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A healthcare professional is providing care for a client with a diagnosis of bipolar disorder. Which client behavior would the healthcare professional identify as characteristic of a manic episode?
- A. Sleeping excessively
- B. Excessive energy
- C. Decreased appetite
- D. Lack of interest in activities
Correct Answer: B
Rationale: During a manic episode in bipolar disorder, individuals often experience heightened energy levels, increased goal-directed activity, and may engage in risky behaviors. This excessive energy is a key characteristic of manic episodes. Choice A, sleeping excessively, is more characteristic of a depressive episode. Choice C, decreased appetite, can be seen in various mood disorders but is not specific to manic episodes. Choice D, lack of interest in activities, is more indicative of a depressive episode rather than a manic episode. It is important for healthcare professionals to recognize these signs to provide appropriate care and support to individuals with bipolar disorder.
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Which client statement indicates an understanding of the education provided about the antidepressant medication sertraline (Zoloft)?
- A. I should take this medication on an empty stomach.
- B. It may take several weeks for this medication to be effective.
- C. I can stop taking this medication when I feel better.
- D. I should avoid taking this medication with other medications.
Correct Answer: B
Rationale: Choice B is the correct answer. It is crucial for clients to understand that sertraline (Zoloft) may take several weeks to show its full effects. Patients should be informed about this delay in onset of action to set realistic expectations and adhere to the treatment plan. This education helps prevent premature discontinuation of the medication due to perceived lack of efficacy. Choices A, C, and D are incorrect. Choice A is inaccurate because sertraline (Zoloft) should be taken with food to reduce the risk of gastrointestinal side effects. Choice C is incorrect because abruptly stopping the medication can lead to withdrawal symptoms and worsening of the condition. Choice D is inaccurate as there are specific medications that should be avoided with sertraline, but a general statement to avoid all other medications is overly broad and not necessary.
When educating the family of a client diagnosed with dissociative identity disorder, which of the following instructions should the nurse include?
- A. Encourage the client to avoid stressful situations.
- B. Encourage the client to participate in daily activities.
- C. Encourage the client to express their feelings.
- D. Encourage the client to develop a daily routine.
Correct Answer: D
Rationale: In cases of dissociative identity disorder, it is beneficial for the client to establish a daily routine. This structure can enhance symptom management and provide a sense of stability, which is particularly important for individuals with this condition. Encouraging the client to avoid stressful situations (Choice A) may not always be possible and does not address the need for structure. While encouraging the client to participate in daily activities (Choice B) is important, having a routine is more crucial for managing dissociative identity disorder. Expressing feelings (Choice C) is valuable but establishing a routine takes precedence in this situation.
A client with bipolar disorder is in the manic phase. Which nursing intervention should the nurse implement to ensure the client's safety?
- A. Provide a structured environment with minimal stimuli.
- B. Encourage the client to participate in group activities.
- C. Monitor the client closely for signs of exhaustion.
- D. Encourage the client to rest and sleep as needed.
Correct Answer: A
Rationale: During the manic phase of bipolar disorder, individuals may engage in impulsive behaviors that can put them at risk of harm. Providing a structured environment with minimal stimuli can help reduce the risk of injury by minimizing triggers for impulsive actions. This intervention promotes a safe and controlled setting for the client, which is crucial in managing the symptoms of mania. Encouraging the client to participate in group activities (Choice B) may increase stimuli and potentially exacerbate manic symptoms. Monitoring for signs of exhaustion (Choice C) is important but does not directly address the safety concerns related to impulsive behaviors during mania. Encouraging the client to rest and sleep as needed (Choice D) may be challenging during the manic phase when individuals typically experience decreased need for sleep.
A client with obsessive-compulsive disorder (OCD) spends hours each day washing her hands. Which intervention should the nurse implement to help the client reduce this behavior?
- A. Encourage the client to set a time limit for washing hands.
- B. Encourage the client to wash hands only when necessary.
- C. Encourage the client to use hand sanitizer instead of washing.
- D. Encourage the client to explore the reasons behind the hand washing.
Correct Answer: A
Rationale: Setting a time limit for hand washing is an effective intervention in managing obsessive-compulsive disorder (OCD) symptoms. By establishing boundaries around the behavior, the client can gradually work towards reducing the excessive hand washing and regaining control over the compulsion. Choice B is not as effective because it does not address the underlying compulsion. Choice C may not be helpful as it may not satisfy the client's need for cleanliness and could reinforce the behavior. Choice D, while important in therapy, may not be the most immediate intervention needed to address the excessive hand washing behavior.
A client is prescribed lorazepam (Ativan) for the management of anxiety. Which statement by the client indicates the need for further teaching?
- A. I should take this medication at the same time every day.
- B. I can drink alcohol while taking this medication.
- C. I should avoid driving while taking this medication.
- D. I should avoid using this medication during pregnancy.
Correct Answer: B
Rationale: The correct answer is B. Clients should avoid alcohol while taking lorazepam (Ativan) due to potential interactions. Alcohol can increase the side effects of lorazepam, such as drowsiness and dizziness, which can be dangerous, especially when combined with activities like driving or operating machinery. Choice A is correct as it promotes medication adherence. Choice C is correct as lorazepam can impair cognitive and motor skills, impacting driving ability. Choice D is correct as lorazepam is not recommended during pregnancy due to potential harm to the fetus.