mood, adjustment and dementia disorders

A nurse is administering venlafaxine capsules to a client diagnosed with depression. What education will the nurse provide to the client about venlafaxine?

"It's best to take the medication with food at the same time each day."

A client has been treated for major depression and is taking antidepressants. They ask the nurse, "How long do I have to take these pills?" How should the nurse respond to the client's question?

"Antidepressants are prescribed for 6 to 12 months before considering discontinuation."

During the discharge planning teaching process, a client who has been prescribed tranylcypromine states that they enjoy a beer or two in the evenings. Which is the nurse's most appropriate response?

"Beer contains tyramine which must be avoided when on this medication."

A nurse should intervene when a depressed client makes which statement?

"Nobody cares about me."

A client with acute mania brings six suitcases and three shopping bags of personal belongings on admission to the unit. When informed that some of the suitcases and bags need to be returned home because of a lack of storage space, the client begins to use profanity against the nurse. Which response by the nurse is most therapeutic?

"Swearing and profanity are unacceptable here."

A 25-year-old pregnant client has two children under the age of 6. They are very protective and will not allow their children play outdoors for fear of tick bites. They tell the nurse that they feel "worn out" from cleaning the house from top to bottom every day. They ask the nurse how they can stop worrying so much. What is the most appropriate response from the nurse?

"Tell me your concerns about the children playing in your backyard."

A client with acute mania has been admitted to the inpatient unit voluntarily. The nurse approaches the client with medication to be taken orally as prescribed by the health care provider. The client states, "I don't need that stuff." Which response by the nurse is best?

"The medication will help you feel calmer."

A client taking mirtazapine is disheartened about a 20-lb (9 kg) weight gain over the past 3 months. The client tells the nurse, "I stopped taking my mirtazapine 15 days ago. I don't want to get depressed again, but I feel awful about my weight." Which response by the nurse is most appropriate?

"I hear how difficult this is for you and will help you approach your health care provider (HCP) about it."

A client with mania is irritable and insulting to an unlicensed assistive personnel (UAP). The UAP states, "I cannot believe this client is so rude. I thought people with mania were overly happy?" Which response by the nurse should help the UAP understand the client's behavior?

"I know it's difficult, but being irritable is a symptom of the client's mania."

A client states that their "life has gone down the tubes" since their divorce 6 months ago. Then, after they lost their job and apartment, they took an overdose of barbiturates so they "could go to sleep and never wake up." Which statement by the nurse should be made first?

"I know you took an overdose of barbiturates. Are you thinking of suicide now?"

A client taking disulfiram during alcohol rehabilitation therapy reports to the nurse that they have a mild cold and plan to use a cough medicine. Which statement made by the client indicates understanding of the nurse's teaching?

"I may experience vomiting and an upset stomach if I take cough medicine while taking this medicine."

A client with bipolar disorder, manic phase, states to the nurse, "You're looking good. I'm taking you out to dinner." What reply by the nurse is most therapeutic?

"I'm Chris Smith, a nurse working on this unit."

A nurse is caring for a client who has been diagnosed with delirium. Which statement about delirium is true?

It's characterized by an acute onset and lasts hours to a number of days.

The nurse attempts to interact with a client who barely responds with yes or no. The client states, "Don't bother me. I want to die." What action should the nurse take?

Sit with the client.

A nurse is taking an admission history, including a medication list, from a client. The listing of which herbal medication would prompt the nurse to ask the client more questions regarding any history of depressive symptoms?

St. John's wort

A 10-year-old client with conduct disorder is hospitalized for aggressive behaviors at home and school. The client threw furniture and yelled at staff members when told it was time for a group meeting. Which of the following nursing interventions would be appropriate for this client? Select all that apply.

Teach the client the benefits of expressing anger in nonviolent ways. Minimize the amount of attention given for negative behavior.

A 14-year-old adolescent tells the nurse about being in love with a 22-year-old neighbor and that they've had sex on several occasions. The client doesn't want the parents to know because the client is in love and is afraid the parents will be angry. What is the nurse's best course of action?

Tell the adolescent that the law requires the nurse to report the sexual contact because of the age difference.

A client with bipolar disorder, mania, has flight of ideas and grandiosity and becomes easily agitated. To prevent harmful behaviors, the nurse should take which action initially?

Tell the client to seek out staff when feeling agitated.

The nurse is about to administer lithium carbonate to a client with bipolar disorder in a mania state. What is the nurse's action after assessing the client's lithium level to be 1.0 mEq/L (mmol/L)?

Administer the lithium carbonate.

A client who has been experiencing depression for 3 months was recently placed on sertraline. The client calls a nurse and reports that significantly improved mood and optimism about the future. Which piece of additional information would require a rapid nursing intervention?

The client is sleeping only 3 hours per night and does not feel fatigued in the morning.

The spouse of a client who was diagnosed 6 years ago with Alzheimer disease approaches the nurse and says, "I'm so excited that my spouse is starting to use donepezil for this illness." What should the nurse tell the spouse?

The medication is effective mostly in the early stages of the illness.

A client diagnosed with major depression and substance use disorder is being admitted to the concurrent disorder treatment unit. In explaining the focus of this program, the nurse should provide which information to the client?

There will be simultaneous treatment of the addiction and the depression.

The health care provider (HCP) prescribes a serum lithium level tomorrow for a client with bipolar disorder, manic phase, who has been receiving lithium 300 mg orally three times daily for the past 5 days. At what time should the nurse plan to have the blood specimen obtained?

before breakfast

In a predischarge program to educate clients with bipolar disorder and their family members, the nurse emphasizes that which symptom is the most significant indicator for the onset of relapse?

decreased need for sleep and racing thoughts

A depressed client in the psychiatric unit hasn't been getting adequate rest and sleep. To encourage restful sleep at night, the nurse should:

gently but firmly set limits on how much time the client spends in bed during the day.

A client with early dementia exhibits disturbances in mental awareness and orientation to reality. The nurse should expect to assess a loss of ability in which other area?

judgment

A nurse is caring for a client in an acute manic state. What is the most effective nursing action that can be taken on behalf of this client?

reducing stimuli for the client

An adolescent with moderate depression has become increasingly introverted. The client reports to the nurse that the social withdrawal has left the client isolated and lonely. Which nursing intervention would be appropriate for this client?

referral to an after-school social recreation program

A 40-year-old executive who was unexpectedly laid off from work 2 days earlier reports fatigue and an inability to cope. The client admits drinking excessively over the previous 48 hours. This behavior is an example of:

situational crisis.

A client is admitted with severe depression after the loss of a child. The nurse documents what findings as supporting the diagnosis of depression?

slow physical movements and slow speech