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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.
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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.
A patient with posttraumatic stress disorder (PTSD) is prescribed prazosin. The nurse understands that this medication is used to treat which symptom of PTSD?
- A. Flashbacks
- B. Nightmares
- C. Hypervigilance
- D. Depression
Correct Answer: B
Rationale: Prazosin is a medication often prescribed to manage nightmares in patients with PTSD. It works by blocking the action of adrenaline on specific receptors, which helps in reducing the intensity and frequency of nightmares. While flashbacks, hypervigilance, and depression are also common symptoms of PTSD, prazosin is specifically indicated for nightmares associated with the disorder. Flashbacks are typically addressed through therapies like cognitive-behavioral therapy, hypervigilance may be managed through counseling and coping strategies, and depression may necessitate antidepressant medications or therapy tailored for depression.
A patient with generalized anxiety disorder (GAD) is prescribed escitalopram. The nurse should educate the patient that the full therapeutic effect of this medication may take:
- A. 1-2 days
- B. 1-2 weeks
- C. 2-4 weeks
- D. 6-8 weeks
Correct Answer: D
Rationale: Escitalopram, an SSRI used in treating generalized anxiety disorder, typically takes 6-8 weeks to achieve its full therapeutic effect. While some improvement may be noticed earlier, the maximum benefit is usually experienced after this timeframe. Options A, B, and C are incorrect because they underestimate the time required for escitalopram to reach its full effectiveness. Educating patients about the realistic timeline for medication effectiveness is crucial in managing expectations and ensuring adherence to the prescribed treatment.
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 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.