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When planning care for a client with schizophrenia, which of the following interventions should be included in the plan of care?
- A. Encourage reality testing
- B. Provide opportunities for socialization
- C. Monitor for command hallucinations
- D. Promote adherence to medication regimen
Correct Answer: A
Rationale: When caring for a client with schizophrenia, encouraging reality testing is essential. This intervention assists the client in distinguishing between delusions and reality, aiding in their treatment. While providing opportunities for socialization can help reduce isolation, monitoring for command hallucinations is crucial for the client's safety. Promoting adherence to the medication regimen is vital for symptom management. Addressing delusional thoughts in a therapeutic manner is preferable to outright discouragement, fostering a supportive environment for the client.
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A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?
- A. Teenagers! They don't know a thing about real stress.
- B. Stress occurs only when there is a loss.
- C. When you are in poor physical condition, you can't experience psychological well-being.
- D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
Correct Answer: D
Rationale: The most appropriate response is D: 'Stress can be psychological. A threat to self-esteem may result in high stress levels.' This response acknowledges the psychological aspect of stress and how a perceived threat to self-esteem can be just as stressful as a physiological change. Choices A, B, and C are incorrect because they do not address the client's concerns or provide a therapeutic response to the situation.
A client has been prescribed lithium for the treatment of bipolar disorder. Which of the following instructions should the nurse include?
- A. Avoid driving until you know how the medication affects you.
- B. Take the medication with food to prevent stomach upset.
- C. You may experience mild nausea when initiating the medication.
- D. Do not double the next dose if you miss one.
Correct Answer: A
Rationale: The correct instruction for the nurse to provide is to advise the client to avoid driving until they know how the medication affects them. Lithium can lead to side effects like dizziness and drowsiness, which could impair one's ability to drive safely. Choice B is incorrect because lithium is usually taken on an empty stomach. Choice C may be true but is not as critical as the potential side effects affecting driving. Choice D is important but not as immediate as ensuring the client's safety while driving.
Which of the following are potential side effects of electroconvulsive therapy (ECT)? Select one that does not apply.
- A. Short-term memory loss
- B. Headache
- C. Confusion
- D. Tardive dyskinesia
Correct Answer: D
Rationale: Potential side effects of ECT include short-term memory loss, headache, confusion, and nausea. Tardive dyskinesia is not a side effect of ECT; it is associated with long-term use of antipsychotic medications, particularly antipsychotics that block dopamine receptors over time. ECT is primarily used for severe depression, bipolar disorder, and certain psychotic disorders. The other choices, short-term memory loss, headache, and confusion, are known side effects of ECT and are usually short-term and manageable.
A healthcare provider is assessing a client with generalized anxiety disorder (GAD). Which of the following findings should the healthcare provider expect? Select one that does not apply.
- A. Restlessness
- B. Fatigue
- C. Excessive worry
- D. Mania
Correct Answer: D
Rationale: In generalized anxiety disorder (GAD), common symptoms include restlessness, fatigue, and excessive worry. These symptoms are typical in individuals with GAD due to persistent and excessive anxiety. Mania, on the other hand, is not a characteristic symptom of GAD. Mania is associated with bipolar disorder and is characterized by distinct features like elevated mood, grandiosity, and impulsivity. Therefore, the correct answer is 'D: Mania,' as it does not align with the expected findings in generalized anxiety disorder.
A client diagnosed with major depressive disorder is being educated by a nurse about the use of antidepressants. Which of the following statements by the client indicates a need for further teaching?
- A. I should avoid alcohol while taking this medication.
- B. It may take several weeks for the medication to take effect.
- C. I can stop taking my medication once I feel better.
- D. I should not discontinue the medication abruptly.
Correct Answer: C
Rationale: The correct answer is C. The client stating, 'I can stop taking my medication once I feel better,' indicates a need for further teaching. It is crucial for clients with major depressive disorder to understand that they should continue taking their medication as prescribed even if they start feeling better. Stopping the medication prematurely can lead to a relapse of symptoms. Choices A, B, and D are correct statements. Avoiding alcohol while taking antidepressants helps prevent interactions and side effects. Understanding that it may take several weeks for the medication to show its full effect is important for managing expectations. Additionally, not discontinuing the medication abruptly is crucial to prevent withdrawal effects or a recurrence of depressive symptoms.