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A client is being discharged on lithium. The nurse encourages the client to follow which health maintenance recommendations? Select all that apply.
- A. Weigh self weekly at the same time of day.
- B. Drink a 2-L bottle of decaffeinated fluid daily.
- C. Do not alter dietary salt intake.
- D. See the doctor if you get the flu.
- E. Restrict involvement in intense exercise.
Correct Answer: B,C,D
Rationale: Maintaining fluid intake, stable salt levels, and monitoring for illness prevent lithium toxicity and ensure therapeutic levels.
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A client who is depressed states, 'I think my family would be better off without me. They don't need to worry.' Which would be the most appropriate response by the nurse?
- A. Are you planning to commit suicide?
- B. What do you think they are worried about?
- C. You don't mean that. Your family loves you.
Correct Answer: A
Rationale: Directly asking about suicidal plans addresses potential ideation, ensuring safety and opening further assessment.
Which individual is at highest risk for committing suicide?
- A. A 71-year-old male, alcohol user, independent minded
- B. A 16-year-old female, diabetic, two best friends
- C. A 47-year-old male, schizophrenic, unemployed
- D. A 57-year-old female, depression, active in church
Correct Answer: A
Rationale: Older men, especially with alcohol use and independence, are at higher suicide risk due to demographic and behavioral factors.
Which variables represent the highest risk for developing major depressive disorder? Select all that apply.
- A. Male gender
- B. Mood disorder in first-degree relatives
- C. Substance abuse
- D. Divorced
- E. Older adult
Correct Answer: B,D
Rationale: Family history of mood disorders and being single or divorced increase the risk of major depressive disorder.
Which best explains the neurochemical processes responsible for depression?
- A. Increased activity of dopamine
- B. Decreased glucocorticoid activity
- C. Decreased serotonin and norepinephrine
- D. Potentiation of GABA
Correct Answer: C
Rationale: Decreased levels of serotonin and norepinephrine in the brain are associated with depression, contributing to mood dysregulation.
A client has just been diagnosed as having major depression. At which time would the nurse expect the client to be at highest risk for self-harm?
- A. Immediately after a family visit
- B. On the anniversary of significant life events in the client's life
- C. During the first few days after admission
- D. Approximately 2 weeks after starting antidepressant medication
Correct Answer: D
Rationale: The risk of self-harm increases about 2 weeks after starting antidepressants, as energy improves before mood stabilizes.