ATI RN
Population Specific Care Questions
Question 1 of 5
Which patient is at greatest risk for physical abuse by a family member?
Correct Answer: D
Rationale: The correct answer is D because the 79-year-old with chronic depression who lives with a grandchild is vulnerable due to age, health condition, and dependency on the grandchild. Older adults with mental health issues are at a higher risk of abuse, especially when living with family members. The other choices are less likely to be at greatest risk for physical abuse. A, B, and C do not have the same level of vulnerability due to age, health condition, or dependency as the 79-year-old with chronic depression living with a grandchild.
Question 2 of 5
A client who received chlorpromazine (Thorazine) for 15 years to treat schizophrenia developed tardive dyskinesia as evidenced by tongue thrusting and chewing motions. The physician discontinued the chlorpromazine and prescribed Seroquel (quetiapine). As a result of this change, the nurse should carefully monitor for:
Correct Answer: C
Rationale: The correct answer is C: Improvement in tardive dyskinesia. Tardive dyskinesia is a side effect of long-term antipsychotic use, such as chlorpromazine. Quetiapine (Seroquel) is a second-generation antipsychotic with a lower risk of causing tardive dyskinesia. By discontinuing chlorpromazine and switching to quetiapine, the client is less likely to experience worsening of tardive dyskinesia symptoms. Monitoring for improvement in tardive dyskinesia is essential in this situation. Choices A, B, and D are incorrect: A: Development of pseudoparkinsonism is less likely with quetiapine compared to first-generation antipsychotics like chlorpromazine. B: Dystonic reactions are acute side effects and are not typically associated with switching to quetiapine. D: Anticholinergic symptoms are not directly related to tardive dyskinesia
Question 3 of 5
A catatonic patient admitted in a stuporous condition begins to demonstrate increased motor activity. During his assessment, the psychiatrist raises the patient's arm above his head and releases it. The patient maintains the position his arm was placed in, immobile in that position for 15 minutes, moving only when the nurse gently lowers his arm. What symptom is demonstrated by this assessment technique?
Correct Answer: B
Rationale: The correct answer is B: Waxy flexibility. This symptom is demonstrated by the patient's ability to maintain the position his arm was placed in, immobile, for an extended period of time. This is characteristic of catatonia, where individuals exhibit increased motor activity and abnormal posturing. Waxy flexibility refers to the tendency of catatonic patients to maintain positions that they are placed in by others, almost as if their limbs are made of wax and can be molded into different positions. Explanation for other choices: A: Echopraxia involves mimicking the movements of others, which is not demonstrated in this scenario. C: Depersonalization refers to feeling detached from oneself, which is not evident in the patient's behavior during the assessment. D: Thought withdrawal is a symptom of schizophrenia where thoughts are believed to be removed from one's mind by an external force, which is not relevant to the patient's motor behavior in this case.
Question 4 of 5
A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?
Correct Answer: D
Rationale: The correct answer is D because the patient is exhibiting the defense mechanism of projection by attributing his own uncomfortable feelings (homosexual urges) to the nurse. This defense mechanism allows the patient to disown his feelings and project them onto others. This behavior is common in individuals struggling with their own conflicting desires or impulses. Incorrect choices: A: Unconscious hostile feelings are not necessarily the root cause in this scenario. B: The patient's behavior is not about preemptively rejecting the nurse due to fear of rejection. C: While emotional intimacy may play a role, the patient's behavior is more about projection of his own feelings onto the nurse rather than distancing himself.
Question 5 of 5
A woman has been severely beaten by her husband, has no relatives or friends in the community, is afraid to return home, has no financial resources of her own, and has no job skills. Which would be the most important referral for the nurse to make?
Correct Answer: D
Rationale: The correct answer is D: Safe house or shelter. This option is the most important referral because the woman is in immediate danger and needs a safe place to stay away from her abusive husband. It prioritizes her safety and well-being. Referring her to a safe house can provide her with protection, resources, and support to help her escape the abusive situation. Choice A (Community food cupboard) is incorrect as it does not address the woman's immediate safety needs. Choice B (Vocational counseling) is also not the most urgent referral in this situation as the woman's safety should be the priority. Choice C (Law enforcement) might be necessary in the long run, but the immediate concern is ensuring the woman's safety by referring her to a safe house or shelter.