A client with bipolar disorder is receiving divalproex sodium as part of the treatment plan. When monitoring the client's blood level for this drug, which level would alert the nurse to the need to change the dosage?

Correct Answer: A

Rationale: The correct answer is A (30 ng/mL). The therapeutic range for divalproex sodium is typically 50-100 ng/mL. A level of 30 ng/mL is below the therapeutic range, indicating that the client may not be receiving enough of the medication to manage their symptoms effectively. This would alert the nurse to consider adjusting the dosage to bring the blood level within the therapeutic range. Choices B, C, and D are all within or above the therapeutic range, indicating that the dosage is likely adequate or potentially too high, but not in need of an immediate change based on blood level monitoring.

Correct Answer: C

Rationale: The correct answer is C because family therapy focuses on addressing issues within the family unit, including managing co-occurring problems within the home environment. This type of therapy aims to improve communication, resolve conflicts, and strengthen relationships among family members. Group therapy, on the other hand, involves individuals coming together to address common issues but does not specifically target problems within the family system. Choices A and D are incorrect because the speed of problem-solving and the setting where therapy is provided do not necessarily differentiate family therapy from group therapy. Choice B is incorrect because group therapy involves interactions among individuals who may or may not be strangers, not specifically those with common problems.

Correct Answer: B

Rationale: The correct answer is B: Play materials such as blocks. This method is most effective for assessing a 4-year-old preschooler as it allows the child to communicate through play, which is developmentally appropriate and engaging. Play materials help the child express themselves, display their emotions, and provide insight into their thoughts and behaviors. Direct, simple questions (A) may not be as effective as children at this age may have limited verbal abilities. Using a Pediatric anxiety rating scale (C) or Children's Depression Inventory (D) is not suitable for this age group as they may not understand the concepts being assessed, leading to inaccurate results.

Correct Answer: C

Rationale: The correct answer is C: To maintain a balanced perspective. Humor can help clients see situations from a different angle, promoting a balanced outlook. It can also create a more relaxed atmosphere, aiding in therapeutic communication. Using humor solely to diminish anger (A) may not address the underlying issues. While humor can refocus attention (B), it should ultimately lead to a balanced perspective. Using humor to delay dealing with issues (D) is counterproductive to therapeutic goals.

Correct Answer: D

Rationale: The correct answer is D: Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA is the best resource for evidence-based research, programs, and practices on mental illness and addictions as it is the leading agency in the U.S. for improving behavioral health. SAMHSA provides up-to-date information, guidelines, and resources based on scientific research and best practices. It focuses specifically on mental health and substance abuse issues, making it the most relevant and reliable source for the nurse's needs. A: The American Psychiatric Association focuses more on the professional organization for psychiatrists rather than providing specific resources on evidence-based research and programs. B: The American Psychological Association is more focused on psychology-related research and practices, not specifically on mental illness and addictions. C: The Clinician's Quick Guide to Interpersonal Psychotherapy is a specific resource on a therapy approach, which may not cover the broad range of information the nurse is seeking on mental illness and addictions.

Correct Answer: A

Rationale: The correct answer is A (30 ng/mL). The therapeutic range for divalproex sodium is typically 50-100 ng/mL. A level of 30 ng/mL is below the therapeutic range, indicating that the client may not be receiving enough of the medication to manage their symptoms effectively. This would alert the nurse to consider adjusting the dosage to bring the blood level within the therapeutic range. Choices B, C, and D are all within or above the therapeutic range, indicating that the dosage is likely adequate or potentially too high, but not in need of an immediate change based on blood level monitoring.

Correct Answer: B

Rationale: The correct answer is B: Cluster B personality disorder. This is because personality disorders are deeply ingrained patterns of behavior that cause distress or impairment. Cluster B includes disorders characterized by dramatic, emotional, or erratic behavior, such as borderline, narcissistic, histrionic, and antisocial personality disorders. Individuals with Cluster B personality disorders may have underlying psychological issues that contribute to suicidal behavior. A: While a history of childhood trauma can certainly contribute to suicidal ideation, it is not specifically related to a psychological cause in the context of this question. C: Social isolation can be a risk factor for suicide, but it is not a direct psychological cause. D: Suicide contagion refers to the phenomenon where exposure to suicide or suicidal behavior influences others to attempt suicide. It is not a psychological cause but rather a social factor.

Correct Answer: A

Rationale: The correct answer is A: Maternal stress. Maternal stress during pregnancy can have long-term effects on the child's behavior, including an increased likelihood of engaging in high-risk behavior as a teen. Stress hormones released by the mother can impact the developing fetus, leading to changes in the child's brain development and stress response systems. This can contribute to behavioral issues later in life. Summary: - A: Maternal stress affects the unborn child's behavior. - B: Parental nurturing is not related to the impact of maternal stress. - C: Appropriate stress responses in the brain do not address the negative impact of maternal stress on the child. - D: Memories of the abuse would not directly influence the unborn child's behavior.

Correct Answer: B

Rationale: The correct answer is B - The developmental age exhibited through behaviors. This is crucial because Erikson's stages of development focus on psychosocial milestones and individuals can exhibit behaviors that reflect their current stage, regardless of chronological age. Understanding the developmental age exhibited through behaviors provides insights into which stage the individual is in and helps tailor appropriate interventions. The other choices are incorrect because: A: The chronological age may not accurately reflect the individual's stage of development. C: The time frame needed to complete a successful outcome at a previous stage is not directly relevant to assessing Erikson's stages. D: The implementation of interventions based on developmental age is important but not as crucial as assessing the developmental age exhibited through behaviors in understanding Erikson's stages.