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Which assessment question, when asked by the nurse, demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder?
- A. Do rules apply to you?
- B. What do you do to manage anxiety?
- C. Do you have a history of disordered eating?
- D. Do you think that you drink too much?
Correct Answer: B
Rationale: The correct answer is B. Inquiring about anxiety management demonstrates an understanding of the common comorbid condition of anxiety often seen alongside major depressive disorder. Anxiety and depression frequently coexist, and addressing anxiety management can provide insights into the patient's overall mental health status. Choices A, C, and D are incorrect because they do not directly address comorbid mental health conditions associated with major depressive disorder.
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A patient with bipolar disorder is being educated by a nurse on the importance of medication adherence. Which statement by the patient indicates understanding?
- A. I will take my medication only when I feel manic symptoms.
- B. I understand that I need to take my medication regularly, even if I feel well.
- C. I will stop taking my medication if I experience side effects.
- D. I will take my medication whenever I remember.
Correct Answer: B
Rationale: The correct answer is B. Taking medication regularly, even when feeling well, is crucial in managing bipolar disorder. Choice A is incorrect because medication adherence should not be based on symptoms alone. Choice C is incorrect as stopping medication due to side effects should be discussed with a healthcare provider. Choice D is incorrect because relying on memory may lead to missed doses, impacting treatment effectiveness.
A patient is being assessed for generalized anxiety disorder (GAD). Which symptom is the patient most likely to report?
- A. Excessive worrying about various aspects of life.
- B. Extreme mood swings between euphoria and depression.
- C. Persistent thoughts of self-harm.
- D. Hearing voices that others do not hear.
Correct Answer: A
Rationale: Patients with generalized anxiety disorder (GAD) commonly present with excessive worrying about various aspects of life. This persistent and uncontrollable worry is a hallmark symptom of GAD and can significantly impact daily functioning and quality of life. Extreme mood swings (choice B), persistent thoughts of self-harm (choice C), and auditory hallucinations (choice D) are more indicative of other mental health conditions like bipolar disorder, depression, and schizophrenia, respectively. These symptoms are not specific to GAD.
The nurse is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the nurse stress to the patient?
- A. Increased attentiveness
- B. Getting up at night to urinate
- C. Improved vision
- D. An upset stomach for no apparent reason
Correct Answer: D
Rationale: The correct early sign of lithium toxicity that the nurse should stress to the patient is an upset stomach for no apparent reason. Early signs of lithium toxicity often manifest as gastrointestinal symptoms such as nausea, vomiting, and diarrhea. This can serve as an important indicator for the patient to seek medical attention promptly to prevent further complications. Choices A, B, and C are incorrect. Increased attentiveness, getting up at night to urinate, and improved vision are not early signs of lithium toxicity. It is crucial for the nurse to educate the patient on recognizing gastrointestinal symptoms as potential indicators of toxicity.
A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, 'You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'
- A. A higher dosage
- B. Once-a-week dosing
- C. A lower dosage
- D. A different drug
Correct Answer: C
Rationale: As the patient transitions to maintenance therapy, the typical approach involves decreasing the dosage to a lower level. This adjustment is made to find the minimum effective dose needed for symptom control while reducing the potential side effects associated with long-term use. Choosing a higher dosage (A) would not align with the goal of maintenance therapy, as it may increase the risk of adverse effects. Once-a-week dosing (B) is not a common adjustment for lithium, which is usually prescribed daily for bipolar disorder. Switching to a different drug (D) is typically considered if the current medication is ineffective or intolerable, not as a routine step in transitioning to maintenance therapy.
During a mental health assessment, a patient states, 'I just don't see the point in anything anymore.' This statement is an indication of which of the following?
- A. Anxiety disorder
- B. Bipolar disorder
- C. Depression
- D. Schizophrenia
Correct Answer: C
Rationale: The patient's statement 'I just don't see the point in anything anymore' reflects feelings of hopelessness and a lack of purpose, which are common symptoms of depression. Depression is characterized by persistent feelings of sadness, emptiness, and loss of interest or pleasure in activities that were once enjoyable. While anxiety disorders can involve excessive worry and fear, bipolar disorder includes episodes of both depression and mania, and schizophrenia typically involves symptoms such as hallucinations and delusions. Therefore, depression is the most appropriate choice based on the patient's statement.