A patient diagnosed with major depressive disorder has taken an antidepressant daily for 3 years. The patient tells the nurse, 'I want to stop taking this medication. I don't think I need it anymore.' What is the nurse's best response to assure safety the patient's safety?

Correct Answer: D

Rationale: The correct answer is D) This medication should be gradually stopped. Let's talk to your health care provider about a plan. This response is the best choice because abruptly stopping an antidepressant medication, especially after taking it for a prolonged period like 3 years, can lead to withdrawal symptoms and potentially worsen the patient's condition. Gradually tapering off the medication under the guidance of a healthcare provider is essential to ensure the patient's safety and minimize the risk of relapse or adverse effects. Option A) Why do you think you don't need this medication anymore? is incorrect because it does not address the potential risks of stopping the medication abruptly and does not provide guidance on a safe discontinuation plan. Option B) Have you talked with your family members about this decision? is also incorrect as it does not focus on the medical aspects of tapering off the medication and does not ensure the patient's safety in managing their medication regimen. Option C) If you stop the medication, your depression will return worse than ever. is incorrect because while relapse is a possibility, it does not offer a proactive approach to safely discontinuing the medication or involve the healthcare provider in the decision-making process. In an educational context, it is crucial for nurses to understand the importance of proper medication management, especially with psychotropic medications like antidepressants. Teaching patients about the potential risks of abrupt medication cessation and the necessity of consulting healthcare providers for any changes in their treatment regimen is essential in promoting patient safety and well-being.

Correct Answer: A

Rationale: In the context of administering lorazepam to a patient with acute anxiety, the most important intervention for the nurse to consider is monitoring for signs of excessive sedation (Option A). Lorazepam is a benzodiazepine that can cause sedation as a common side effect. Monitoring for excessive sedation is crucial as it can lead to respiratory depression, especially in patients with compromised respiratory function. Option B, ensuring the patient is hydrated before administration, is not directly related to the safe administration of lorazepam. While hydration is important for overall health, it is not a specific consideration when administering this medication. Option C, administering the medication only after meals, is not a key consideration for lorazepam administration. In fact, it is often given on an empty stomach to facilitate faster absorption. Option D, monitoring the patient for signs of depression, is not directly related to the immediate effects of lorazepam administration. While monitoring for mental health changes is important in general nursing care, it is not the most critical consideration when administering lorazepam for acute anxiety. In an educational context, nurses need to understand the pharmacological properties of medications they administer, common side effects, and appropriate monitoring strategies to ensure patient safety. Understanding the specific considerations for each medication is crucial in providing effective and safe care to patients with behavioral health needs.

Correct Answer: C

Rationale: In caring for a patient diagnosed with schizophrenia, the nurse would most likely observe an inability to distinguish between reality and fantasy. This is because schizophrenia is a mental disorder characterized by disruptions in thinking, perception, and emotions, leading to difficulties in determining what is real and what is not. Patients with schizophrenia often experience hallucinations and delusions, which can blur the line between reality and fantasy. Option A, excessive energy and impulsive behavior, is more commonly associated with conditions like bipolar disorder or ADHD, not typically seen in schizophrenia. Option B, difficulty in maintaining eye contact and speaking in a monotone voice, may occur in individuals with social anxiety or depression but is not a defining characteristic of schizophrenia. Option D, hyperactivity and racing thoughts, are more indicative of conditions like mania in bipolar disorder or ADHD, rather than schizophrenia. By understanding the specific behavioral manifestations of schizophrenia, nurses can provide targeted care and support to patients, emphasizing the importance of accurate assessment and understanding of mental health conditions in nursing practice.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Tuna sandwich. The rationale behind recommending a tuna sandwich lies in the nutritional benefits it offers to individuals with Alzheimer's disease. Tuna is rich in omega-3 fatty acids, specifically DHA, which has been linked to brain health and potentially slowing the progression of cognitive decline in Alzheimer's patients. Omega-3 fatty acids are known to have neuroprotective properties and can help support brain function. Now, let's discuss why the other options are not the best choice for a client with Alzheimer's disease. Option B) Hamburgers are typically high in saturated fats and cholesterol, which are not ideal for individuals with Alzheimer's as they can contribute to cardiovascular issues that may exacerbate cognitive decline. Option C) Turkey sandwich is a healthier choice compared to hamburgers, but it may not provide the same benefits as tuna in terms of omega-3 fatty acids crucial for brain health. Option D) Cheese pizza is high in saturated fats, sodium, and low in the essential nutrients needed for brain health, making it a less optimal choice for individuals with Alzheimer's disease. From an educational standpoint, it is essential for nurses to understand the role of nutrition in managing chronic conditions like Alzheimer's disease. By recommending foods rich in nutrients like omega-3 fatty acids, nurses can contribute to the overall well-being of their patients and potentially slow down the progression of the disease. This knowledge empowers nurses to provide holistic care that addresses not just the symptoms but also the underlying factors contributing to the condition.

Correct Answer: D

Rationale: The correct answer is D) Secondary trauma. In this scenario, the nurse working on a Covid-19 unit is likely experiencing secondary trauma, which occurs when an individual is indirectly exposed to traumatic events through their work with traumatized individuals. The nurse on the mental health hotline is hearing about the struggles of the nurse from the Covid-19 unit, leading to emotional distress and a questioning of their nursing career. Option A) Acute trauma refers to a single traumatic event, which does not fit the ongoing stress and impact of working on a Covid-19 unit. Option B) Chronic trauma typically involves repeated exposure to traumatic events over time but does not capture the indirect nature of the trauma experienced by the nurse on the hotline. Option C) Complex trauma involves exposure to multiple traumatic events, often in childhood, and does not align with the current situation described in the question. Understanding secondary trauma is crucial for nurses working in behavioral health settings as it can impact their own mental health and job satisfaction. Recognizing the signs and symptoms of secondary trauma allows nurses to seek support, practice self-care, and continue providing effective care to their patients.