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A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse not implement?
- A. Agree with the client's delusions to avoid confrontation.
- B. Monitor for signs of suicidal ideation
- C. Promote a regular sleep schedule
- D. Discourage the expression of negative feelings
Correct Answer: A
Rationale: During a depressive episode in bipolar disorder, it is crucial not to agree with the client's delusions to avoid reinforcing false beliefs. Monitoring for signs of suicidal ideation is essential for safety. Promoting a regular sleep schedule can help stabilize mood. Discouraging the expression of negative feelings is not recommended as it is important to allow clients to express their emotions and feel heard.
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In the treatment of a patient with bipolar disorder experiencing a depressive episode, which medication is commonly prescribed?
- A. Valproic acid
- B. Risperidone
- C. Fluoxetine
- D. Lithium
Correct Answer: C
Rationale: The correct answer is C, Fluoxetine. Fluoxetine, a commonly prescribed antidepressant, is used to manage depressive episodes in bipolar disorder. It helps alleviate symptoms of depression by increasing the levels of serotonin in the brain, which can improve mood and reduce feelings of sadness and hopelessness. While mood stabilizers like lithium are often used in bipolar disorder, for depressive episodes, antidepressants like fluoxetine are preferred to address the specific symptoms associated with depression. Valproic acid is a mood stabilizer often used in bipolar disorder to manage manic episodes. Risperidone is an atypical antipsychotic that may be used in bipolar disorder to help control manic episodes or as an adjunctive treatment, but it is not a first-line medication for depressive episodes.
How do psychiatrists determine which diagnosis to give a patient?
- A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
- B. Hospital policy dictates how psychiatrists diagnose mental disorders.
- C. Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing factors.
- D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.
Correct Answer: A
Rationale: The correct answer is A. Psychiatrists use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association (APA) to determine diagnoses. The DSM-5 provides standardized criteria for the classification of mental disorders, ensuring accurate and reliable diagnosis and treatment. Choices B and D are inaccurate as hospital policy does not dictate psychiatric diagnoses, and the American Medical Association is not responsible for psychiatric diagnostic criteria. Choice C describes a more general approach to assessment and does not specifically address the standardized criteria used in psychiatric diagnosis.
Which of the following statements should a healthcare professional recognize as true about defense mechanisms? Select the one that doesn't apply.
- A. They are employed when there is a threat to biological or psychological integrity.
- B. They are controlled by the id and deal with primal urges.
- C. They are used in an effort to relieve mild to moderate anxiety.
- D. They are protective devices for the superego.
Correct Answer: B
Rationale: Defense mechanisms are employed by the ego in the face of threats to biological and psychological integrity to relieve mild to moderate anxiety. They act as protective devices for the ego, not the id or superego. The id represents primal instincts, while the superego is associated with moral standards. Defense mechanisms help individuals cope with stressors by redirecting focus and are often unconscious and self-deceptive.
A client diagnosed with schizophrenia is receiving discharge teaching. Which of the following instructions should the healthcare provider include? Select one that does not apply.
- A. Continue taking medications as prescribed
- B. Avoid all social interactions
- C. Report any side effects of medications to the healthcare provider
- D. Develop a daily routine
Correct Answer: B
Rationale: Discharge instructions for a client diagnosed with schizophrenia should focus on promoting medication adherence, monitoring and reporting any medication side effects, and establishing a structured daily routine to support stability and well-being. Encouraging the client to avoid all social interactions is not appropriate as social support can be beneficial for individuals with schizophrenia. Social interactions can help reduce feelings of isolation, improve overall well-being, and provide emotional support. Therefore, advising the client to avoid all social interactions would not be in the best interest of their recovery and management of the condition.
In evaluating a client's response to stress, what would indicate a secondary appraisal of the stressful event?
- A. When the individual judges the event to be benign
- B. When the individual judges the event to be irrelevant
- C. When the individual judges the resources and skills needed to deal with the event
- D. When the individual judges the event to be pleasurable
Correct Answer: C
Rationale: A secondary appraisal occurs when an individual evaluates the resources and skills required to cope with a stressful event. This type of appraisal focuses on the person's perceived ability to manage the situation. In contrast, choices A, B, and D do not involve the assessment of resources and skills. Choice A relates to a benign judgment of the event, choice B to an irrelevant judgment, and choice D to a pleasurable judgment, which are aspects of primary rather than secondary appraisals.