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A client who is depressed begins to cry and states, 'I'm just really sick of feeling this way. Nothing ever seems to go right in my life.' Which would be the most appropriate response by the nurse?
- A. Don't cry. Try to look at the positive side of things.
- B. You are feeling really sad right now. It's a hard time.
- C. Hang in there. Your medication will start helping in a few days.
- D. Nothing ever goes right?
Correct Answer: B
Rationale: Acknowledging the client's sadness validates their feelings, fostering a therapeutic connection without dismissing emotions.
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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 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.
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.
During report, the nurse learns that a client with mania has not slept since admission 2 days ago. On entering the day room, the nurse finds this client dancing to loud music. Which would be the most appropriate statement by the nurse?
- A. Do you think you could sit still for a few minutes so we can talk?
- B. How are you ever going to get any rest if you keep that music on?
- C. Let's go to the conference room and talk for a while.
- D. Turn the radio down so we can hear ourselves talk.
Correct Answer: C
Rationale: Redirecting to a quieter environment reduces stimuli, promoting calmness and aiding rest.
Which statements about the etiology of bipolar disorder do most psychoanalytical theories subscribe to? Select all that apply.
- A. Norepinephrine levels may be increased in mania.
- B. Manic episodes are a defense against underlying depression.
- C. Acetylcholine seems to be implicated in mania.
- D. The id takes over the ego and acts as an undisciplined hedonistic being (child).
Correct Answer: B,D
Rationale: Psychoanalytical theories view mania as a defense against depression, with the id overriding the ego, acting impulsively.