Nokea
A client diagnosed with complex somatic symptom disorder and depression is prescribed medication therapy to treat both the pain and the symptoms of depression. When teaching the client about the medication, which of the following would the nurse emphasize?
- A. Need for signing a no-suicide contract
- B. Avoidance of foods that contain aged cheese
- C. Use of sunscreen when exposed to bright sunlight
- D. Limiting of the amount of water ingested
Correct Answer: B
Rationale: The correct answer is B: Avoidance of foods that contain aged cheese. Aged cheese contains tyramine, which can interact with certain medications used to treat depression, such as MAOIs. This interaction can lead to a dangerous increase in blood pressure known as a hypertensive crisis. Therefore, it is crucial for the client to avoid foods high in tyramine, such as aged cheese, to prevent this potentially life-threatening reaction. Signing a no-suicide contract (choice A) is important but not directly related to medication teaching. Using sunscreen (choice C) and limiting water intake (choice D) are not relevant considerations for this medication regimen.
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A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer?
- A. Diphenhydramine (Benadryl)
- B. Propranolol (Inderal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: A
Rationale: The correct answer is A: Diphenhydramine (Benadryl). Dystonic reactions are extrapyramidal side effects commonly seen with antipsychotic medications. Diphenhydramine is a first-line treatment for dystonic reactions due to its anticholinergic properties. It helps block the excessive dopamine activity in the brain that causes these reactions. Propranolol (B) is a beta-blocker and not typically used for dystonic reactions. Risperidone (C) and Aripiprazole (D) are antipsychotic medications themselves and would not be used to treat dystonic reactions caused by antipsychotic medications.
The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use?
- A. Methylphenidate
- B. Atomoxetine
- C. Bupropion
- D. Clonidine
Correct Answer: B
Rationale: The correct answer is B: Atomoxetine. Atomoxetine is the preferred agent for ADHD in children with sleeping difficulties as it does not typically affect sleep patterns. Methylphenidate (A) may worsen sleep issues due to its stimulant properties. Bupropion (C) can also cause insomnia. Clonidine (D) may help with sleep but is not the first-line choice for ADHD without comorbid conditions like tics or aggression.
Which statement shows a nurse has empathy for a patient who made a suicide attempt?
- A. "You must have been very upset when you tried to hurt yourself."
- B. "It makes me sad to see you going through such a difficult experience."
- C. "If you tell me what is troubling you, I can help you solve your problems."
- D. "Suicide is a drastic solution to a problem that may not be such a serious matter."
Correct Answer: A
Rationale: The correct answer is A because it directly acknowledges the patient's emotions and perspective without judgment. It shows understanding and validation of the patient's feelings, indicating empathy. Choice B focuses on the nurse's feelings, not the patient's. Choice C offers a solution without addressing the patient's emotional state. Choice D minimizes the seriousness of the patient's situation and lacks empathy. Overall, choice A demonstrates the most empathetic response by recognizing and empathizing with the patient's emotional distress.
A nurse who has worked with a client diagnosed with generalized anxiety disorder (GAD) when he was an inpatient on the psychiatric unit sees the client in the waiting room of the outpatient psychiatric clinic. The client motions to the nurse to come over so he can tell the nurse how things have been going since he was discharged. While talking with the client, the nurse determines that the client's therapy has been effective when the client states which of the following?
- A. I am still experiencing quite a bit of stress at home and at work; things are different at home than they were in the hospital.
- B. When my mother-in-law comes over now, I go out to my workshop and work on one of my projects.
- C. I'm still drinking coffee; I can't quit after drinking it all these years.
- D. I've learned having a beer after I get home from work helps me relax.
Correct Answer: B
Rationale: The correct answer is B because the client's behavior of going to the workshop to work on projects when his mother-in-law visits indicates a healthy coping mechanism to manage stress. This shows that the therapy has been effective in helping the client find a constructive way to deal with his anxiety triggers. Choice A indicates ongoing stress, which suggests therapy may not be effective. Choice C shows a habit that has not changed, indicating little progress. Choice D suggests the use of alcohol as a coping mechanism, which is not a healthy or sustainable way to manage anxiety.
Which statement by a patient would lead the nurse to suspect unsuccessful completion of the psychosocial developmental task of infancy?
- A. I know how to do things right, so I prefer jobs where I work alone rather than on a team.'
- B. I do not allow other people to truly get to know me.'
- C. I depend on frequent praise from others to feel good about myself.'
- D. I usually need to do things several times before I get them right.'
Correct Answer: C
Rationale: The correct answer is C because depending on frequent praise from others to feel good about oneself indicates a lack of self-confidence and self-esteem, which are key components of successful completion of the psychosocial developmental task of infancy according to Erikson's theory. This statement suggests an inability to develop a sense of autonomy and self-reliance, which are crucial in the infancy stage.
Choice A is incorrect because preferring to work alone rather than on a team may indicate a preference for autonomy, which is a positive trait related to the successful completion of the task of autonomy vs. shame and doubt in infancy.
Choice B is incorrect because not allowing others to truly get to know oneself could indicate introversion or privacy preferences, which may not necessarily suggest unsuccessful completion of the infancy developmental task.
Choice D is incorrect because needing to do things several times before getting them right may indicate a learning style or perfectionism rather than a sign of unsuccessful completion of the psychosocial developmental task of infancy.