Nokea
A client who has been discharged home on Celexa (citalopram) calls the nurse complaining that the medication causes her to feel too drowsy. The nurse should make which of the following suggestions?
- A. Make an appointment to change to a different medication.
- B. Take the medication at night.
- C. Be patient while this early side effect subsides.
- D. Skip a dose if drowsiness is excessive.
Correct Answer: B
Rationale: Taking citalopram at night minimizes daytime drowsiness, a common side effect, improving adherence.
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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.
Which client is at highest risk for carrying out a suicide plan?
- A. A client who plans to take a bottle of sleeping pills.
- B. A client who says, 'My life is over.'
- C. A client who has a private gun collection.
- D. A client who says, 'I'm going to jump off the next bridge I see.'
Correct Answer: C
Rationale: Access to a lethal means like a gun collection significantly increases the likelihood of completing a suicide plan.
A client is admitted for major depression. What should the nurse expect to find during assessment?
- A. Anhedonia, feelings of worthlessness, and difficulty focusing
- B. Depressed mood, guilt, and pressured speech
- C. Changes in sleep pattern, tired, and grandiose mood
- D. Difficulty focusing, feelings of helplessness, and flight of ideas
Correct Answer: A
Rationale: Major depression typically presents with anhedonia, worthlessness, and difficulty focusing, unlike symptoms of mania.
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.
At 1 AM, the client with mania rushes to the nurses' station and demands that the psychiatrist come to the unit now to write an order for a pass to go home. What would be the nurse's most therapeutic response?
- A. Go to the day room and wait while I call your psychiatrist.
- B. Don't be unreasonable. I can't call the psychiatrist at this time of night.
- C. I can't call the psychiatrist now, but you and I can talk about your request for a pass.
- D. You must really be upset to want a pass immediately; I'll give you some medication.
Correct Answer: C
Rationale: This response sets limits on an unreasonable demand while opening a dialogue to address the client's needs.