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A patient with major depressive disorder has been prescribed sertraline (Zoloft). Which statement by the patient indicates a need for further teaching?
- A. I should take my medication with food to avoid stomach upset.
- B. I should avoid alcohol while taking this medication.
- C. I can stop taking my medication once I feel better.
- D. I might experience some improvement in mood within a few weeks.
Correct Answer: C
Rationale: Choice C is the correct answer. It is crucial for patients to understand that they should not stop taking their medication once they feel better. Discontinuing antidepressants abruptly can lead to a relapse of depressive symptoms. Patients should continue taking their medication as prescribed by their healthcare provider, even if they start feeling better, to ensure the best outcomes in managing major depressive disorder. Choices A, B, and D are all accurate statements. Taking medication with food can help reduce stomach upset, avoiding alcohol is essential while on sertraline to prevent interactions, and experiencing some improvement in mood within a few weeks is a common expectation when starting an antidepressant like sertraline.
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The school staff has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer 'locking up' other children on the playground to the point where the children get scared. The staff recognizes that this behavior is most likely an indication of:
- A. The need to dominate others
- B. Inventing traumatic events
- C. A need to develop close relationships
- D. A potential symptom of traumatization
Correct Answer: D
Rationale: This behavior of playacting as a police officer and 'locking up' other children to the point of causing fear may suggest that the child is displaying potential symptoms of traumatization. It could indicate that the child has experienced or witnessed traumatic events, leading to the replication of such scenarios as a coping mechanism or way to process the trauma. Choices A, B, and C are incorrect because the behavior described is more indicative of a potential trauma response rather than a need to dominate others, invent traumatic events, or develop close relationships.
A patient with borderline personality disorder is admitted to the psychiatric unit. Which behavior is most characteristic of this disorder?
- A. Avoiding social interactions due to fear of rejection.
- B. Engaging in impulsive and self-destructive behaviors.
- C. Having a grandiose sense of self-importance.
- D. Exhibiting a pattern of unstable relationships.
Correct Answer: B
Rationale: Borderline personality disorder is characterized by impulsivity and self-destructive behaviors, such as substance abuse, reckless driving, and self-harm. These behaviors are often used to cope with intense emotional distress and are a key feature of this disorder. While individuals with borderline personality disorder may also struggle with unstable relationships, the hallmark feature that sets it apart is the impulsivity and self-destructive behaviors. Avoiding social interactions due to fear of rejection is more characteristic of avoidant personality disorder. Having a grandiose sense of self-importance is a feature of narcissistic personality disorder.
Which nursing response provides accurate information to discuss with the female patient diagnosed with bipolar disorder and her support system?
- A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
- B. Antidepressant therapy should be carefully monitored due to the risk of a manic episode in bipolar disorder.
- C. It's crucial to inform your healthcare provider promptly if you experience sleep disturbances.
- D. Are your family members prepared to play an active role in helping manage this disorder?
Correct Answer: A
Rationale: Choice A is the correct answer as it emphasizes the importance of avoiding triggers like alcohol and caffeine that can lead to symptom relapse in patients with bipolar disorder. Educating the patient and their support system about these triggers is essential for managing the condition effectively and preventing exacerbations of symptoms. Choice B is incorrect as it overly focuses on antidepressant therapy, which is not the primary concern related to triggers for symptom relapse. Choice C, while important, does not directly address triggers for symptom relapse in bipolar disorder. Choice D is also relevant but does not provide immediate information on managing triggers for symptom relapse.
A patient is being discharged with a prescription for an antidepressant for their depression. Which instruction is most important?
- A. Take the medication with food to prevent stomach upset.
- B. Refrain from driving until you understand the effects of the medication.
- C. Do not discontinue the medication suddenly.
- D. Avoid alcohol consumption while taking this medication.
Correct Answer: C
Rationale: The most critical instruction is to not discontinue the antidepressant medication suddenly. Abrupt discontinuation can lead to withdrawal symptoms and potentially trigger a relapse of depression. Options A, B, and D are important but not as crucial as ensuring the patient follows the prescribed regimen and consults with a healthcare provider before making any changes to the medication routine.
Which assessment question, when asked by the nurse, demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder?
- A. Do rules apply to you?
- B. What do you do to manage anxiety?
- C. Do you have a history of disordered eating?
- D. Do you think that you drink too much?
Correct Answer: B
Rationale: The correct answer is B. Inquiring about anxiety management demonstrates an understanding of the common comorbid condition of anxiety often seen alongside major depressive disorder. Anxiety and depression frequently coexist, and addressing anxiety management can provide insights into the patient's overall mental health status. Choices A, C, and D are incorrect because they do not directly address comorbid mental health conditions associated with major depressive disorder.