A patient diagnosed with major depressive disorder has been prescribed an antidepressant. The nurse should monitor for which of the following side effects?

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: 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.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Flat affect. Negative symptoms in schizophrenia refer to deficits in normal emotional responses or other functions. Flat affect specifically refers to a lack of emotional expression, which is a common negative symptom in schizophrenia. Option A) Auditory hallucinations are an example of a positive symptom, not a negative symptom. Positive symptoms involve the presence of abnormal behaviors or experiences. Option B) Disorganized speech is also a positive symptom commonly seen in schizophrenia, characterized by incoherent or illogical speech patterns. Option D) Delusions of persecution are another example of a positive symptom, involving false beliefs of being targeted or harmed by others. Educationally, understanding the distinction between positive and negative symptoms in schizophrenia is crucial for nurses working with patients with mental health conditions. Recognizing these symptoms helps in providing appropriate care and support tailored to the individual's needs.

Correct Answer: C

Rationale: Milieu management provides a therapeutic environment in which the patient can feel comfortable and safe while engaging in activities that meet the patient's physical and mental health needs. Counseling refers to activities designed to promote problem solving and enhanced coping and includes interviewing, crisis intervention, stress management, and conflict resolution. Health teaching involves identifying health education needs and giving information about these needs. Psychobiological interventions involve medication administration and monitoring response to medications.