a nurse is caring for a client with a diagnosis of catatonic schizophrenia what clinical finding does the nurse expect the client to exhibit
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Nursing Elites

ATI RN

ATI RN Custom Exams Set 2

1. A client with a diagnosis of catatonic schizophrenia is expected to exhibit which clinical finding?

Correct answer: C

Rationale: In catatonic schizophrenia, immobile posturing is a common clinical finding where the patient may maintain a rigid or bizarre posture for prolonged periods. Crying (Choice A) is not typically associated with catatonic schizophrenia. Self-mutilation (Choice B) is more commonly seen in conditions like borderline personality disorder. Repetitious activities (Choice D) are not a hallmark symptom of catatonic schizophrenia.

2. For which client situation would a consultation with a rapid response team (RRT) be most appropriate?

Correct answer: A

Rationale: A consultation with a Rapid Response Team (RRT) is most appropriate for the 45-year-old client described in Choice A. This client is 2 years post kidney transplant, presenting with no urine output for 6 hours, a temperature of 101.4°F, heart rate of 98 beats per minute, respirations of 20 breaths per minute, and a blood pressure of 88/72 mm Hg, along with restlessness. These clinical signs are indicative of possible acute renal failure and sepsis, requiring immediate intervention by the rapid response team. Choices B, C, and D do not present the same level of urgency and severity of symptoms as the client in Choice A, making them less appropriate for consultation with the RRT.

3. A client takes an antidepressant and oral contraceptives. Which herbal supplement should the nurse educate the client about as a potential drug-herb interaction?

Correct answer: D

Rationale: St. John’s Wort is the correct answer because it can interact with antidepressants and oral contraceptives, potentially affecting their efficacy. Iron supplement, garlic, and green tea do not typically interact with antidepressants or oral contraceptives to the same extent as St. John’s Wort.

4. The nurse is teaching the client diagnosed with colon cancer who is scheduled for a colostomy the next day. Which behavior indicates the best method of applying adult teaching principles?

Correct answer: A

Rationale: Choice A is the best method of applying adult teaching principles because repeating information and addressing the client’s questions as they arise is effective for reinforcing learning in adults. This approach allows for clarification of doubts and ensures that the client understands the information provided. Choice B is incorrect as teaching all the information in one session may overwhelm the client and hinder retention. Choice C is incorrect as using medical terms without ensuring the client's understanding may lead to confusion. Choice D is incorrect because waiting for the client to ask questions may result in missed opportunities to address important information proactively.

5. A family came to the emergency department with complaints of food poisoning. Which client should the nurse see first?

Correct answer: B

Rationale: In cases of food poisoning, a 2-year-old with reduced urine output is a critical finding indicating dehydration, requiring immediate attention to prevent complications. The reduced urine output is a sign of decreased fluid intake or increased fluid loss, putting the child at high risk for dehydration. This client should be seen first to assess hydration status, initiate necessary interventions, and prevent further complications. While the other symptoms presented by the other clients are concerning, the 2-year-old's decreased urine output poses the most immediate threat to their well-being.

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