Week 7 mental health

Which nursing diagnosis would most likely apply to a client diagnosed with major depressive disorder as well as one experiencing acute mania? A: Deficient diversional activity B: Disturbed sleep pattern C: Fluid volume excess D: Defensive coping

B: Disturbed sleep pattern

A nurse instructs a client taking a medication that inhibits the action of monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of what? A: hypotensive shock. B: hypertensive crisis. C: cardiac dysrhythmia. D: cardiogenic shock.

B: hypertensive crisis.

When counseling clients diagnosed with major depressive disorder, what therapy would an advanced practice nurse address the client's negative thought patterns? A: psychoanalytic B: desensitization C: cognitive-behavioral D: alternative and complementary

C: cognitive-behavioral

Consider these three anticonvulsant medications: divalproex, carbamazepine, and gabapentin. Which medication also belongs to this classification? A: clonazepam B: risperidone C: lamotrigine D: aripiprazole

C: lamotrigine

A client diagnosed with major depressive disorder is receiving imipramine 200 mg at bedtime. Which assessment finding would prompt the nurse to collaborate with the health care provider regarding potentially hazardous side effects of this drug? A: dry mouth B: blurred vision C: nasal congestion D: urinary retention

D: urinary retention

A client says to the nurse, "My life doesn't have any happiness in it anymore. I once enjoyed holidays, but now they're just another day." the nurse documents this report using what medical term? A: dysthymia. B: anhedonia. C: euphoria D: anergia

B: anhedonia.

A nurse prepares the plan of care for a client experiencing an acute manic episode. Which nursing diagnoses are most likely? (Select all that apply.) A: Imbalanced nutrition: more than body requirements B: Impaired mood regulation C: Sleep deprivation D: Chronic confusion E: Social isolation

B: Impaired mood regulation C: Sleep deprivation

A health teaching plan for a client taking lithium should include which instructions? A: maintain normal salt and fluids in the diet. B: drink twice the usual daily amount of fluid. C: double the lithium dose if diarrhea or vomiting occurs. D: avoid eating aged cheese, processed meats, and red wine

A: maintain normal salt and fluids in the diet.

A client is experiencing psychomotor agitation associated with major depressive disorder. Which observation presented by the client would the nurse associate with this symptom? A: pacing aimlessly around the room. B: asking the nurse to repeat instructions. C: reporting prickly skin sensations. D: demonstrating slowed verbal responses.

A: pacing aimlessly around the room.

A client diagnosed with acute mania has distributed pamphlets about a new business venture on a street corner for 2 days. Which nursing diagnosis has priority? A: Risk for injury B: Ineffective coping C: Impaired social interaction D: Ineffective therapeutic regimen management

A: Risk for injury

The spouse of a client diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. Which response should the nurse provide? A: "A high proportion of clients with bipolar disorders are found among creative writers." B: "A higher rate of relatives with bipolar disorder is found among clients with bipolar disorder." C: "Clients with bipolar disorder have higher rates of relatives who respond in an exaggerated way to daily stress." D: "More individuals with bipolar disorder come from high socioeconomic and educational backgrounds."

B: "A higher rate of relatives with bipolar disorder is found among clients with bipolar disorder."

Which documentation indicates that the treatment plan for a client diagnosed with acute mania has been effective? A: "Converses with few interruptions; clothing matches; participates in activities." B: "Irritable, suggestible, distractible; napped for 10 minutes in afternoon." C: "Attention span short; writing copious notes; intrudes in conversations." D: "Heavy makeup; seductive toward staff; pressured speech."

A: "Converses with few interruptions; clothing matches; participates in activities."

A client was diagnosed with seasonal affective disorder (SAD). During which month would this client's symptoms be most acute? A: january B: april C: june D: september

A: january

While the exact cause of bipolar disorder has not been determined; however, what is consistent for most clients? A: several factors, including genetics, are implicated. B: brain structures were altered by stress early in life. C: excess sensitivity in dopamine receptors may trigger episodes. D: inadequate norepinephrine reuptake disturbs circadian rhythms.

A: several factors, including genetics, are implicated.

The nurse receives a laboratory report indicating a client's serum level is 1 mEq/L. the client's last dose of lithium was 8 hours ago. What does this result indicate? A: within therapeutic limits. B: below therapeutic limits. C: above therapeutic limits. D: invalid because of the time lapse since the last dose.

