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During a mental health assessment, a patient states, 'I just don't see the point in anything anymore.' This statement is an indication of which of the following?
- A. Anxiety disorder
- B. Bipolar disorder
- C. Depression
- D. Schizophrenia
Correct Answer: C
Rationale: The patient's statement 'I just don't see the point in anything anymore' reflects feelings of hopelessness and a lack of purpose, which are common symptoms of depression. Depression is characterized by persistent feelings of sadness, emptiness, and loss of interest or pleasure in activities that were once enjoyable. While anxiety disorders can involve excessive worry and fear, bipolar disorder includes episodes of both depression and mania, and schizophrenia typically involves symptoms such as hallucinations and delusions. Therefore, depression is the most appropriate choice based on the patient's statement.
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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 with bipolar disorder is being educated by a nurse on the importance of medication adherence. Which statement by the patient indicates understanding?
- A. I will take my medication only when I feel manic symptoms.
- B. I understand that I need to take my medication regularly, even if I feel well.
- C. I will stop taking my medication if I experience side effects.
- D. I will take my medication whenever I remember.
Correct Answer: B
Rationale: The correct answer is B. Taking medication regularly, even when feeling well, is crucial in managing bipolar disorder. Choice A is incorrect because medication adherence should not be based on symptoms alone. Choice C is incorrect as stopping medication due to side effects should be discussed with a healthcare provider. Choice D is incorrect because relying on memory may lead to missed doses, impacting treatment effectiveness.
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.
A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, 'You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'
- A. A higher dosage
- B. Once-a-week dosing
- C. A lower dosage
- D. A different drug
Correct Answer: C
Rationale: As the patient transitions to maintenance therapy, the typical approach involves decreasing the dosage to a lower level. This adjustment is made to find the minimum effective dose needed for symptom control while reducing the potential side effects associated with long-term use. Choosing a higher dosage (A) would not align with the goal of maintenance therapy, as it may increase the risk of adverse effects. Once-a-week dosing (B) is not a common adjustment for lithium, which is usually prescribed daily for bipolar disorder. Switching to a different drug (D) is typically considered if the current medication is ineffective or intolerable, not as a routine step in transitioning to maintenance therapy.
What is a priority intervention for a patient with severe anxiety?
- A. Encouraging the patient to discuss their feelings in detail.
- B. Providing a calm and quiet environment.
- C. Encouraging the patient to participate in group activities.
- D. Providing detailed information about their treatment plan.
Correct Answer: B
Rationale: When dealing with a patient experiencing severe anxiety, providing a calm and quiet environment is a priority intervention. This approach helps reduce stimuli and anxiety levels, creating a more soothing atmosphere for the individual. Encouraging the patient to discuss their feelings in detail or participate in group activities may be beneficial in certain situations, but establishing a peaceful setting takes precedence when managing severe anxiety. Providing detailed information about their treatment plan, although important, may not be the immediate priority when the patient is in a state of severe anxiety and needs a calming environment first.