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When providing instructions to a patient who has just been prescribed Isocarboxazid (Marplan), it is important for the nurse to include:
- A. Interactions with other medications
- B. Requires tyramine-free diet: avoid food and drugs that increase norepinephrine levels to prevent hypertensive crisis
- C. Palpitations
- D. Course hand tremor
Correct Answer: A
Rationale: The correct answer is A because Isocarboxazid is an MAOI, which can have dangerous interactions with other medications resulting in serious side effects. It is crucial for the nurse to educate the patient about potential drug interactions to prevent harm. Choice B is incorrect as Isocarboxazid does not require a tyramine-free diet like other MAOIs such as phenelzine. Choices C and D are unrelated side effects of Isocarboxazid and not the key information that needs to be communicated to the patient.
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A family has presented at a community mental health clinic. The mother reports that the children ages 8 and 10 are 'not doing well since their father died three months ago.' The nurse demonstrates an understanding of the goals of a family mental health assessment when initially:
- A. Assessing the mother's ability to provide physical care for her children.
- B. Encouraging the mother to discuss the problems with the children's teachers.
- C. Observing how the children interact with both their mother and with each other.
- D. Arranging for the family members to attend age-appropriate grief management groups.
Correct Answer: D
Rationale: The correct answer is D because arranging for the family members to attend age-appropriate grief management groups aligns with the goal of assessing and addressing the family's mental health needs following a significant loss. This approach recognizes the impact of the father's death on the children and the mother, providing them with support and coping strategies. It acknowledges the importance of addressing grief and promoting healthy coping mechanisms within the family unit.
Choices A, B, and C are incorrect because they do not directly address the family's mental health needs in the context of grief and loss. Assessing the mother's ability to provide physical care, encouraging discussions with teachers, and observing interactions are important but do not specifically target the emotional and psychological impact of the father's death on the family.
In the Graduate Diploma in Family Medicine (GDFM) / MMed(Family Medicine) modular course, in which unit is the topic of depression in the elderly covered?
- A. Unit 523.
- B. Unit 411.
- C. Unit 213.
- D. Unit 423.
Correct Answer: D
Rationale: Unit 423 is commonly designated for topics like depression in the elderly in such curricula.
Which of the following are risk factors for pathological gambling?
- A. Impulsivity.
- B. Alcohol abuse.
- C. Parents who gamble.
- D. All of the above
Correct Answer: D
Rationale: All listed factors"impulsivity, alcohol abuse, parental gambling, and tolerance"are recognized risk factors for developing pathological gambling.
The forensic psychiatric nurse oftentimes has conflicting goals when providing psychiatric care while serving the legal system. Which situation best demonstrates this conflict?
- A. Performing a mental health assessment on an individual diagnosed with paranoid schizophrenia who is accused of violently attacking a neighbor he believed was 'spying for the government'
- B. Providing both physical and emotional care to a female who was raped while securing and preserving the evidence that will be used in a court of law
- C. Arranging for and then leading an anger management therapy group for a group of female offenders who are about to be paroled
- D. Conducting a depression screening on a newly incarcerated prisoner serving a 25-year sentence in a federal prison
Correct Answer: A
Rationale: The correct answer is A because it demonstrates the conflict between providing psychiatric care and serving the legal system. In this scenario, the nurse must assess a patient with paranoid schizophrenia who committed a violent act due to delusions. The nurse needs to balance the patient's mental health needs with addressing the legal implications of the violent behavior.
Choice B involves caring for a rape victim and preserving evidence, which aligns with both nursing and legal responsibilities. Choice C focuses on providing therapy to offenders, which does not inherently present a conflict between psychiatric care and legal duties. Choice D involves conducting a depression screening for a prisoner, which is important for mental health care but does not inherently involve a conflict with legal obligations.
A new patient in an alcoholism rehabilitation program says, 'I’m just a social drinker. I usually have a drink or two at brunch, a few cocktails in the afternoon, wine at dinner, and a few drinks in the evening.' Which response by the nurse will help the patient view the drinking more honestly?
- A. I see,' and use interested silence.
- B. I think you may be drinking more than you report.'
- C. Being a social drinker involves having a drink or two once or twice a week.'
- D. You describe drinking steadily throughout the day and evening. Am I correct?'
Correct Answer: D
Rationale: Step 1: The nurse needs to provide a reflection that highlights the patient's patterns of drinking.
Step 2: Option D reflects the patient's drinking pattern accurately and objectively.
Step 3: By repeating the patient's own words back to them, the nurse helps the patient see the extent of their drinking.
Step 4: This response encourages the patient to reflect on their alcohol consumption more honestly.
Step 5: Option D is correct as it addresses the patient's behavior directly and prompts self-reflection.
Summary:
- Option A is passive and does not challenge the patient's perception.
- Option B is confrontational and may lead to defensiveness.
- Option C provides a generalized definition of social drinking, not addressing the patient's specific behavior.