A: within therapeutic limits.

This nursing diagnosis applies to a client experiencing acute mania: Imbalanced nutrition: less than body requirements related to insufficient caloric intake and hyperactivity as evidenced by 5- pound weight loss in 4 days. What is an appropriate outcome for this client? A: ask staff for assistance with feeding within 4 days. B: drink six servings of a high-calorie, high-protein drink each day. C: consistently sit with others for at least 30 minutes at mealtime within 1 week. D: consistently wear appropriate attire for age and sex within 1 week while on the psychiatric unit.

B: drink six servings of a high-calorie, high-protein drink each day.

A client diagnosed with bipolar disorder is prescribed lithium. the client telephones the nurse to say, "I've had severe diarrhea for 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" What advise will they give to the client? A: restrict food and fluids for 24 hours and stay in bed. B: have someone bring the client to the clinic immediately. C: drink a large glass of water with 1 teaspoon of salt added. D: take one dose of an over-the-counter antidiarrheal medication now.

B: have someone bring the client to the clinic immediately.

A client waves a newspaper and says, "I must have my credit card and use the computer right now. A store is having a big sale, and I need to order 10 dresses and four pairs of shoes." What is the nurse's appropriate intervention? A: suggesting the client have a friend do the shopping and bring purchases to the unit. B: inviting the client to sit together and look at new fashion magazines. C: telling the client computer use is not allowed until self-control improves. D: asking whether the client has enough money to pay for the purchases.

B: inviting the client to sit together and look at new fashion magazines.

A client diagnosed with major depressive disorder repeatedly tells staff, "I have cancer. It's my punishment for being a bad person." Diagnostic tests reveal no cancer. What is the priority nursing diagnosis? A: powerlessness B: risk for suicide C: stress overload D: spiritual distress

B: risk for suicide

A client diagnosed with bipolar disorder becomes hyperactive after discontinuing lithium. the client threatens to hit another client. Which comment by the nurse is appropriate? A: "Stop that! No one did anything to provoke an attack by you." B: "If you do that one more time, you will be secluded immediately." C: "Do not hit anyone. If you are unable to control yourself, we will help you." D: "You know we will not let you hit anyone. Why do you continue this behavior?"

C: "Do not hit anyone. If you are unable to control yourself, we will help you."

Which dinner menu is best suited for a client with acute mania? A: Spaghetti and meatballs, salad, and a banana B: Beef and vegetable stew, a roll, and chocolate pudding C: Broiled chicken breast on a roll, an ear of corn, and an apple D: Chicken casserole, green beans, and flavored gelatin with whipped cream

C: Broiled chicken breast on a roll, an ear of corn, and an apple

A client became severely depressed when the last of the family's six children moved out of the home 4 months ago. the client repeatedly says, "No one cares about me. I'm not worth anything." Which response by the nurse would be the most helpful? A: "Things will look brighter soon. Everyone feels down once in a while." B: "Our staff members care about you and want to try to help you get better." C: "It is difficult for others to care about you when you repeatedly say the same negative things." D: "I'd to sit with you for 10 minutes now and 10 minutes after lunch because I value spending time with you."

D: "I'd to sit with you for 10 minutes now and 10 minutes after lunch because I value spending time with you."

A client with diagnosed bipolar disorder was hospitalized 7 days ago and has been taking lithium 600 mg tid. Staff observes increased agitation, pressured speech, poor personal hygiene, and hyperactivity. Which action demonstrates that the nurse understands the most likely cause of the client's behavior? A: Educate the client about the proper ways to perform personal hygiene and coordinate clothing. B: Continue to monitor and document the client's speech patterns and motor activity. C: Ask the health care provider to prescribe an increased dose and frequency of D: Consider the need to check the lithium level. the client may not be swallowing medications.

D: Consider the need to check the lithium level. the client may not be swallowing medications.

A client diagnosed with acute mania has disrobed in the hall three times in 2 hours. What intervention should the nurse implement? A: direct the client to wear clothes at all times. B: ask if the client finds clothes bothersome. C: tell the client that others feel embarrassed. D: arrange for one-on-one supervision.

D: arrange for one-on-one supervision.

