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A nurse in a mental health clinic receives a request from a client who is undergoing psychotherapy to obtain a copy of the therapist's notes. Which of the following responses should the nurse make?
- A. "Are you not happy with your treatment?"
- B. "Why are you interested in seeing your therapist's notes?"
- C. "We can provide a copy of your records, but the therapist's notes are not included."
- D. "I don't think you will benefit from reviewing your therapist's notes right now."
Correct Answer: C
Rationale: The correct response, C, is appropriate because therapist's notes are considered confidential and are not typically shared with clients. Providing a copy of the client's records without the therapist's notes is in line with maintaining client confidentiality and upholding ethical standards in mental health practice. Choice A is incorrect as it assumes the client is unhappy with their treatment without any basis. Choice B is not ideal as it probes the client's reasons, potentially violating their privacy. Choice D is inappropriate as it undermines the client's autonomy and right to access their records.
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A nurse is planning care for an older adult client who has dementia. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)
- A. Give the client one simple direction at a time.
- B. Refute the client's delusions using logic.
- C. Allow the client to choose among a variety of activities each day.
- D. Reinforce orientation to time, place, and person.
- E. Establish eye contact when communicating with the client.
Correct Answer: A, D, E
Rationale: Correct Answer: A, D, E
Rationale:
A: Giving the client one simple direction at a time is important as individuals with dementia may have difficulty processing complex information.
D: Reinforcing orientation to time, place, and person helps maintain the client's sense of reality and reduce confusion.
E: Establishing eye contact when communicating with the client promotes engagement and helps in maintaining their attention.
Summary:
B: Refuting the client's delusions using logic can be counterproductive as it may cause distress and worsen their symptoms.
C: Allowing the client to choose among a variety of activities may overwhelm them. It is better to provide structured activities.
F & G: Not applicable.
A nurse is planning care for a client who has bipolar disorder and is experiencing mania. Which of the following interventions should the nurse include in the plan?
- A. Place the client in seclusion when he exhibits signs of anxiety.
- B. Encourage the client to spend time in the dayroom.
- C. Withdraw the client's TV privileges if he does not attend group therapy.
- D. Encourage the client to take frequent rest periods.
Correct Answer: D
Rationale: The correct answer is D: Encourage the client to take frequent rest periods. During manic episodes in bipolar disorder, individuals often experience decreased need for sleep and increased energy levels. Encouraging the client to take rest periods can help prevent exhaustion and promote relaxation, which may help in managing manic symptoms. Placing the client in seclusion when anxious (choice A) can exacerbate feelings of isolation and distress. Encouraging the client to spend time in the dayroom (choice B) may increase stimulation, which can worsen manic symptoms. Withdrawing TV privileges (choice C) for not attending group therapy may not directly address the manic symptoms. Thus, choice D is the most appropriate intervention for managing mania in this client.
A nurse is caring for a client with major depressive disorder who has a new prescription for fluoxetine. Which statement by the client indicates an understanding of the medication?
- A. I should expect to see improvement in my mood within a few days.
- B. I may experience increased thoughts of suicide at the beginning of treatment.
- C. I need to avoid foods high in tyramine while taking this medication.
- D. I will need to have my lithium levels checked regularly.
Correct Answer: B
Rationale: The correct answer is B. This statement indicates an understanding of the medication because it acknowledges the possibility of increased thoughts of suicide at the beginning of treatment, which is a crucial side effect to monitor for in clients starting on antidepressants like fluoxetine. It shows that the client is aware of the potential risks associated with the medication and is prepared to address them with healthcare providers if they occur.
Choice A is incorrect because improvement in mood with fluoxetine typically takes several weeks, not a few days. Choice C is incorrect as tyramine-related dietary restrictions are associated with MAOIs, not SSRIs like fluoxetine. Choice D is incorrect as lithium levels are not monitored with fluoxetine therapy.
A nurse is assessing a client who has bipolar disorder and is experiencing a depressive episode. Which of the following findings should the nurse expect?
- A. Inability to carry out a simple task
- B. Client reports auditory hallucinations
- C. Moves quickly from one idea to the next
- D. Client expresses illusions of grandeur
Correct Answer: A
Rationale: The correct answer is A: Inability to carry out a simple task. During a depressive episode in bipolar disorder, individuals often experience cognitive impairment, including difficulty concentrating and making decisions. This can lead to an inability to carry out simple tasks. Choices B, C, and D are more indicative of symptoms seen in manic episodes, such as auditory hallucinations (B), racing thoughts (C), and grandiosity (D). By understanding the characteristic symptoms of bipolar disorder episodes, the nurse can appropriately assess and provide interventions for the client.
A nurse is assessing a client who has bipolar disorder and is experiencing a depressive episode. Which of the following findings should the nurse expect?
- A. Inability to carry out a simple task
- B. Client reports auditory hallucinations
- C. Moves quickly from one idea to the next
- D. Client expresses illusions of grandeur
Correct Answer: A
Rationale: The correct answer is A: Inability to carry out a simple task. During a depressive episode in bipolar disorder, clients often experience symptoms such as psychomotor retardation, low energy, and difficulty concentrating. This can lead to an inability to carry out simple tasks due to lack of motivation and feelings of worthlessness. Clients may struggle with daily activities and find it challenging to complete even basic tasks. This is a common symptom of depression in bipolar disorder.
Choice B is incorrect as auditory hallucinations are more commonly associated with psychotic disorders or schizophrenia. Choice C is incorrect as rapid speech and jumping from one idea to the next are more indicative of a manic episode in bipolar disorder. Choice D is incorrect as expressing illusions of grandeur is a symptom of mania, not depression.