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A male client arrives at the mental health clinic and asks the nurse for more lithium and the antidepressant amitriptyline that he uses to help him sleep. After reviewing the assessment findings with the healthcare provider, a serum creatinine is obtained. Which information supports the reason for this laboratory test?
- A. Creatinine can measure how the body is metabolizing the lithium in the liver.
- B. The effects of amitriptyline can promote and potentiate the risk of lithium toxicity.
- C. The combination of lithium and amitriptyline may need to be changed if creatinine is high.
- D. Lithium is excreted by the kidneys, and creatinine is related to kidney functioning.
Correct Answer: D
Rationale: Lithium is excreted by the kidneys, and monitoring creatinine levels assesses renal function, guiding dosage to prevent toxicity.
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An adolescent female with an eating disorder is admitted to the in-patient psychiatric unit. Which intervention should the nurse implement?
- A. Encourage the client to weigh herself daily at bedtime.
- B. Recommend exercise and recreation in the morning.
- C. Allow the client to select an arts and crafts activity.
- D. Put the client in charge of choosing snacks for the unit.
Correct Answer: C
Rationale: Allowing the client to select an arts and crafts activity provides a positive, non-food-related outlet for expression, supporting therapeutic engagement.
The charge nurse of the psychiatric unit observes clients in the day area. Which client is exhibiting symptoms of a conversion disorder?
- A. A young woman who suddenly goes blind with no indication of organic pathology.
- B. An older adult who continuously complains of a headache and back pain.
- C. An adolescent who becomes extremely anxious about going outside.
- D. A middle-aged man who is complaining of shortness of breath and is diaphoretic.
Correct Answer: A
Rationale: Sudden blindness with no organic pathology is indicative of a conversion disorder, involving neurological symptoms without a neurological basis.
When a male client is asked about his reason for coming to the mental health clinic, he replies, “It all started because I work in a hostile work environment. My boss would not let me go to a religious service, so I went to human resources, and they didn't want to do anything. It has been a really difficult time for me.†Which response should the nurse provide?
- A. Why do you think you have a hostile work environment?
- B. Have you considered resigning from your position?
- C. Have the feelings associated with these events brought you to the clinic?
- D. How have you responded to those in your work environment about these events?
Correct Answer: C
Rationale: This response acknowledges the client's feelings and experiences, allowing for further exploration of the issues that brought him to the clinic, fostering therapeutic communication.
A homeless female client who reports feeling sad and depressed tells the mental health nurse that in the past two days, the client has only had four hours of sleep. Which action is most important for the nurse to implement within the first 24 hours after treatment is initiated?
- A. Allow the client to rest and sleep.
- B. Begin planning for the client's discharge.
- C. Encourage verbalization of feelings.
- D. Ensure the client attends groups addressing coping skills for dealing with depression.
Correct Answer: A
Rationale: Allowing the client to rest and sleep is a priority, as sleep deprivation can exacerbate depression symptoms, addressing immediate physical needs.
A male client with known auditory hallucinations begins talking loudly and gesturing wildly while in the unit's day room. Which action should the nurse implement first?
- A. Sit in the chair next to the client.
- B. Listen to what the client is saying.
- C. Escort the client to his room.
- D. Administer a PRN sedative.
Correct Answer: B
Rationale: Listening to what the client is saying is crucial to understand the content and nature of the auditory hallucinations, guiding further interventions.