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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 shows the client is aware of the time frame for the medication to work.
Explanation for why other choices are incorrect:
A: Taking St. John's wort with amitriptyline can lead to serotonin syndrome, so it is not recommended.
C: Amitriptyline may cause orthostatic hypotension, not raise blood pressure.
D: Amitriptyline should be taken with food to minimize gastrointestinal side effects.
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A nurse is providing teaching to a client who has generalized anxiety disorder about strategies to manage anxiety. Which of the following should the nurse include? (Select all that apply)
- A. Progressive muscle relaxation
- B. Journaling
- C. Avoiding stressful situations
- D. Deep breathing exercises
- E. Drinking caffeinated beverages
Correct Answer: A,B,D
Rationale: The correct strategies for managing anxiety include A: Progressive muscle relaxation, B: Journaling, and D: Deep breathing exercises. Progressive muscle relaxation helps reduce muscle tension and promote relaxation. Journaling allows the client to express emotions and thoughts, reducing stress. Deep breathing exercises help calm the nervous system and reduce anxiety symptoms.
Avoiding stressful situations (C) is not a feasible long-term solution as it may limit the client's ability to cope with anxiety triggers. Drinking caffeinated beverages (E) can actually worsen anxiety symptoms due to the stimulant effect.
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 is known to cause metabolic side effects, including weight gain. This is due to its impact on appetite regulation and metabolism. Monitoring weight is crucial to prevent potential health risks associated with obesity. The other options are incorrect as risperidone is not known to cause increased blood pressure (A), excessive salivation (C), or bradycardia (D). Monitoring for these effects is not typically necessary when a client is prescribed risperidone.
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 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. "We can provide a copy of your records, but the therapist's notes are not included."
- C. "Why are you interested in seeing your therapist's notes?"
- D. "I don't think you will benefit from reviewing your therapist's notes right now."
Correct Answer: B
Rationale: The correct answer is B because therapist's notes are considered privileged information and are not typically included in a client's medical records. Providing these notes could compromise the therapeutic relationship and confidentiality. Option A is incorrect as it assumes the client is unhappy with treatment. Option C is inappropriate as it questions the client's motivation. Option D is incorrect as it dismisses the client's request without proper justification. Options E, F, and G are not provided, but B is the most appropriate response in this scenario.
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. This intervention helps the client explore and address underlying emotions driving self-mutilation, promoting self-awareness and healthier coping mechanisms. Option A may escalate feelings of lack of control, triggering more self-harm. Option C isolates the client, worsening feelings of abandonment. Option D is dismissive and oversimplifies the behavior.