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: 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.

Correct Answer: D

Rationale: The correct answer is D, developing a safety plan with the patient. This intervention is crucial for addressing self-harm behaviors in patients with borderline personality disorder. A safety plan helps the patient identify triggers, warning signs, coping strategies, and support networks to prevent self-harm. It also outlines specific steps to take in a crisis situation. This intervention is more direct and practical compared to the other options. A: Keeping a journal may be helpful for self-reflection but may not provide immediate strategies to prevent self-harm. B: Setting boundaries is important but may not directly address self-harm behaviors. C: Providing coping skills is beneficial, but a safety plan is more specific and tailored to managing self-harm risks. In summary, developing a safety plan is the most effective intervention for addressing self-harm behaviors in patients with borderline personality disorder.

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: A

Rationale: The correct answer is A: Decreased need for sleep. During a manic episode in bipolar disorder, individuals often experience decreased need for sleep. This is a key symptom of mania, as it is characterized by high energy levels, impulsivity, and decreased need for rest. In contrast, option B (feelings of worthlessness) is more reflective of symptoms seen in depressive episodes, not manic episodes. Option C (increased need for sleep) is also not indicative of mania, as mania is associated with decreased sleep. Option D (avoidance of social interactions) may occur in some cases, but it is not a defining feature of mania.