Question 1 of 5.

Extract:The following scenario applies to the next 6 items The nurse in the behavioral health clinic is caring for a 26-year-old female client. Item 5 of 6 Nurses' Note 1025: Client presents for initial evaluation, reporting that she “feels all over the place and it is time that she receives some treatment.” “At times I feel empty inside, sometimes feel hyped up, and at times, like now, I feel sad”. On assessment, the client has a constricted affect, and her eyes were cast downward. Client reports that her depression has been present for as long as she can remember, including throughout grade school. Her first clearly recalled depressive episode occurred in the sixth grade, when she felt she was "not living up to my own expectations." These episodes varied in duration—some lasting several months, others only a few hours—but typically persisted for 2 to 4 weeks. Onset could range from a day to a week, while the offset was often abrupt, resolving within a day or less. She reported intermittent difficulty falling asleep. Lately, she has had to use 2-3 tablets of diphenhydramine to help her fall asleep. She denied experiencing racing thoughts but acknowledged being told on numerous occasions that she spoke in ways that felt ‘pressured.' She also endorsed distractibility and noted frequent difficulty completing tasks. During times of good mood or when she felt "aligned with others,” she found herself more productive, particularly in creative endeavors. However, at other times, even simple tasks felt overwhelming. She described experiencing "a flurry of thoughts," particularly while writing or during creative projects. At age 23, she experienced what she referred to as "an explosive outburst of rage," which culminated in her punching a hole in her roommate's car's windshield. She reports this occurred during a two-day ‘episode' of her being irritable. Medical history of tension headaches, mild eczema in winter months, and seasonal allergic rhinitis. The client consumes 1-2 glasses of alcohol a year. She does smoke cigarettes daily and started smoking when she was 20. Orders 1130: • lamotrigine 25 mg p.o. daily • follow-up in two weeks • obtain thyroid panel • trazodone 50 mg p.o. at bedtime • discontinue diphenhydramine

It is essential that the nurse educates the client to while taking lamotrigine.

Question 2 of 5.

After a period of unsuccessful treatment with Elavil (amitriptyline), a woman diagnosed with depression is switched to Parnate (tranylcypromine). Which statement by the client indicates the client understands the side effects of Parnate?

Question 3 of 5.

A nurse is conducting a psychoeducational group for family members of clients hospitalized with depression. Which family member's statement indicates a need for additional teaching?

Question 4 of 5.

A client is receiving paroxetine (Paxil) 20 mg every morning. After taking the first three doses, the client tells the nurse that the medication upsets his stomach. Which of the following instructions should the nurse give to the client?

Question 5 of 5.

A client who is depressed states, 'I'm an awful person. Everything about me is bad. I can't do anything right.' Which of the following responses by the nurse is most therapeutic?