Nokea
Which patient should be most carefully assessed for fluid and electrolyte imbalance among those receiving the following drugs?
- A. lithium (Eskalith)
- B. clozapine (Clozaril)
- C. diazepam (Valium)
- D. amitriptyline
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Adolescents often display fluctuations in mood along with undeveloped emotional regulation and poor tolerance for frustration. Emotional and behavioral control usually increases over the course of adolescence due to:
- A. Limited executive function
- B. Cerebellum maturation
- C. Cerebral stasis and hormonal changes
- D. A slight reduction in brain volume
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?
- A. Fluoxetine (Prozac)
- B. Isocarboxazid (Marplan)
- C. Amitriptyline
- D. Duloxetine (Cymbalta)
Correct Answer: A
Rationale: Fluoxetine (Prozac) is a suitable alternative antidepressant for Tammy due to its approval for the treatment of bulimia nervosa. It belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, similar to citalopram, which Tammy is already taking. Fluoxetine has shown efficacy in treating bulimia nervosa and can be a beneficial choice for individuals with this condition.
In a client's history, a significant indicator suggesting marginal coping skills and the need for careful risk assessment for violence is a history of
- A. childhood trauma.
- B. family involvement.
- C. academic problems.
- D. chemical dependence.
Correct Answer: D
Rationale: A history of chemical dependence is a critical factor indicating marginal coping skills and the need for assessing the risk of violence. Substance abuse can impair judgment, increase impulsivity, and escalate the likelihood of violent behavior. It is essential to thoroughly evaluate and address substance abuse issues in clients to enhance treatment outcomes and ensure safety.
During cognitive-behavioral therapy, a 12-year-old patient reports to the nurse practitioner:
- A. I was so mad I wanted to hit my mother.
- B. I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd.
- C. I forgot that you told me to breathe when I become angry.
- D. I scream as loud as I can when the train goes by the house.
Correct Answer: B
Rationale: In cognitive-behavioral therapy, recognizing and challenging negative thoughts is crucial for progress. Choice B demonstrates the patient's ability to identify and correct distorted thoughts, indicating positive advancement in therapy. This cognitive restructuring is a key component of cognitive-behavioral therapy, helping individuals develop healthier thinking patterns and coping strategies.
In the care plan of a male patient diagnosed with a dissociative disorder, the nursing diagnosis of ineffective coping is included. Which behavior demonstrated by the patient supports this nursing diagnosis?
- A. Has no memory of the physical abuse he endured.
- B. Using both alcohol and marijuana.
- C. Often reports being unaware of surroundings.
- D. Reports feelings of 'not really being here.'
Correct Answer: B
Rationale: The correct answer is B because using substances like alcohol and marijuana can be a sign of ineffective coping mechanisms in patients with dissociative disorders. Substance abuse is often used as a maladaptive way to cope with stress, trauma, or other underlying issues. Choices A, C, and D may be related to dissociative symptoms but do not directly reflect ineffective coping behaviors as substance abuse does.