making it the priority nursing order.
Question 3 of 5
A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales. Today, he argued with several office mates and threatened to kill one of them. The police were called, and he was brought to the mental health center for evaluation. He has had previous admissions to the unit for stabilization of paranoid schizophrenia. When the nurse meets him, he points at staff in the nursing station and states loudly, 'They're all plotting to destroy me. Isn't that true?' Which would be the most appropriate response?
Correct Answer: C
Rationale: The correct answer is C because it demonstrates empathy and validates the patient's feelings without agreeing with the delusion. By acknowledging the patient's fear, the nurse can establish trust and rapport, which are crucial in therapeutic communication. This response shows understanding and compassion, helping to de-escalate the situation and provide a supportive environment for the patient. Choice A is incorrect as it denies the patient's belief and may lead to increased agitation. Choice B is incorrect as it challenges the patient's delusion, which can worsen the situation and lead to further confrontation. Choice D is incorrect as it dismisses the patient's feelings and may cause the patient to become defensive or feel misunderstood.
Question 4 of 5
The nurse is sitting with a patient diagnosed as having schizophrenia, disorganized type, who starts to laugh uncontrollably, although nothing funny has occurred. The nurse should say:
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's behavior in a non-confrontational manner and invites the patient to share their experience. By saying "You're laughing. Tell me what's happening," the nurse shows empathy and encourages open communication. Choice A may unintentionally minimize the patient's experience. Choice B may come off as accusatory. Choice C doesn't actively engage the patient in conversation. Encouraging the patient to express their feelings can help establish trust and facilitate therapeutic communication.
Question 5 of 5
A patient has schizophrenia and is troubled by negative symptoms, muscle stiffness, and motor restlessness. His Advanced Practice Nurse (APN) is considering changing the patient's antipsychotic medication, haloperidol (Haldol, a typical or first generation antipsychotic drug). For planning purposes, which medication can the nurse assume that the APN will probably choose?
Correct Answer: C
Rationale: The correct answer is C: Olanzapine (Zyprexa). Olanzapine is an atypical or second-generation antipsychotic that is effective in treating both positive and negative symptoms of schizophrenia. It also has a lower risk of causing extrapyramidal symptoms like muscle stiffness and motor restlessness compared to typical antipsychotics like haloperidol. Chlorpromazine (A) is a typical antipsychotic with similar side effects as haloperidol. Clozapine (B) is an atypical antipsychotic that is effective for treatment-resistant schizophrenia but is usually considered as a last resort due to its potential for serious side effects. Fluoxetine (D) is an antidepressant and not typically used as a first-line treatment for schizophrenia.