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A client with a history of bipolar disorder is stabilized on a mood stabilizer and has been prescribed lamotrigine (Lamictal). Which outcome indicates that the medication is effective?
- A. Decrease in manic episodes.
- B. Improvement in depressive symptoms.
- C. Reduction in anxiety symptoms.
- D. Increased sleep duration.
Correct Answer: B
Rationale: The correct answer is B: Improvement in depressive symptoms. Lamotrigine is commonly used as a mood stabilizer and is particularly effective in managing depressive symptoms in bipolar disorder. While it may also help with preventing manic episodes, its primary indication is for treating depressive symptoms. Choices A, C, and D are incorrect because lamotrigine is not specifically indicated for reducing manic episodes, anxiety symptoms, or increasing sleep duration in bipolar disorder.
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A client who is admitted with a closed head injury after a fall has a blood alcohol level (BAL) of 0.28 (28%) and is difficult to arouse. Which intervention during the first 6 hours following admission should the nurse identify as the priority?
- A. Place in a side-lying position with head of bed elevated.
- B. Administer disulfiram (Antabuse) immediately
- C. Give lorazepam (Ativan) PRN for signs of withdrawal.
- D. Provide thiamine and folate supplements as prescribed.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
An adolescent with anorexia nervosa is undergoing nutritional therapy. Which finding best indicates that the client is making progress in treatment?
- A. Client gains 2 pounds in a week.
- B. Client describes a positive body image.
- C. Client engages in recreational activities.
- D. Client begins to talk about future goals.
Correct Answer: A
Rationale: The correct answer is A. Weight gain is a crucial indicator of progress in the treatment of anorexia nervosa. In individuals with anorexia, restoring and maintaining a healthy weight is a primary goal to address the underlying nutritional deficiencies and health complications associated with the disorder. While choices B, C, and D are positive developments in the client's overall well-being and recovery journey, they are not as directly linked to the core issue of nutritional rehabilitation in anorexia nervosa. Describing a positive body image, engaging in recreational activities, and talking about future goals are important aspects of psychological and emotional recovery, but weight gain is a more immediate and objective measure of progress in treating anorexia nervosa.
A client with postpartum depression receives a prescription for sertraline (Zoloft). What information is most important to include in client teaching?
- A. Avoid foods high in tyramine, such as processed meats, red wine, and Swiss cheese.
- B. Contact the healthcare provider immediately if suicidal thoughts occur.
- C. Increase activity level to include regular exercise.
- D. Contact the healthcare provider immediately if muscle stiffness occurs.
Correct Answer: B
Rationale: The most critical information to include in client teaching for a client with postpartum depression starting sertraline (Zoloft) is to contact the healthcare provider immediately if suicidal thoughts occur. This is vital for the client's safety as antidepressants, including sertraline, can sometimes increase the risk of suicidal thoughts, especially at the start of treatment. Choices A, C, and D are not the most crucial information in this scenario. Choice A about avoiding foods high in tyramine is not directly related to sertraline use. Choice C about increasing activity level is important but not as critical as addressing suicidal ideation. Choice D about muscle stiffness is a potential side effect of sertraline but is not as urgent as monitoring for suicidal thoughts.
A male client with schizophrenia is being discharged from the psychiatric unit after being stabilized with antipsychotic medications. What is the most important instruction to include in the discharge teaching?
- A. "You should see your psychiatrist every 6 months."
- B. "It's important to adhere to the medication regimen as prescribed."
- C. "Try to avoid caffeine and alcohol completely."
- D. "You should exercise daily to maintain a healthy lifestyle."
Correct Answer: B
Rationale: The most important instruction to include in the discharge teaching for a male client with schizophrenia who has been stabilized with antipsychotic medications is to adhere to the medication regimen as prescribed. Medication adherence is crucial in managing schizophrenia, preventing relapse, and maintaining stability. While seeing the psychiatrist regularly (Choice A) is important, adherence to medication is more critical for the client's immediate well-being. Avoiding caffeine and alcohol (Choice C) may be beneficial but is not as crucial as medication adherence. Daily exercise (Choice D) is important for overall health but is not the most critical instruction for managing schizophrenia.
Which actions are likely to help promote the self-esteem of a male client with major depression?
- A. Ask the client about his long-term goals.
- B. Discuss the challenges of his medical condition.
- C. Include the client in determining treatment protocol.
- D. Encourage the client to engage in recreational therapy.
Correct Answer: C
Rationale: Including the client in determining the treatment protocol is the most suitable action to promote the self-esteem of a male client with major depression. This approach empowers the client, involves him in decision-making regarding his care, and fosters a sense of control and self-worth. Option A, asking about his long-term goals, may not directly address his immediate self-esteem needs related to his current condition. Option B, discussing the challenges of his medical condition, may inadvertently focus on negative aspects and potentially lower self-esteem. Option D, encouraging engagement in recreational therapy, is beneficial but may not directly address the client's sense of control and self-worth in decision-making related to his treatment.