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A client with major depressive disorder is started on fluoxetine (Prozac). What should the nurse include in the client's discharge teaching?
- A. It may take 4-6 weeks for the medication to be effective.
- B. You should take this medication at bedtime.
- C. Avoid consuming dairy products while taking this medication.
- D. You can stop taking the medication once you feel better.
Correct Answer: A
Rationale: The correct answer is A: "It may take 4-6 weeks for the medication to be effective." SSRIs like fluoxetine typically take 4-6 weeks to reach their full effect, so clients should be informed to expect a gradual improvement in symptoms. Choice B is incorrect because fluoxetine is usually taken in the morning to prevent sleep disturbances. Choice C is incorrect as there is no specific need to avoid consuming dairy products while taking fluoxetine. Choice D is incorrect because clients should never stop taking antidepressants abruptly, as it can lead to withdrawal symptoms and worsening of the condition.
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A client with PTSD is experiencing flashbacks and nightmares. Which intervention should the nurse implement first?
- A. Encourage the client to talk about the flashbacks.
- B. Assist the client in developing coping strategies.
- C. Discuss relaxation techniques with the client.
- D. Refer the client to a PTSD support group.
Correct Answer: A
Rationale: Encouraging the client to talk about the flashbacks is the most appropriate initial intervention for a client with PTSD experiencing flashbacks and nightmares. This intervention helps the client express their feelings, thoughts, and experiences related to the trauma they are going through. It can assist in processing the traumatic events and starting the healing process. Choice B, assisting the client in developing coping strategies, is important but should come after the client has started to verbalize and process their experiences. Choice C, discussing relaxation techniques, may be beneficial later in the treatment process but may not be as effective initially as addressing the traumatic experiences. Choice D, referring the client to a PTSD support group, is also valuable but may not be as immediate as encouraging the client to talk about their flashbacks to begin the therapeutic process.
A client with an eating disorder is planning to attend group meetings with Overeaters Anonymous. The LPN/LVN describes this group to the client, knowing that which finding(s) are characteristic of this form of self-help group? Select one that does not apply.
- A. A common goal is shared by all members
- B. Members are required to remain anonymous
- C. The leader is a professional mental health care provider
- D. Attendance must be prescribed by the health care provider
Correct Answer: A
Rationale: Overeaters Anonymous is a self-help group characterized by shared goals among members to address eating disorders. This provides a supportive environment for personal change and growth. Choice B is incorrect as members are not required to remain anonymous in Overeaters Anonymous. Choice C is incorrect as the leader in such self-help groups is usually a member who has experienced similar issues, not necessarily a professional mental health care provider. Choice D is incorrect as attendance at Overeaters Anonymous meetings is voluntary and not prescribed by a healthcare provider.
A client diagnosed with undifferentiated schizophrenia is being discharged on aripiprazole (Abilify) 5 mg every night. When developing the teaching plan about the most common adverse effects, which of the following should the nurse include? Select one that does not apply.
- A. Headaches that will subside in a few weeks
- B. Transient mild anxiety
- C. Insomnia
- D. Torticollis
Correct Answer: D
Rationale: The correct answer is D: Torticollis. Common side effects of aripiprazole include headaches, mild anxiety, and insomnia. These side effects are manageable during treatment. Torticollis is not a common adverse effect associated with aripiprazole and is more commonly seen with other medications or conditions. Therefore, the nurse should not include torticollis in the teaching plan about the most common adverse effects of aripiprazole.
A male adolescent is admitted with bipolar disorder after being released from jail for assault with a deadly weapon. When the nurse asks the teen to identify his reason for the assault, he replies, 'Because he made me mad!' Which goal is best for the nurse to include in the client's plan of care? The client will
- A. outline methods for managing anger.
- B. control impulsive actions toward self and others.
- C. verbalize feelings when anger occurs.
- D. recognize consequences for behaviors exhibited.
Correct Answer: B
Rationale: In this scenario, the client's response indicates poor impulse control, a common issue in individuals with bipolar disorder. The most critical goal for the nurse to include in the client's plan of care is to help the client control impulsive actions toward self and others. This goal is essential for preventing harmful behaviors and mitigating the social consequences associated with impulsivity. While outlining methods for managing anger, verbalizing feelings when anger occurs, and recognizing consequences for behaviors exhibited are important aspects of therapy, they do not directly address the urgent need to control impulsive behavior in this case.
The nurse suspects child abuse when assessing a 3-year-old boy and noticing several small, round burns on his legs and trunk that might be the result of cigarette burns. Which parental behavior provides the greatest validation for such suspicions?
- A. The parents' explanation of how the burns occurred is different from the child's explanation of how they occurred.
- B. The parents seem to dismiss the severity of the child's burns, saying they are very small and have not posed any problem.
- C. The parents become very anxious when the nurse suggests that the child may need to be admitted for further evaluation.
- D. The parents tell the nurse that the child was burned in a house fire which is incompatible with the nurse's observation of the type of burn.
Correct Answer: D
Rationale: (D) provides the most validation for suspecting child abuse. The parent's explanation (subjective data) that the child was burned in a house fire is incompatible with the objective data observed by the nurse (small, round burns on the legs and trunk). (A) relies on subjective data, and the child's explanation might not accurately reflect the situation due to various factors like age or fear. The apparent lack of concern from the parents (B) is inconclusive as the nurse's interpretation of their reaction could be subjective. While parental anxiety (C) could hint at potential child abuse, it's important to note that most parents would naturally be anxious about their child's hospitalization, making it a less definitive indicator compared to the inconsistency in the explanation provided by the parents in option (D).