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The nurse is preparing medications for a client with bipolar disorder and notices that the antipsychotic medication was discontinued several days ago. Which medication should also be discontinued?
- A. Alprazolam (Xanax)
- B. Benztropine (Cogentin)
- C. Magnesium (Milk of Magnesia)
- D. Lithium (Lithotabs)
Correct Answer: B
Rationale: The correct answer is B: Benztropine (Cogentin). Benztropine is a medication commonly used to treat extrapyramidal side effects caused by antipsychotic medications. If the antipsychotic medication is discontinued, there is no longer a need for Benztropine. Alprazolam (A) is used to treat anxiety and should not be automatically discontinued. Magnesium (C) is a laxative and unrelated to bipolar disorder treatment. Lithium (D) is a mood stabilizer commonly used in bipolar disorder treatment and should not be discontinued without a healthcare provider's guidance.
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The mental health team is determining treatment options for a male patient who is experiencing psychotic symptoms. Which question(s) should the team answer to determine whether a community outpatient or inpatient setting is most appropriate? Select all that apply.
- A. Is the patient expressing suicidal thoughts?
- B. Does the patient have intact judgment and insight into his situation?
- C. Does the patient have experiences with either community or inpatient mental healthcare facilities?
- D. Does the patient require a therapeutic environment to support the management of psychotic symptoms?
Correct Answer: C
Rationale: The correct answer is C: Does the patient have experiences with either community or inpatient mental healthcare facilities? This question is crucial in determining the most appropriate setting for the patient's treatment. If the patient has prior experience with either setting, it can help the mental health team understand which environment may be more beneficial for the patient's current needs. If the patient has had positive experiences in a community outpatient setting, they may be more likely to benefit from that environment. On the other hand, if the patient has had previous success in an inpatient setting, that may be a more appropriate option. This question helps the team tailor the treatment plan to the patient's individual needs based on their past experiences.
Choices A, B, and D are incorrect as they do not directly address the patient's past experiences with different treatment settings, which is the most relevant factor in determining the appropriate treatment setting for the patient.
A middle-aged adult with major depressive disorder suffers from psychomotor retardation, hypersomnia, and motivation. Which intervention is likely to be most effective in returning this client to a normal level of functioning?
- A. Provide education on methods to enhance sleep.
- B. Teach the client to develop a plan for daily structured activities.
- C. Suggest that the client develop a list of pleasurable activities.
- D. Encourage the client to exercise.
Correct Answer: B
Rationale: The correct answer is B: Teach the client to develop a plan for daily structured activities. This intervention is most effective because it addresses the symptoms of psychomotor retardation, hypersomnia, and lack of motivation commonly seen in major depressive disorder. Structured activities can help the client regain a sense of routine, purpose, and accomplishment, which can improve mood and motivation. Providing education on sleep methods (A) may help with hypersomnia but may not address overall functioning. Developing a list of pleasurable activities (C) can be beneficial, but structured activities are more likely to improve functioning. Encouraging exercise (D) can be helpful but may be challenging for someone with psychomotor retardation.
A psychiatric nurse is reviewing prescriptions for a patient with major depression at the county clinic. Since the patient has a mild intellectual disability, the nurse would question which classification of antidepressant drugs:
- A. Selective serotonin reuptake inhibitors
- B. Monoamine oxidase inhibitors
- C. Serotonin and norepinephrine reuptake inhibitors
- D. All of the above
Correct Answer: B
Rationale: The correct answer is B: Monoamine oxidase inhibitors. Due to the patient's mild intellectual disability, MAOIs would be questioned because they have a higher risk of adverse effects, dietary restrictions, and drug interactions compared to other antidepressants. Selective serotonin reuptake inhibitors (Choice A) and serotonin and norepinephrine reuptake inhibitors (Choice C) are safer options for patients with intellectual disabilities as they have fewer side effects and interactions. Choice D is incorrect as all categories of antidepressants may not be suitable for the patient.
A young adult female visits the mental health clinic complaining of diarrhea, headache, and muscle aches. She is afebrile, denies chills, and all laboratory findings are within normal limits. During the physical assessment, the client tells the RN that her sister thinks she is neurotic and calls her a hypochondriac. Which response is best for the RN to provide?
- A. Unless your sister has a medical education, ignore her comments.
- B. I can hear that your sister comments are over-whelming you.
- C. Do you think it’s possible that you might be a hypochondriac?
- D. Besides your sister’s comments, what in your life is troubling you?
Correct Answer: B
Rationale: The correct answer is B: "I can hear that your sister's comments are overwhelming you." This response acknowledges the client's feelings and shows empathy, validating her experience. It demonstrates active listening and understanding without judgment. Choice A dismisses the client's feelings, which can be harmful. Choice C may come off as accusatory and may make the client defensive. Choice D shifts the focus away from the client's emotions, missing an opportunity for therapeutic communication.
The nurse leading a group session of adolescent clients gives the members a handout about anger management. One of the male clients is fidgety, interrupts peers when they try to talk, and talks about his pets at home. What nursing action is best for the nurse to take?
- A. Give the client permission to leave and return in 10 minutes.
- B. Explore the client’s feelings about his pets and home life.
- C. Encourage his peers to help involve him in the activity.
- D. Redirect him by encouraging him to read from the handout.
Correct Answer: D
Rationale: The correct answer is D: Redirect him by encouraging him to read from the handout. This option addresses the client's behavior by redirecting his focus back to the group activity. By encouraging him to read from the handout, the nurse provides a constructive way for the client to engage with the material and participate in the session. This approach helps the client stay on track with the intended purpose of the group session, which is anger management.
Other choices are incorrect:
A: Giving the client permission to leave may reinforce disruptive behavior.
B: Exploring the client's feelings about his pets may not address the immediate issue of his behavior.
C: Involving peers may not effectively address the client's disruptive behavior.
Overall, option D is the most appropriate as it directly addresses the client's behavior and redirects him in a positive way.