A healthcare professional is assessing a patient with major depressive disorder. Which finding is most concerning?

Correct Answer: C

Rationale: The correct answer is C: Difficulty sleeping. This finding is most concerning because it can indicate severe depression or potential suicidal ideation. Insomnia is a common symptom of major depressive disorder and can exacerbate the patient's condition. It is important to address sleep disturbances promptly to prevent further deterioration. Rationale for why other choices are incorrect: A: Decreased interest in activities is a common symptom of major depressive disorder but may not necessarily indicate immediate risk. B: Feelings of worthlessness are also common in depression but may not be as urgent as sleep disturbances. D: Changes in appetite can be a symptom of depression, but difficulty sleeping poses a more immediate concern for potential harm to the patient's well-being.

Correct Answer: B

Rationale: The correct answer is B because it demonstrates an understanding that medication adherence is vital for managing schizophrenia symptoms. Taking medication regularly helps maintain stability and prevent symptom recurrence. Choice A indicates inconsistent medication use, C suggests premature discontinuation, and D implies erratic dosing. Overall, choice B aligns with evidence-based treatment guidelines for schizophrenia.

Correct Answer: B

Rationale: The correct answer is B: Risk for suicide. This is the priority nursing diagnosis because individuals with major depressive disorder have an increased risk of suicidal ideation and behaviors. Assessing and addressing this risk is crucial for patient safety. Choice A is not the priority as nutritional imbalances may not pose immediate harm compared to suicide risk. Choice C, disturbed sleep pattern, and choice D, ineffective coping, are important but not as critical as addressing the risk of suicide in a patient with major depressive disorder.

Correct Answer: C

Rationale: The correct initial intervention for a patient with PTSD experiencing flashbacks is providing relaxation techniques (Choice C). This is because relaxation techniques can help the patient cope with the distressing symptoms and manage their anxiety levels during flashbacks. Encouraging the patient to avoid triggers (Choice A) may provide temporary relief but does not address the root cause of the flashbacks. Encouraging the patient to talk about their feelings (Choice B) may be beneficial in the long run but may not be the best initial intervention during a flashback. Advising the patient to avoid social situations (Choice D) can lead to isolation and may not address the immediate distress caused by the flashbacks.

Correct Answer: A

Rationale: The correct answer is A because clozapine can suppress the immune system, increasing the risk of infections. Reporting signs of infection promptly can help prevent serious complications. Choice B is incorrect because stopping clozapine abruptly can lead to withdrawal symptoms or a relapse of symptoms. Choice C is incorrect because clozapine should be taken with food to reduce gastrointestinal side effects. Choice D is incorrect because alcohol can interact with clozapine, leading to increased sedation and potentially dangerous side effects.

Correct Answer: C

Rationale: The correct answer is C: Apathy. Negative symptoms in schizophrenia refer to the absence or reduction of normal behaviors or functions. Apathy is a common negative symptom characterized by a lack of interest, motivation, or emotion. Hallucinations (A) and delusions (B) are positive symptoms, involving distortions of perception or belief. Disorganized speech (D) is a symptom of disorganized thinking, which is also a positive symptom in schizophrenia. Thus, apathy best aligns with the concept of negative symptoms in schizophrenia.

Correct Answer: B

Rationale: The correct answer is B because excessive worrying about various aspects of life is a core symptom of GAD. This persistent and uncontrollable worry is disproportionate to the actual events or situations. Fear of social situations (A) is common in social anxiety disorder, not GAD. Hallucinations (C) are not typically associated with GAD. Impulsive behaviors (D) are more indicative of conditions like ADHD or impulse control disorders.

Correct Answer: B

Rationale: The correct answer is B: Allowing the patient to wash hands at specified times. This option acknowledges the patient's need for hand washing while also setting boundaries. By allowing the patient to wash hands at specified times, the nurse can help establish a routine and gradually reduce the excessive hand washing behavior. Encouraging the patient to stop washing hands (A) may increase anxiety and resistance. Ignoring the behavior (C) can reinforce it. Setting strict limits (D) may cause distress and worsen the OCD symptoms. Option B strikes a balance between addressing the patient's needs and promoting healthier behaviors.

Correct Answer: D

Rationale: The correct answer is D: Nausea. Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat OCD. Nausea is a common side effect of SSRI medications due to their impact on serotonin levels in the gastrointestinal tract. This can lead to stomach upset and feelings of nausea. Increased appetite (A) and weight gain (C) are more commonly associated with other types of medications, such as antipsychotics or mood stabilizers. Dry mouth (B) is a side effect seen with some antidepressants, but it is not a common side effect of fluvoxamine.