Nokea
Which of the following interventions should not be included in the care plan for a client with major depressive disorder?
- A. Encourage participation in activities
- B. Promote adequate nutrition and hydration
- C. Discourage verbalization of feelings
- D. Monitor for suicidal ideation
Correct Answer: C
Rationale: Interventions for a client with major depressive disorder should focus on promoting activities, adequate nutrition, hydration, and monitoring for suicidal ideation. Verbalizing feelings is a crucial part of therapy for clients with depression as it helps in processing emotions and seeking support. Therefore, discouraging verbalization of feelings is not appropriate and goes against therapeutic principles.
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A client with major depressive disorder is prescribed an antidepressant. Which of the following instructions should the nurse exclude from the teaching?
- A. It may take several weeks for the medication to take effect
- B. Avoid alcohol while taking this medication
- C. Discourage the client from washing her hands
- D. You may experience an increase in energy before your mood improves
Correct Answer: C
Rationale: The nurse should not include the instruction to discourage the client from washing her hands in the teaching for a client prescribed an antidepressant. This instruction is not relevant to the medication regimen. Instead, the nurse should educate the client that it may take several weeks for the medication to take effect, to avoid alcohol, not to discontinue the medication abruptly, and that there may be an increase in energy before mood improves. Regular blood tests are not typically required for most antidepressants.
A client with schizophrenia is prescribed an antipsychotic medication. Which of the following side effects shouldn't the nurse monitor for?
- A. Tardive dyskinesia
- B. Decreased need for sleep
- C. Orthostatic hypotension
- D. Hyperglycemia
Correct Answer: B
Rationale: The correct answer is B, 'Decreased need for sleep.' While antipsychotic medications can cause side effects like tardive dyskinesia, orthostatic hypotension, and hyperglycemia, a decreased need for sleep is not a common side effect. It is important for the nurse to monitor the client for the known side effects of antipsychotic medications to ensure early detection and appropriate management.
A client with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?
- A. The client identifies and challenges negative thoughts.
- B. The client reports an increase in suicidal thoughts.
- C. The client experiences an increase in anxiety.
- D. The client shows no change in behavior.
Correct Answer: A
Rationale: In cognitive-behavioral therapy, identifying and challenging negative thoughts is a fundamental aspect of the treatment process. This cognitive restructuring helps individuals with major depressive disorder to develop healthier thinking patterns and cope more effectively with their emotions, which ultimately leads to improvement in their mental health. Therefore, when a client is able to identify and challenge negative thoughts, it indicates that they are actively engaging in the therapeutic process and making progress towards better mental well-being.
A client prescribed sertraline for depression is receiving discharge instructions. Which statement by the client indicates an accurate understanding of the medication?
- A. I should take this medication at bedtime to avoid nausea.
- B. I should avoid drinking alcohol while taking this medication.
- C. I should take this medication with food to avoid stomach upset.
- D. It may take several weeks for this medication to be effective.
Correct Answer: D
Rationale: The correct answer is D because sertraline, used for depression, typically takes several weeks to become effective. It is important for clients to understand this delayed onset of action to manage their expectations and continue taking the medication as prescribed despite not seeing immediate results.
A client with bipolar disorder is experiencing a manic episode. Which of the following interventions should the nurse avoid implementing?
- A. Provide a structured environment
- B. Encourage rest periods
- C. Limit setting on inappropriate behaviors
- D. Allow the client to engage in stimulating activities
Correct Answer: D
Rationale: During a manic episode in bipolar disorder, interventions should focus on providing a structured environment, encouraging rest periods, and setting limits on inappropriate behaviors. Allowing the client to engage in stimulating activities may exacerbate the symptoms of mania, such as increased energy, impulsivity, and risk-taking behaviors. Therefore, it is important to avoid encouraging such activities to prevent worsening of manic symptoms.