A client diagnosed with bipolar disorder has rapidly changing mood cycles. the health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed? A: phenytoin B: clonidine C: risperidone D: carbamazepine

D: carbamazepine

A nurse provided medication education for a client diagnosed with major depressive disorder who began a new prescription for phenelzine. Which behavior indicates effective learning? the client A: monitors sodium intake and weight daily. B: wears support stockings and elevates the legs when sitting. C: can identify foods with high selenium content that should be avoided. D: confers with a pharmacist when selecting over-the-counter medications.

D: confers with a pharmacist when selecting over-the-counter medications.

A client diagnosed with major depressive disorder refuses solid foods. In order to meet nutritional needs, which beverage will the nurse offer to this client? A: tomato juice B: orange juice C: hot tea D: milk

D: milk

A client diagnosed with bipolar disorder will be discharged tomorrow. the client is taking a mood stabilizing medication. What is the priority nursing intervention for the client as well as the client's family during this phase of treatment? A: Attending psycho education sessions B: Decreasing physical activity C: Increasing food and fluids D: Meeting self-care needs

A: Attending psycho education sessions

A client diagnosed with bipolar disorder commands other clients, "Get me a book. Take this stuff out of here," and other similar demands. the nurse wants to interrupt this behavior without entering into a power struggle. Which initial approach should the nurse select? A: Distraction: "Let's go to the dining room for a snack." B: Humor: "How much are you paying servants these days?" C: Limit setting: "You must stop ordering other clients around." D: Honest feedback: "Your controlling behavior is annoying others."

A: Distraction: "Let's go to the dining room for a snack."

A nurse caring for a client diagnosed with major depressive disorder reads in the client's medical record, "This client shows vegetative signs of depression." Which nursing diagnoses most clearly relate to this documentation? (Select all that apply.) A: Imbalanced nutrition: less than body requirements B: Chronic low self-esteem C: Sexual dysfunction D: Self-care deficit E: Powerlessness F: Insomnia

A: Imbalanced nutrition: less than body requirements C: Sexual dysfunction D: Self-care deficit F: Insomnia

Which suggestions are appropriate for the family of a client diagnosed with bipolar disorder who is being treated as an outpatient during a hypomanic episode? (Select all that apply.) A: Limit credit card access. B: Provide a structured environment. C: Encourage group social interaction. D: Supervise medication administration. E: Monitor the client's sleep patterns.

A: Limit credit card access. B: Provide a structured environment. D: Supervise medication administration. E: Monitor the client's sleep patterns.

A client diagnosed with major depressive disorder does not interact with others except when addressed, and then only in monosyllables. the nurse wants to show nonjudgmental acceptance and support for the client. Which communication technique will be effective? A: Make observations. B: Ask the client direct questions. C: Phrase questions to require yes or no answers. D: Frequently reassure the client to reduce guilt feelings.

A: Make observations.

A client diagnosed with major depressive disorder shows vegetative signs of depression. Which nursing actions should be implemented? (Select all that apply.) A: Offer laxatives if needed. B: Monitor food and fluid intake. C: Provide a quiet sleep environment. D: Eliminate all daily caffeine intake. E: Restrict intake of processed foods.

A: Offer laxatives if needed. B: Monitor food and fluid intake. C: Provide a quiet sleep environment.

A client tells the nurse, "I'm ashamed of being bipolar. When I'm manic, my behavior embarrasses everyone. Even if I take my medication, there are no guarantees. I'm a burden to my family." These statements support which nursing diagnoses? (Select all that apply.) A: Powerlessness B: Defensive coping C: Chronic low self-esteem D: Impaired social interaction E: Risk-prone health behavior

A: Powerlessness C: Chronic low self-esteem

Which documentation for a client diagnosed with major depressive disorder indicates the treatment plan was effective? A: Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild. B: Slept 10 hours uninterrupted. Attended craft group; stated "project was a failure, just like me." C: Slept 5 hours with brief interruptions. Personal hygiene adequate with assistance. Weight loss of 1 pound. D: Slept 7 hours uninterrupted. Preoccupied with perceived inadequacies. States, "I feel tired all the time."

A: Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild.

An adult diagnosed with major depressive disorder was treated with medication and cognitive behavioral therapy. the client now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest? A: Social skills training B: Relaxation training classes C: Desensitization techniques D: Use of complementary therapy

A: Social skills training

A client became depressed after the last of the family's six children moved out of the home 4 months ago. Select the best initial outcome for the nursing diagnosis Situational low self-esteem related to feelings of abandonment. A: The client will verbalize realistic positive characteristics about self by (date). B: The client will agree to take an antidepressant medication regularly by (date). C: The client will initiate social interaction with another person daily by (date). D: The client will identify two personal behaviors that alienate others by (date).

