A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, 'You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing':

Correct Answer: C

Rationale: The correct answer is C: A lower dosage. This adjustment is appropriate for maintenance therapy in bipolar I disorder to prevent toxicity and maintain therapeutic levels. Lowering the dose reduces the risk of adverse effects while still providing the necessary benefits. Increasing the dosage (choice A) may lead to toxicity. Once a week dosing (choice B) is not standard for lithium. Switching to a different drug (choice D) is not necessary if the patient has been responding well to lithium.

Correct Answer: A

Rationale: The correct answer is A because it acknowledges and validates the patient's feelings without making assumptions or imposing personal beliefs. It focuses on the patient's emotions and provides empathy and support. B: Imposes a religious belief that may not align with the patient's beliefs. C: Implies the patient should feel a certain way, which can be invalidating. D: Assumes what the patient wants without considering their feelings or preferences.

Correct Answer: B

Rationale: The correct answer is B because when the nurse has a therapeutic relationship with the client, it means they work collaboratively. The nurse considers the client a partner in care planning, involving them in decision-making and respecting their autonomy. This approach fosters trust and empowers the client in their care. A: The nurse should maintain professional boundaries and not become friends with the client to avoid conflicts of interest. C: Adhering strictly to the plan of care without flexibility may not meet the client's individual needs and preferences. D: While avoiding a directive approach is important, there are times when the nurse needs to provide guidance and direction for the client's benefit.

Correct Answer: B

Rationale: The correct answer is B because three out of the four criteria listed by the student are correct. (1) an appropriate perception of reality, (2) the ability to accept oneself, and (3) the ability to establish relationships are indeed important criteria for good mental health. However, (4) a need for detachment and the desire for privacy is not typically considered a criteria for good mental health. It is important to emphasize that maintaining healthy boundaries and privacy is essential, but it is not a defining criteria for good mental health. Therefore, the student's list is good but not perfect.

Correct Answer: B

Rationale: The correct answer is B because it reflects active listening and encourages the client to express their concerns further. It shows empathy and validates the client's feelings. Choice A provides information without addressing the client's feelings. Choice C puts the client on the spot and may come off as confrontational. Choice D dismisses the client's concerns and lacks empathy. Overall, choice B is therapeutic as it fosters a supportive and open communication environment.