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A nurse is providing teaching to a client who has a depressive disorder and a new prescription for amitriptyline. Which of the following statements by the client indicates an understanding of the teaching?
- A. "I can continue to take St. John's wort while taking this medication."
- B. "I know it will be a couple of weeks before the medication helps me feel better."
- C. "I expect this medication to raise my blood pressure."
- D. "I should take this medication on an empty stomach."
Correct Answer: B
Rationale: The correct answer is B: "I know it will be a couple of weeks before the medication helps me feel better." This statement indicates an understanding of the teaching because amitriptyline, a tricyclic antidepressant, typically takes a few weeks to reach its full therapeutic effect in treating depressive symptoms. This indicates the client understands the delayed onset of action of the medication.
Incorrect options:
A: "I can continue to take St. John's wort while taking this medication." - St. John's wort can interact with amitriptyline, leading to potentially dangerous side effects.
C: "I expect this medication to raise my blood pressure." - Amitriptyline can indeed cause orthostatic hypotension, not raise blood pressure.
D: "I should take this medication on an empty stomach." - Amitriptyline is usually taken with food to minimize gastrointestinal side effects.
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A nurse in an acute mental health care facility is prioritizing care for multiple clients. Which of the following clients should the nurse see first?
- A. A client who has narcissistic personality disorder and is mocking others during group therapy
- B. A client who has obsessive-compulsive disorder and is upset about a change in daily routine
- C. A client who has depressive disorder and requires assistance with ADLs
- D. A client who is taking clozapine to treat schizophrenia and reports a sore throat
Correct Answer: D
Rationale: The correct answer is D. The nurse should see the client taking clozapine first due to the potential side effect of agranulocytosis, which can manifest as a sore throat. This is a serious adverse effect that requires immediate attention to prevent complications. The other clients do not present with urgent or life-threatening issues. A: Narcissistic behavior is disruptive but not a medical emergency. B: Upset about a routine change is distressing but does not pose a physical health risk. C: Assistance with ADLs is important but not immediately life-threatening. Therefore, prioritizing the client on clozapine with a sore throat is crucial to ensure timely intervention and prevent serious complications.
A nurse is teaching a client who has generalized anxiety disorder about buspirone. Which statement indicates the client understands the teaching?
- A. I should take this medication as needed for acute anxiety.
- B. I may experience sedation and drowsiness with this medication.
- C. I should avoid grapefruit juice while taking this medication.
- D. This medication has a risk for dependence.
Correct Answer: C
Rationale: The correct answer is C. This is because grapefruit juice can interact with buspirone and increase its concentration in the blood, leading to potential side effects. Choice A is incorrect because buspirone is not meant for acute anxiety but requires regular dosing. Choice B is incorrect as sedation is not a common side effect of buspirone. Choice D is incorrect because buspirone is not associated with dependence or abuse potential.
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.
A nurse in an acute care mental health facility is placing a client in seclusion and restraints. Which of the following actions should the nurse plan to take?
- A. Ensure that the prescription for restraints be renewed every 6 hr.
- B. Document the client's behavior every 15 min.
- C. Request a provider to evaluate the client in person every 36 hr.
- D. Plan to monitor the client every 30 min while restrained.
Correct Answer: B
Rationale: The correct answer is B: Document the client's behavior every 15 min. This action is crucial in ensuring the safety and well-being of the client in seclusion and restraints. Documenting the client's behavior every 15 minutes allows the nurse to monitor for any changes in the client's condition, response to the intervention, or signs of distress. It helps in identifying any potential risks or improvements, enabling timely intervention or adjustment of the care plan. This frequent documentation also ensures compliance with regulatory standards and serves as a detailed record of the client's status during the intervention.
Other choices are incorrect:
A: Ensuring prescription renewal every 6 hours may be too frequent and not necessary unless there are specific indications.
C: Requesting a provider evaluation every 36 hours may not provide timely assessment and intervention in case of any changes in the client's condition.
D: Monitoring the client every 30 minutes while restrained may not be frequent enough to detect sudden changes or risks promptly.
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 is C: "We can provide a copy of your records, but the therapist's notes are not included." This response aligns with ethical guidelines and laws that protect the confidentiality of therapist-client communication. Providing therapist's notes without proper authorization may breach confidentiality and harm the therapeutic relationship. Other choices lack professionalism and may undermine the client's trust. Option A implies judgment and defensiveness. Option B can be seen as intrusive and may put the client on the defensive. Option D dismisses the client's request and may discourage open communication. Overall, option C respects confidentiality, maintains boundaries, and upholds the client's right to privacy.