A: The client will verbalize realistic positive characteristics about self by (date).

A client being treated with paroxetine 50 mg po daily reports to the clinic nurse, "I took a few extra tablets earlier today and now I feel bad." Which assessments are most critical? (Select all that apply.) A: Vital signs B: Urinary frequency C: Psychomotor retardation D: Presence of abdominal pain and diarrhea E: Hyperactivity or feelings of restlessness

A: Vital signs D: Presence of abdominal pain and diarrhea E: Hyperactivity or feelings of restlessness

Four new clients were admitted to the behavioral health unit in the past 12 hours. the nurse directs a psychiatric technician to monitor these clients for safety. Which client diagnosis will need the most watchful supervision? A: bipolar I disorder. B: bipolar II disorder. C: dysthymic disorder. D: cyclothymic disorder.

A: bipolar I disorder.

A client diagnosed with bipolar disorder is dressed in a red leotard and bright scarves. the client twirls and shadow boxes. the client says gaily, "Do you like my scarves? Here they are my gift to you." How should the nurse document the client's mood? A: euphoric B: irritable C: suspicious D: confident

A: euphoric

A client diagnosed with bipolar disorder who takes lithium carbonate 300 mg three times daily reports nausea. To reduce the nausea most effectively, the nurse suggests that the lithium be taken with what? A: food B: an antacid C: an antiemetic D: a large glass of juice

A: food

Transcranial Magnetic Stimulation (TCM) is scheduled for a client diagnosed with major depressive disorder. Which comment by the client indicates teaching about the procedure was effective? A: "They will put me to sleep during the procedure, so I won't know what is happening." B: "I might be a little dizzy or have a mild headache after each procedure." C: "I will be unable to care for my children for about 2 months." D: "I will avoid eating foods that contain tyramine."

B: "I might be a little dizzy or have a mild headache after each procedure."

A client diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." Which response by the nurse will best assist the client to reframe this overgeneralization? A: "I really doubt that one person can be blamed for all the bad things that happen." B: "Let's look at one bad thing that happened to see if another explanation exists." C: "You are being extremely hard on yourself. Try to have a positive focus." D: "Are you saying that you don't have any good things happen?"

B: "Let's look at one bad thing that happened to see if another explanation exists."

A client diagnosed with bipolar disorder is in the maintenance phase of treatment. the client asks, "Do I have to keep taking this lithium even though my mood is stable now?" What is the nurse's most appropriate response? A: "You will be able to stop the medication in about 1 month." B: "Taking the medication every day helps reduce the risk of a relapse." C: "Most clients take medication for approximately 6 months after discharge." D: "It's unusual that the health care provider hasn't already stopped your medication."

B: "Taking the medication every day helps reduce the risk of a relapse."

A client diagnosed with major depressive disorder says, "No one cares about me anymore. I'm not worth anything." Today the client is wearing a new shirt and has neat, clean hair. Which remark by the nurse supports building a positive self-esteem for this client? A: "You look nice this morning." B: "You're wearing a new shirt." C: "I like the shirt you are wearing." D: "You must be feeling better today."

B: "You're wearing a new shirt."

During a psychiatric assessment, the nurse observes a client's facial expression is without emotion. the client says, "Life feels so hopeless to me. I've been feeling sad for several months." How will the nurse document the client's affect and mood? A: Affect depressed; mood flat B: Affect flat; mood depressed C: Affect labile; mood euphoric D: Affect and mood are incongruent.

B: Affect flat; mood depressed

A client demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action will the staff take initially? A: Confer with the health care provider to consider use of seclusion for this client. B: Hold a staff meeting to discuss consistency and limit-setting approaches. C: Conduct a meeting with all staff and clients to discuss the behavior. D: Explain to the client that the behavior is unacceptable.

B: Hold a staff meeting to discuss consistency and limit-setting approaches.

