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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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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 intervention is most appropriate to promote the self-esteem of a patient with severe depression?
- A. Encouraging the patient to spend time alone for self-reflection.
- B. Involving the patient in simple, achievable activities to ensure success.
- C. Allowing the patient to rest and avoid responsibilities.
- D. Providing frequent reassurances and compliments.
Correct Answer: B
Rationale: Involving the patient in simple, achievable activities is a constructive approach to promote self-esteem by fostering a sense of accomplishment and success. This method encourages positive reinforcement and helps the patient regain confidence and self-worth, which are essential in managing depression. Choice A could potentially lead to rumination and worsen depressive symptoms. Choice C might reinforce avoidance behaviors and hinder progress. Choice D, while supportive, may not address the core need for building self-esteem through personal achievements.
A healthcare provider is educating a patient about the side effects of selective serotonin reuptake inhibitors (SSRIs). Which side effect should the provider emphasize?
- A. Weight gain
- B. Increased libido
- C. Nausea
- D. Insomnia
Correct Answer: C
Rationale: When educating patients about SSRIs, it is crucial to emphasize the common side effect of nausea. Nausea is a frequently reported side effect of SSRIs that can impact adherence to treatment. By highlighting this side effect, patients can be better prepared and informed about what to expect when taking these medications. Choices A, B, and D are incorrect as weight gain, increased libido, and insomnia are not typically associated with SSRIs as common side effects. Nausea is a more relevant and prevalent side effect to address with patients.
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.
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.