Nokea
Which statement by the patient indicates a need for further teaching regarding the treatment of major depressive disorder?
- A. I have been on this antidepressant for 3 days. I understand that the full effect may take weeks to occur.
- B. I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.
- C. I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.
- D. I realize that there are many antidepressants and it might take a while until we find the one that works best for me.
Correct Answer: B
Rationale: Choice B indicates a need for further teaching because the patient is planning to switch directly from Prozac, an SSRI, to a monoamine oxidase inhibitor (MAOI) without allowing for a washout period. This abrupt switch poses a risk of serotonin syndrome, which can be life-threatening. It is essential to educate the patient about the importance of consulting healthcare providers before changing medications to prevent potential adverse effects.
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Which response by a 15-year-old demonstrates a common symptom observed in patients diagnosed with major depressive disorder?
- A. I'm so restless. I can't seem to sit still.
- B. I spend most of my time studying. I have to get into a good college.
- C. I'm not trying to diet, but I've lost about 5 pounds in the past 5 months.
- D. I go to sleep around 11 p.m. but I'm always up by 3 a.m. and can't go back to sleep.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which statement demonstrates a well-structured attempt at limit setting?
- A. Hitting me when you are angry is unacceptable.
- B. I expect you to behave yourself during dinner.
- C. Come here, right now!
- D. Good boys don't bite.
Correct Answer: A
Rationale: Choice A, 'Hitting me when you are angry is unacceptable,' demonstrates a well-structured attempt at limit setting because it clearly defines the unacceptable behavior without ambiguity. This statement sets a clear boundary and clearly communicates the consequence for the behavior. In contrast, choices B, C, and D are less effective in setting limits as they are either vague expectations or commands without specific consequences for crossing the limit.
Luc's family comes home one evening to find him extremely agitated, and they suspect he is in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting?
- A. Hypodermic needles
- B. Fast food wrappers
- C. Empty soda cans
- D. Energy drink containers
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When should healthcare professionals be most alert to the possibility of communication errors resulting in harm to the patient?
- A. Change of shift reports
- B. Admission interviews
- C. One-to-one conversations with patients
- D. Conversations with patient families
Correct Answer: A
Rationale: Healthcare professionals should be most alert to the possibility of communication errors resulting in harm to the patient during change of shift reports. This is a critical time when information is transferred between healthcare providers, and any errors in communication during this handover can lead to adverse outcomes for the patient.
Gilbert, age 19, is described by his parents as a moody child with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert's early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:
- A. Favorable with medication
- B. In the relapse stage
- C. Improvable with psychosocial interventions
- D. To have a less positive outcome
Correct Answer: D
Rationale: The scenario describes Gilbert as having an early and slow onset of schizophrenia, which typically indicates a less positive prognosis. Individuals with such presentations may experience more severe symptoms and difficulties in functioning, leading to a poorer long-term outcome. In Gilbert's case, his challenges with completing tasks, social withdrawal, and fixation on security measures suggest a more challenging prognosis. Early detection and intervention are crucial in managing schizophrenia, but the described symptoms and onset pattern are concerning for a less favorable outcome.