A nurse taught a client about a tyramine-restricted diet. Which menu selection would the indicate the client understood the information? A: Macaroni and cheese, hot dogs, banana bread, caffeinated coffee B: Mashed potatoes, ground beef patty, corn, green beans, apple pie C: Avocado salad, ham, creamed potatoes, asparagus, chocolate cake D: Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls

B: Mashed potatoes, ground beef patty, corn, green beans, apple pie

At a unit meeting, the staff discusses decor for a special room for clients with acute mania. Which suggestion is appropriate? A: An extra-large window with a view of the street B: Neutral walls with pale, simple accessories C: Brightly colored walls and print drapes D: Deep colors for walls and upholstery

B: Neutral walls with pale, simple accessories

A client experiencing acute mania dances around the unit, seldom sits, monopolizes conversations, interrupts, and intrudes. Which nursing intervention will best assist the client with energy conservation? A: Monitor physiological functioning. B: Provide a subdued environment. C: Supervise personal hygiene. D: Observe for mood changes.

B: Provide a subdued environment.

When a hyperactive client diagnosed with acute mania is hospitalized, what is the initial nursing intervention? A: Allow the client to act out feelings. B: Set limits on client behavior as necessary. C: Provide verbal instructions to the client to remain calm. D: Restrain the client to reduce hyperactivity and aggression.

B: Set limits on client behavior as necessary.

What is the focus of priority nursing interventions for the period immediately after electroconvulsive therapy (ECT) treatment? A: Nutrition and hydration B: Supporting physiological stability C: Reducing disorientation and confusion D: Assisting the client to identify and test negative thoughts

B: Supporting physiological stability

A client demonstrating characteristics of acute mania relapsed after discontinuing lithium. New orders are written to resume lithium twice daily and begin olanzapine. What is the rationale for the addition of olanzapine to the medication regimen? A: To minimize the side effects of lithium. B: To bring hyperactivity under rapid control. C: To enhance the anti manic actions of lithium. D: To be used for long-term control of hyperactivity.

B: To bring hyperactivity under rapid control.

What is the priority intervention for a client diagnosed with major depressive disorder and feelings of worthlessness? A: distracting the client from self-absorption. B: careful unobtrusive observation around the clock. C: allowing the client to spend long periods alone in meditation. D: opportunities to assume a leadership role in the therapeutic milieu

B: careful unobtrusive observation around the clock.

A client experiencing acute mania is dancing atop a pool table in the recreation room. the client waves a cue in one hand and says, "I'll throw the pool balls if anyone comes near me." To best assure safety, what is the nurse's first intervention? A: tell the client, "You need to be secluded." B: clear the room of all other clients. C: help the client down from the table. D: assemble a show of force.

B: clear the room of all other clients.

Outcome identification for the treatment plan of a client experiencing grandiose thinking associated with acute mania will focus on what? A: developing an optimistic outlook. B: distorted thought self-control. C: interest in the environment. D: sleep pattern stabilization.

B: distorted thought self-control.

A client being treated for depression has taken sertraline daily for a year. the client calls the clinic nurse and says, "I stopped taking my antidepressant 2 days ago. Now I am having nausea, nervous feelings, and I can't sleep." the nurse will advise the client to: A: "Go to the nearest emergency department immediately." B: "Do not to be alarmed. Take two aspirin and drink plenty of fluids." C: "Take a dose of your antidepressant now and come to the clinic to see the health care provider." D: "Resume taking your antidepressants for 2 more weeks and then discontinue them again."

C: "Take a dose of your antidepressant now and come to the clinic to see the health care provider."

A nurse assesses a client who takes lithium. Which findings demonstrate evidence of complications? A: Pharyngitis, mydriasis, and dystonia B: Alopecia, purpura, and drowsiness C: Diaphoresis, weakness, and nausea D: Ascites, dyspnea, and edema

C: Diaphoresis, weakness, and nausea

A person was directing traffic on a busy street, rapidly shouting, "To work, you jerk, for perks" and making obscene gestures at cars. the person has not slept or eaten for 3 days. Which assessment findings will have priority concern for this client's plan of care? A: Insulting, aggressive behavior B: Pressured speech and grandiosity C: Hyperactivity; not eating and sleeping D: Poor concentration and decision making

C: Hyperactivity; not eating and sleeping

A client diagnosed with depressive disorder begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. What information should the nurse provide to the client and family? A: Need to restrict sodium intake to 1 gram daily. B: Need to minimize exposure to bright sunlight. C: Importance of reporting increased suicidal thoughts. D: Importance of maintaining a tyramine-free diet

C: Importance of reporting increased suicidal thoughts.

