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Which intervention is most appropriate to promote the self-esteem of a patient with severe depression?
- A. Encouraging the patient to spend time alone for self-reflection.
- B. Involving the patient in simple, achievable activities to ensure success.
- C. Allowing the patient to rest and avoid responsibilities.
- D. Providing frequent reassurances and compliments.
Correct Answer: B
Rationale: Involving the patient in simple, achievable activities is a constructive approach to promote self-esteem by fostering a sense of accomplishment and success. This method encourages positive reinforcement and helps the patient regain confidence and self-worth, which are essential in managing depression. Choice A could potentially lead to rumination and worsen depressive symptoms. Choice C might reinforce avoidance behaviors and hinder progress. Choice D, while supportive, may not address the core need for building self-esteem through personal achievements.
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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 patient with generalized anxiety disorder (GAD) is prescribed buspirone. Which statement by the patient indicates a need for further teaching?
- A. I can take this medication on an as-needed basis.
- B. It may take a few weeks to feel the full effect of this medication.
- C. This medication has a lower risk of dependency compared to benzodiazepines.
- D. I should take this medication consistently every day.
Correct Answer: A
Rationale: The correct answer is A. Buspirone is not meant to be taken on an as-needed basis. It should be taken consistently every day to achieve the desired therapeutic effect. Choice B is correct as it accurately reflects that buspirone may take a few weeks to reach its full effect. Choice C is also correct as buspirone indeed has a lower risk of dependency compared to benzodiazepines. Choice D is correct because taking buspirone consistently every day is the appropriate way to use this medication.
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.
A patient with major depressive disorder has been prescribed sertraline (Zoloft). Which statement by the patient indicates a need for further teaching?
- A. I should take my medication with food to avoid stomach upset.
- B. I should avoid alcohol while taking this medication.
- C. I can stop taking my medication once I feel better.
- D. I might experience some improvement in mood within a few weeks.
Correct Answer: C
Rationale: Choice C is the correct answer. It is crucial for patients to understand that they should not stop taking their medication once they feel better. Discontinuing antidepressants abruptly can lead to a relapse of depressive symptoms. Patients should continue taking their medication as prescribed by their healthcare provider, even if they start feeling better, to ensure the best outcomes in managing major depressive disorder. Choices A, B, and D are all accurate statements. Taking medication with food can help reduce stomach upset, avoiding alcohol is essential while on sertraline to prevent interactions, and experiencing some improvement in mood within a few weeks is a common expectation when starting an antidepressant like sertraline.
Which nursing response provides accurate information to discuss with the female patient diagnosed with bipolar disorder and her support system?
- A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
- B. Antidepressant therapy should be carefully monitored due to the risk of a manic episode in bipolar disorder.
- C. It's crucial to inform your healthcare provider promptly if you experience sleep disturbances.
- D. Are your family members prepared to play an active role in helping manage this disorder?
Correct Answer: A
Rationale: Choice A is the correct answer as it emphasizes the importance of avoiding triggers like alcohol and caffeine that can lead to symptom relapse in patients with bipolar disorder. Educating the patient and their support system about these triggers is essential for managing the condition effectively and preventing exacerbations of symptoms. Choice B is incorrect as it overly focuses on antidepressant therapy, which is not the primary concern related to triggers for symptom relapse. Choice C, while important, does not directly address triggers for symptom relapse in bipolar disorder. Choice D is also relevant but does not provide immediate information on managing triggers for symptom relapse.