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When attempting to determine a teenager's mental health resilience, what assessment question should the nurse ask that is not applicable?
- A. How did you cope when your father deployed with the Army for a year in Iraq?
- B. Who did you go to for advice while your father was away for a year in Iraq?
- C. How do you feel about talking to a mental health counselor?
- D. Why would you think that is a better option than meeting with me?
Correct Answer: D
Rationale: Assessing a teenager's mental health resilience involves exploring coping mechanisms, support systems, and attitudes towards seeking help. Option D is not relevant to assessing resilience but rather focuses on the comparison between seeking advice from a counselor versus the nurse, which doesn't directly gauge the teenager's resilience.
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Which characteristic identified during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? Select one that doesn't apply.
- A. Female
- B. 7 years old
- C. Comorbid autism diagnosis
- D. Outbursts occur at least once a week
Correct Answer: C
Rationale: Characteristics such as age, frequency of outbursts, and occurrence in multiple settings support a diagnosis of disruptive mood dysregulation disorder. While comorbid conditions like autism can coexist with disruptive mood dysregulation disorder, it is not a characteristic that serves to support a diagnosis of this specific disorder.
Tatiana has been hospitalized for an acute manic episode. On admission, the nurse suspects lithium toxicity. What assessment findings would indicate the nurse's suspicion as correct?
- A. Shortness of breath, gastrointestinal distress, chronic cough
- B. Ataxia, severe hypotension, large volume of dilute urine
- C. Gastrointestinal distress, thirst, nystagmus
- D. Electroencephalographic changes, chest pain, dizziness
Correct Answer: B
Rationale: The correct answer is B. Ataxia, severe hypotension, and a large volume of dilute urine are classic signs of lithium toxicity. Ataxia refers to a lack of muscle coordination, severe hypotension indicates dangerously low blood pressure, and the large volume of dilute urine is a result of the kidneys' inability to concentrate urine properly, a common feature of lithium toxicity.
A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms?
- A. Her memory problems will likely decrease.
- B. Depressive episodes should be less severe.
- C. She will probably enjoy social interactions more.
- D. She should experience a reduction in hallucinations.
Correct Answer: D
Rationale: First-generation antipsychotic medications are effective in reducing hallucinations in patients with schizophrenia. These medications primarily target positive symptoms such as hallucinations and delusions. Therefore, the nurse should inform the patient that she should experience a reduction in hallucinations with the prescribed first-generation antipsychotic medication.
During pregnancy, a woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:
- A. Maternal stress
- B. Parental nurturing
- C. Appropriate stress responses in the brain
- D. Memories of the abuse
Correct Answer: A
Rationale: Maternal stress during pregnancy can have long-term effects on the child's behavior and stress responses. Research shows that exposure to high levels of stress hormones in the womb can influence the developing fetal brain and the child's future behavior, potentially leading to high-risk behaviors during adolescence.
Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?
- A. Fluoxetine (Prozac)
- B. Isocarboxazid (Marplan)
- C. Amitriptyline
- D. Duloxetine (Cymbalta)
Correct Answer: A
Rationale: Fluoxetine (Prozac) is a suitable alternative antidepressant for Tammy due to its approval for the treatment of bulimia nervosa. It belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, similar to citalopram, which Tammy is already taking. Fluoxetine has shown efficacy in treating bulimia nervosa and can be a beneficial choice for individuals with this condition.