The admission note indicates a client diagnosed with major depressive disorder has anergia and anhedonia. For which measures should the nurse plan? (Select all that apply.) A: Channeling excessive energy B: Reducing guilty ruminations C: Instilling a sense of hopefulness D: Assisting with self-care activities E: Accommodating psychomotor retardation

C: Instilling a sense of hopefulness D: Assisting with self-care activities E: Accommodating psychomotor retardation

A person was online continuously for over 24 hours, posting rhymes on official government websites and inviting politicians to join social networks. the person has not slept or eaten for 3 days. What features of mania are evident? A: Increased muscle tension and anxiety B: Vegetative signs and poor grooming C: Poor judgment and hyperactivity D: Cognitive deficits and paranoia

C: Poor judgment and hyperactivity

The plan of care for a client in the manic state of bipolar disorder should include which interventions? (Select all that apply.) A: Touch the client to provide reassurance. B: Invite the client to lead a community meeting. C: Provide a structured environment for the client. D: Ensure that the client's nutritional needs are met. E: Design activities that require the client's concentration.

C: Provide a structured environment for the client. D: Ensure that the client's nutritional needs are met.

Major depressive disorder resulted after a client's employment was terminated. the client now says to the nurse, "I'm not worth the time you spend with me. I am the most useless person in the world." Which nursing diagnosis applies? A: Powerlessness B: Defensive coping C: Situational low self-esteem D: Disturbed personal identity

C: Situational low self-esteem

A client diagnosed with major depressive disorder received six electroconvulsive therapy (ECT) sessions and aggressive doses of antidepressant medication. the client owns a small business and was counseled not to make major decisions for a month. What is the correct rationale for this counseling? A: Antidepressant medications alter catecholamine levels, which impairs decision making abilities. B: Antidepressant medications may cause confusion related to limitation of tyramine in the diet. C: Temporary memory impairments and confusion may occur with ECT. D: The client needs time to readjust to a pressured work schedule.

C: Temporary memory impairments and confusion may occur with ECT.

A client diagnosed with major depressive disorder began taking escitalopram 5 days ago. the client now says, "This medicine isn't working." What is the nurse's best intervention? A: discuss with the health care provider the need to increase the dose. B: reassure the client that the medication will be effective soon. C: explain the time lag before antidepressants relieve symptoms. D: critically assess the client for symptoms of improvement.

C: explain the time lag before antidepressants relieve symptoms.

A client experiencing acute mania undresses in the group room and dances. How should the nurse intervene initially? A: quietly asking the client, "Why don't you put your clothes on?" B: firmly telling the client, "Stop dancing and put on your clothing." C: putting a blanket around the client and walking with the client to a quiet room. D: letting the client stay in the group room and moving the other clients to a different area.

C: putting a blanket around the client and walking with the client to a quiet room.

A client diagnosed with major depressive disorder began taking a tricyclic antidepressant 1 week ago. Today the client says, "I don't think I can keep taking these pills. They make me so dizzy, especially when I stand up." the nurse will implement which intervention? A: limit the client's activities to those that can be performed in a sitting position. B: withhold the drug, force oral fluids, and notify the health care provider. C: teach the client strategies to manage postural hypotension. D: update the client's mental status examination.

C: teach the client strategies to manage postural hypotension.

A disheveled client in the acute phase of major depressive disorder is withdrawn, has psychomotor retardation, and has not showered for several days. What action will the nurse take? A: bring up the issue at the community meeting. B: calmly tell the client, "You must bathe daily." C: make observations about the client's poor personal hygiene. D: firmly and neutrally assist the client with showering.

D: firmly and neutrally assist the client with showering.

A client newly diagnosed with bipolar disorder is prescribed lithium. Which information from the client's medical history indicates that monitoring of serum concentrations of the drug will be challenging and critical? A: arthritis B: epilepsy C: psoriasis D: heart failure

D: heart failure

A nurse worked with a client diagnosed with major depressive disorder, severe withdrawal, and psychomotor retardation. After 3 weeks, the client did not improve. the nurse is most at risk for what feelings? A: guilt and despair. B: over-involvement. C: interest and pleasure. D: ineffectiveness and frustration.

D: ineffectiveness and frustration.