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A healthcare professional is assessing a patient with major depressive disorder. Which finding is most concerning?
- A. Decreased interest in activities
- B. Feelings of worthlessness
- C. Difficulty sleeping
- D. Changes in appetite
Correct Answer: C
Rationale: The correct answer is C: Difficulty sleeping. This finding is most concerning because it can indicate severe depression or potential suicidal ideation. Insomnia is a common symptom of major depressive disorder and can exacerbate the patient's condition. It is important to address sleep disturbances promptly to prevent further deterioration.
Rationale for why other choices are incorrect:
A: Decreased interest in activities is a common symptom of major depressive disorder but may not necessarily indicate immediate risk.
B: Feelings of worthlessness are also common in depression but may not be as urgent as sleep disturbances.
D: Changes in appetite can be a symptom of depression, but difficulty sleeping poses a more immediate concern for potential harm to the patient's well-being.
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A patient with obsessive-compulsive disorder (OCD) is prescribed fluvoxamine. What is a common side effect of this medication?
- A. Increased appetite
- B. Dry mouth
- C. Weight gain
- D. Nausea
Correct Answer: D
Rationale: The correct answer is D: Nausea. Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat OCD. Nausea is a common side effect of SSRI medications due to their impact on serotonin levels in the gastrointestinal tract. This can lead to stomach upset and feelings of nausea. Increased appetite (A) and weight gain (C) are more commonly associated with other types of medications, such as antipsychotics or mood stabilizers. Dry mouth (B) is a side effect seen with some antidepressants, but it is not a common side effect of fluvoxamine.
A patient with bipolar disorder is experiencing a depressive episode. Which intervention is most appropriate?
- A. Encouraging the patient to participate in physical activities.
- B. Providing a stimulating environment to keep the patient engaged.
- C. Allowing the patient to isolate until they feel better.
- D. Encouraging the patient to express their feelings and concerns.
Correct Answer: D
Rationale: The correct answer is D because encouraging the patient to express their feelings and concerns is crucial in addressing depressive symptoms in bipolar disorder. This intervention can help the patient process their emotions, improve self-awareness, and facilitate therapeutic communication. It also promotes a supportive environment for the patient to receive appropriate care.
Incorrect choices:
A: While physical activities can be beneficial, they may not address the underlying emotional issues during a depressive episode.
B: Providing a stimulating environment might overwhelm the patient and worsen their symptoms.
C: Allowing the patient to isolate may exacerbate feelings of loneliness and hopelessness, and hinder recovery.
A patient is experiencing a manic episode. Which intervention is most effective?
- A. Encouraging the patient to participate in group activities
- B. Providing a low-stimulation environment
- C. Allowing the patient to move freely around the unit
- D. Engaging the patient in competitive games
Correct Answer: B
Rationale: The correct answer is B: Providing a low-stimulation environment. This is effective because it helps reduce excessive sensory input which can trigger or exacerbate manic symptoms. Manic patients are often sensitive to stimuli, so a calm and quiet environment can help in de-escalating their agitation and hyperactivity.
A: Encouraging group activities can be overwhelming for a manic patient due to the increased stimulation and potential for overstimulation.
C: Allowing free movement may lead to risky behaviors or agitation, as the patient may not be able to self-regulate effectively.
D: Engaging in competitive games can escalate the manic symptoms and potentially lead to aggressive or impulsive behaviors.
In summary, providing a low-stimulation environment is the most effective intervention as it helps manage manic symptoms by reducing triggers and promoting a sense of calm.
A patient with panic disorder is prescribed alprazolam. Which instruction is most important for the nurse to include in the teaching plan?
- A. Avoid driving until you know how the medication affects you.
- B. Take the medication with food to avoid stomach upset.
- C. Take the medication at bedtime to help with sleep.
- D. Increase the dose if you do not feel better in a few days.
Correct Answer: A
Rationale: The correct answer is A: Avoid driving until you know how the medication affects you. This is crucial because alprazolam can cause drowsiness and impair cognitive function. It is important to prioritize safety and prevent accidents. Choice B is incorrect as alprazolam does not necessarily need to be taken with food. Choice C is incorrect as alprazolam is typically taken during the day due to its sedative effects. Choice D is incorrect as increasing the dose without medical guidance can lead to overdose and adverse effects.
When discharging a patient with schizophrenia on risperidone, what is an important point to include in the discharge teaching?
- A. Avoiding foods high in tyramine is essential.
- B. Getting blood levels checked regularly is necessary.
- C. Being cautious when driving due to possible drowsiness is crucial.
- D. Taking this medication on an as-needed basis is recommended.
Correct Answer: B
Rationale: The correct answer is B: Getting blood levels checked regularly is necessary. This is important because risperidone is a medication that requires monitoring of blood levels to ensure it is within the therapeutic range for effectiveness and to prevent side effects. Regular monitoring helps to adjust the dosage if needed.
Choice A is incorrect because foods high in tyramine are a concern when taking MAOIs, not risperidone. Choice C is incorrect because drowsiness is a common side effect initially, but it may improve over time and caution while driving should be based on individual response. Choice D is incorrect because risperidone is not meant to be taken on an as-needed basis; it should be taken consistently to maintain stability in treating schizophrenia.