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.
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A nurse is planning care for a client who has borderline personality disorder and engages in self-mutilation. Which intervention should the nurse include?
- A. Restrict the client's access to personal belongings.
- B. Encourage the client to express feelings of anger.
- C. Place the client in seclusion when self-injurious behavior occurs.
- D. Tell the client to stop the self-mutilation behavior.
Correct Answer: B
Rationale: The correct answer is B: Encourage the client to express feelings of anger. For a client with borderline personality disorder and self-mutilation behavior, it is essential to address underlying emotions. Encouraging the client to express feelings of anger can help them identify and process their emotions, reducing the likelihood of resorting to self-injury. Restricting access to personal belongings (A) may lead to feelings of frustration and exacerbate the behavior. Placing the client in seclusion (C) may cause feelings of abandonment and increase distress. Simply telling the client to stop self-mutilation (D) overlooks the complex emotional reasons behind the behavior.
A nurse is admitting a client who has dementia to a long-term care facility. The client tells the nurse that she lived in this facility years ago and took care of all the residents by herself. The nurse should document this as which of the following findings?
- A. Projection
- B. Perseveration
- C. Agnosia
- D. Confabulation
Correct Answer: D
Rationale: The correct answer is D: Confabulation. Confabulation is the unintentional fabrication of memories or events to fill in gaps in memory due to cognitive impairment. In this scenario, the client with dementia is creating false memories of taking care of all the residents by herself, which is a classic example of confabulation. This behavior is not intentional lying but a result of memory deficits.
Choice A: Projection involves attributing one's own unacceptable feelings or thoughts to others, which is not applicable in this context.
Choice B: Perseveration is the repetition of a particular response, such as repeating a word or phrase, which does not align with the client's false memory.
Choice C: Agnosia refers to the inability to recognize familiar objects or people due to brain damage, which is not evident in the client's statement.
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.
A nurse is assessing a client who has histrionic personality disorder. Which of the following manifestations should the nurse expect?
- A. Suspicious of others
- B. Callousness
- C. Self-centered behavior
- D. Violates others' rights
Correct Answer: C
Rationale: The correct answer is C: Self-centered behavior. Histrionic personality disorder is characterized by attention-seeking behavior, excessive emotions, and a need for approval. Individuals with this disorder often exhibit self-centered behavior to gain attention and validation from others. Choice A is incorrect as suspicion of others is more indicative of paranoid personality disorder. Choice B, callousness, is not a typical feature of histrionic personality disorder, but rather more aligned with antisocial personality disorder. Choice D, violating others' rights, is more characteristic of individuals with antisocial personality disorder as well.
A client with schizophrenia is prescribed risperidone. Which of the following should the nurse monitor for as an adverse effect of this medication?
- A. Increased blood pressure
- B. Weight gain
- C. Excessive salivation
- D. Bradycardia
Correct Answer: B
Rationale: The correct answer is B: Weight gain. Risperidone, an atypical antipsychotic, is known to cause metabolic side effects such as weight gain. This occurs due to its effects on increasing appetite and altering metabolism. Monitoring weight regularly is crucial to detect and manage this adverse effect to prevent complications like diabetes and cardiovascular issues. Increased blood pressure (A) is not a common adverse effect of risperidone. Excessive salivation (C) is more commonly associated with medications like clozapine. Bradycardia (D) is not a typical side effect of risperidone.