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A nurse is assessing a patient with schizophrenia who is experiencing delusions. Which intervention is most appropriate?
- A. Agree with the patient's delusions to avoid confrontation.
- B. Encourage the patient to explore the basis of the delusions.
- C. Engage the patient in reality-based activities.
- D. Ask the patient to explain the delusions in detail.
Correct Answer: C
Rationale: The most appropriate intervention when assessing a patient with schizophrenia experiencing delusions is to engage the patient in reality-based activities. This intervention helps distract the patient from the delusions and reorients them to the present, promoting grounding in reality. Choice A is incorrect because agreeing with delusions can reinforce them and hinder treatment. Choice B may exacerbate the delusions by delving deeper into their basis. Choice D may not be beneficial as it focuses solely on the delusions without addressing the need to ground the patient in reality.
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A patient with major depressive disorder has been prescribed an MAOI. The patient should be educated to avoid which type of food to prevent hypertensive crises?
- A. High-protein foods
- B. High-fiber foods
- C. Tyramine-rich foods
- D. Low-fat foods
Correct Answer: C
Rationale: The correct answer is C: Tyramine-rich foods. Patients prescribed MAOIs should avoid tyramine-rich foods to prevent hypertensive crises. Tyramine-rich foods can interact with MAOIs, leading to a sudden and dangerous increase in blood pressure. Examples of tyramine-rich foods include aged cheeses, cured meats, pickled or fermented foods, and certain beverages like beer and wine. Choices A, B, and D are incorrect because they are not associated with causing hypertensive crises when taken with MAOIs.
During a manic episode, which nursing intervention is most appropriate?
- A. Encourage group activities to increase socialization.
- B. Provide a structured environment with limited stimuli.
- C. Allow the patient to engage in physical activities freely.
- D. Give the patient detailed and complex tasks to complete.
Correct Answer: B
Rationale: During a manic episode, individuals may experience heightened energy levels and reduced impulse control. Providing a structured environment with limited stimuli is the most appropriate nursing intervention. This approach helps reduce excessive stimulation and potential triggers for further escalation of manic behavior. It promotes a calming and controlled setting, assisting in managing symptoms and promoting the patient's well-being. Encouraging group activities (Choice A) may lead to overstimulation, allowing the patient to engage in physical activities freely (Choice C) could be risky due to impulsivity, and giving detailed tasks (Choice D) might overwhelm the individual.
What should the nurse include in patient education for a patient starting on bupropion for major depressive disorder?
- A. Avoid consuming alcohol while taking this medication.
- B. Take the medication in the morning to prevent insomnia.
- C. It may cause significant weight gain.
- D. It is used as a first-line treatment for anxiety.
Correct Answer: A
Rationale: Patients prescribed bupropion should be educated to avoid consuming alcohol while on this medication to reduce the risk of seizures. Bupropion lowers the seizure threshold, and alcohol can further increase this risk. It is important for patients to understand the potential consequences of combining bupropion with alcohol to ensure their safety and treatment effectiveness. Choices B, C, and D are incorrect. Taking bupropion in the morning does not prevent insomnia; it is not associated with significant weight gain; and it is not a first-line treatment for anxiety.
During a manic episode in bipolar disorder, which intervention is most appropriate for a patient?
- A. Encourage the patient to engage in group activities.
- B. Provide a structured and low-stimulus environment.
- C. Allow the patient to set their schedule.
- D. Engage the patient in high-energy physical activities.
Correct Answer: B
Rationale: During a manic episode in bipolar disorder, individuals may experience heightened energy levels, impulsivity, and decreased need for sleep. Providing a structured and low-stimulus environment is crucial in managing manic episodes. This intervention helps reduce overstimulation and provides a calm and predictable setting, which can be beneficial in helping the patient regain control and stability. Group activities and high-energy physical activities may exacerbate the symptoms of mania by increasing stimulation and excitement. Allowing the patient to set their schedule may not provide the necessary structure needed during a manic episode, hence making it less appropriate.
In treating social anxiety disorder, which medication is commonly prescribed to patients with this condition?
- A. Methylphenidate
- B. Sertraline
- C. Lithium
- D. Haloperidol
Correct Answer: B
Rationale: Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat social anxiety disorder. SSRIs are a first-line pharmacological treatment for social anxiety disorder due to their effectiveness in reducing anxiety symptoms by increasing serotonin levels in the brain, which helps regulate mood and emotions. Methylphenidate is a stimulant primarily used in attention deficit hyperactivity disorder (ADHD) but not in social anxiety disorder. Lithium is typically used in bipolar disorder, while haloperidol is an antipsychotic medication more commonly used in conditions like schizophrenia. Therefore, the correct choice for treating social anxiety disorder is Sertraline (B).