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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: "I may experience increased thoughts of suicide at the beginning of treatment." This statement indicates an understanding of the medication because fluoxetine, an SSRI, can initially increase suicidal ideation in clients with major depressive disorder due to sudden improvement in energy levels before mood improvement. This is important for the client to know for safety monitoring.
Choice A is incorrect as improvement in mood may take several weeks, not days. Choice C is incorrect as avoiding tyramine-rich foods is relevant for MAOIs, not SSRIs like fluoxetine. Choice D is incorrect as lithium levels are monitored for clients taking lithium, not fluoxetine.
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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 creation of false memories or distortion of actual memories without the intention to deceive. In this scenario, the client is not intentionally lying, but rather recalling a memory that did not occur. This is common in individuals with dementia. Projection (A) involves attributing one's thoughts or feelings to someone else. Perseveration (B) is the persistent repetition of a response. Agnosia (C) is the inability to recognize familiar objects or people. In this case, the client's statement aligns most closely with confabulation, making it the correct choice.
A nurse is providing discharge teaching to a client who has bipolar disorder and a new prescription for lithium. Which statement by the client indicates an understanding of the teaching?
- A. I will reduce my sodium intake to help lithium work better
- B. I should take my medication on an empty stomach
- C. I need to drink 2-3 liters of water each day
- D. I can stop taking lithium once my symptoms improve
Correct Answer: C
Rationale: The correct answer is C: "I need to drink 2-3 liters of water each day." This statement indicates an understanding of the teaching because lithium can cause dehydration and increase the risk of toxicity. Adequate hydration helps to prevent this. Choice A is incorrect because reducing sodium intake is not directly related to lithium's effectiveness. Choice B is incorrect as lithium should be taken with food to reduce gastrointestinal side effects. Choice D is incorrect because stopping lithium abruptly can lead to a relapse of symptoms.
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 is working with a client who has an anxiety disorder and is in the orientation phase of the therapeutic relationship. Which of the following statements should the nurse make during this phase?
- A. We should discuss resources to implement in your daily life.
- B. Let me show you simple relaxation exercises to manage stress.
- C. We should establish our roles in the initial session.
- D. Let's talk about how you can change your response to stress.
Correct Answer: C
Rationale: The correct answer is C: "We should establish our roles in the initial session." During the orientation phase of the therapeutic relationship, it is crucial to clarify the roles of both the nurse and the client to establish boundaries and expectations. This helps set the foundation for a trusting and effective therapeutic alliance. Discussing resources (A) and relaxation exercises (B) are important but typically occur later in the relationship. Talking about changing responses to stress (D) may be premature in the orientation phase. The other choices are not relevant to the specific goal of the orientation phase, which is to define roles and expectations.
A nurse is caring for a client who has a history of opioid use disorder. Which medication should the nurse anticipate administering to prevent withdrawal symptoms?
- A. Methadone
- B. Disulfiram
- C. Naloxone
- D. Bupropion
Correct Answer: A
Rationale: Rationale: A nurse should anticipate administering Methadone to prevent withdrawal symptoms in a client with opioid use disorder. Methadone is a long-acting opioid agonist that helps manage withdrawal symptoms and cravings, making it an effective treatment option. Disulfiram is used for alcohol dependence, Naloxone is an opioid antagonist used for overdose reversal, and Bupropion is an antidepressant. These medications are not indicated for preventing opioid withdrawal symptoms.