A nurse is working with a patient diagnosed with bipolar disorder who is in the manic phase. Which of the following behaviors should the nurse anticipate observing in this patient?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Elevated mood, increased energy, and impulsive behavior. During the manic phase of bipolar disorder, individuals often exhibit symptoms such as heightened mood, increased energy levels, impulsivity, racing thoughts, and decreased need for sleep. These symptoms can lead to risky behaviors and poor decision-making. Option A) Lethargy and lack of interest in activities is incorrect because these are characteristics of the depressive phase of bipolar disorder, not the manic phase. Option C) Frequent crying episodes and withdrawal from others are more indicative of symptoms seen in the depressive phase of bipolar disorder, not the manic phase. Option D) Hypersomnia (excessive sleeping) and difficulty concentrating are also more commonly associated with the depressive phase of bipolar disorder, rather than the manic phase. Educationally, understanding the symptoms of bipolar disorder in its different phases is crucial for nurses to provide appropriate care and interventions for patients. Recognizing the distinct behaviors seen in the manic phase helps nurses ensure patient safety, manage symptoms effectively, and provide support during episodes of mania. This knowledge also aids in developing individualized care plans and promoting a therapeutic nurse-patient relationship.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Increased suicidal thoughts or behaviors. When a patient with major depressive disorder is prescribed an antidepressant, there is a risk of increased suicidal ideation, especially in the initial stages of treatment. This phenomenon, known as activation syndrome, can occur as the antidepressant starts to take effect before mood improvement is observed. Therefore, close monitoring for any signs of increased suicidal thoughts or behaviors is crucial to ensure the safety of the patient. Option A) Increased energy and insomnia may actually be expected side effects of some antidepressants as they can have activating properties. However, this is not the most critical side effect to monitor in a patient with major depressive disorder. Option B) Decreased appetite and weight loss are common side effects of some antidepressants, but they are not as immediately concerning as increased suicidal thoughts or behaviors in a patient with major depressive disorder. Option C) Dizziness and confusion are potential side effects of medications, but they are not the primary side effects to monitor for in this specific case. In an educational context, understanding the potential side effects of medications used in behavioral nursing is essential for providing safe and effective care to patients. Nurses need to be vigilant in monitoring for both common and serious side effects, especially in patients with mental health conditions. Recognizing and addressing adverse effects promptly can help prevent complications and ensure optimal outcomes for patients undergoing treatment for major depressive disorder.

Correct Answer: C

Rationale: In assessing a patient with bulimia nervosa, monitoring for self-induced vomiting and the use of laxatives after meals is crucial. This behavior is characteristic of bulimia nervosa, where individuals engage in binge eating episodes followed by compensatory behaviors like vomiting or laxative use to prevent weight gain. By choosing option C, the nurse can identify potential signs of this eating disorder and provide appropriate care and interventions. Option A is incorrect as excessive weight gain and sedentary behavior are not typically associated with bulimia nervosa. Option B describes behaviors more in line with anorexia nervosa, where individuals exhibit extreme weight loss and restrict their food intake significantly. Option D describes binge eating followed by purging behaviors, which is indeed a characteristic of bulimia nervosa. However, the specific purging behaviors mentioned in option C (self-induced vomiting and laxative use) are more indicative of bulimia nervosa than just general purging. Educationally, understanding the specific behaviors associated with different eating disorders is essential for nurses to accurately assess and provide care for patients with these conditions. By recognizing the unique signs and symptoms of bulimia nervosa, nurses can intervene early, provide appropriate support, and help patients on the path to recovery.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Agranulocytosis. Clozapine, an atypical antipsychotic medication commonly used to treat schizophrenia, is associated with the potential side effect of agranulocytosis, which is a severe decrease in white blood cells. This condition can compromise the patient's immune system, leading to an increased risk of infections and potentially life-threatening consequences. Option A) Extrapyramidal symptoms (EPS) are more commonly associated with typical antipsychotic medications, such as haloperidol, rather than clozapine. Clozapine is known for its lower risk of causing EPS. Option C) Tardive dyskinesia is a side effect often associated with long-term use of typical antipsychotic medications rather than clozapine. Option D) Neuroleptic malignant syndrome (NMS) is a rare but serious side effect that can occur with antipsychotic medications, but it is more commonly linked to typical antipsychotics rather than clozapine. Educationally, understanding the side effect profile of medications used in psychiatric nursing is crucial for safe and effective patient care. Monitoring for and recognizing potential side effects like agranulocytosis with clozapine is essential for early intervention and prevention of serious complications in patients with schizophrenia. Nurses play a vital role in medication management and monitoring, making knowledge of potential side effects a cornerstone of their practice.

Correct Answer: B

Rationale: The correct answer is option B because it follows the SOAP (Subjective, Objective, Assessment, Plan) format, which is a standard for problem-oriented charting in healthcare. In this entry, the subjective component (S) includes the patient's self-report of feeling ready to blow up, the objective component (O) describes the observed behavior of pacing and mumbling, the assessment (A) identifies auditory hallucinations, and the plan (P) outlines the intervention given (haloperidol) and its effect. Option A is incorrect because it lacks a clear assessment and plan section, providing more of a narrative than a problem-oriented entry. Option C is vague and does not clearly delineate the components of SOAP. Option D is also incorrect as it does not clearly separate the subjective, objective, assessment, and plan components as required for problem-oriented charting. Educationally, understanding problem-oriented charting is crucial for accurate and concise documentation in healthcare settings. It helps healthcare providers communicate effectively, track patient progress, and make informed decisions about patient care. By adhering to standardized formats like SOAP, healthcare professionals can ensure comprehensive and organized documentation, facilitating continuity of care and promoting patient safety.