A patient diagnosed with major depressive disorder was hospitalized for 8 days. Treatment included six electroconvulsive therapy sessions and aggressive dose adjustments of antidepressant medications. The patient owns a small business and was counseled not to make major decisions for a month. Select the correct rationale for this counseling.

Correct Answer: A

Rationale: The correct answer is A) Temporary memory impairments and confusion can be associated with electroconvulsive therapy. In this scenario, the patient underwent a significant treatment regimen for major depressive disorder, including electroconvulsive therapy and aggressive medication adjustments. Electroconvulsive therapy can lead to temporary memory impairments and confusion as side effects. Therefore, counseling the patient not to make major decisions for a month is crucial to ensure that they have time to fully recover from these potential cognitive effects. Option B) is incorrect because while antidepressant medications can have side effects, they do not directly impair decision-making abilities by altering catecholamine levels. Option C) is also incorrect as the limitation of tyramine in the diet is more relevant to MAOI medications, not the situation described in the question. Option D) is misleading as it does not address the cognitive effects of the treatment received by the patient. From an educational perspective, understanding the potential side effects of psychiatric treatments is essential for nurses working with patients with mental health disorders. It is important to recognize how different treatments can impact cognitive function and decision-making abilities, and to provide appropriate guidance and support to patients during their recovery process.

Correct Answer: D

Rationale: In this scenario, the priority nursing intervention for a patient diagnosed with bulimia nervosa and a low BMI of 17.5 is to assess the patient for signs of self-induced vomiting and purging behaviors (Option D). This intervention is crucial because individuals with bulimia nervosa often engage in these harmful behaviors to control their weight, leading to serious physical and psychological consequences. By identifying and addressing these behaviors promptly, nurses can prevent further health complications and provide appropriate interventions. Option A, monitoring the patient's nutritional intake and weight regularly, is important in the overall management of bulimia nervosa, but it is not the priority when the patient's BMI is critically low. Option B, encouraging the patient to discuss their eating habits openly, may be beneficial for building rapport and trust but does not address the immediate health risks associated with a low BMI. Option C, providing structured meal plans and counseling, is also essential in the long-term treatment of bulimia nervosa but does not address the urgent need to assess and intervene in self-induced purging behaviors. From an educational perspective, understanding the priority of interventions based on the patient's condition and prioritizing immediate health risks in psychiatric nursing is crucial. By focusing on the most critical aspect of care first, nurses can ensure patient safety and well-being in acute situations like this one. The rationale behind choosing the correct intervention should always be grounded in evidence-based practice and an understanding of the specific needs of patients with eating disorders.

Correct Answer: D

Rationale: In the context of caring for a patient diagnosed with anorexia nervosa, the most appropriate response by the nurse is option D: Provide a non-judgmental and supportive environment to encourage the patient to eat. This option is the most suitable because it focuses on creating a safe and supportive space for the patient to feel comfortable and encouraged to make their own choices regarding eating. Option A, forcing the patient to eat, is not recommended as it can lead to feelings of distress, loss of autonomy, and potential resistance from the patient. Anorexia nervosa is a complex mental health disorder that involves underlying psychological factors, and coercion can exacerbate the situation. Option B, allowing the patient to make decisions without intervention, may not be appropriate in this scenario as individuals with anorexia nervosa may struggle with distorted thoughts and beliefs about food and eating. Providing support and guidance is crucial in helping the patient navigate these challenges. Option C, while well-intentioned, may not be as effective as option D. Simply explaining the importance of nourishment may not address the deeper emotional and psychological issues that contribute to the patient's refusal to eat. Creating a non-judgmental and supportive environment is key to building trust and facilitating positive changes in behavior. In an educational context, it is important for nurses to understand the complexities of eating disorders like anorexia nervosa and to approach care with empathy, sensitivity, and evidence-based practices. By focusing on building trust, providing support, and empowering the patient to make choices, nurses can play a crucial role in promoting recovery and well-being for individuals with eating disorders.

Correct Answer: C

Rationale: In the context of psychiatric nursing, it is crucial to understand the effects of different herbal treatments on mental health conditions like depression. In this scenario, the correct answer is C) St. John's Wort. St. John's Wort is a well-known herbal remedy that has been used traditionally to alleviate symptoms of mild to moderate depression. It contains active compounds that are believed to have antidepressant properties by affecting neurotransmitters in the brain. Option A) Black cohosh is not typically used for depression but rather for menopausal symptoms and gynecological issues. Option B) Ginseng is more commonly associated with boosting energy and reducing stress rather than treating depression. Option D) Ginkgo is often used for improving memory and cognitive function, not specifically for depression. Educationally, understanding the effects of various herbal treatments on mental health conditions allows psychiatric nurses to have informed discussions with clients seeking alternative or complementary therapies. It highlights the importance of evidence-based practice in guiding treatment decisions and promoting holistic care for individuals with mental health challenges. By knowing the specific uses and effects of different herbal remedies, nurses can better support their clients in making informed choices about their mental health care.

Correct Answer: D

Rationale: In this scenario, the child's varying recollections of the traumatic event indicate symptoms of dissociative amnesia, making option D the correct answer. Dissociative amnesia is a common response to trauma where individuals block out specific details or entire events as a coping mechanism to protect themselves from the emotional distress associated with the memory. Option A, depersonalization, involves feeling detached from oneself, which is not reflected in the child's situation. Option B, derealization, refers to a sense of unreality about one's surroundings, which is also not applicable in this case. Option C, hypervigilance, is a symptom commonly seen in post-traumatic stress disorder (PTSD) where individuals remain in a heightened state of alertness; however, it does not explain the child's varying recollections. Educationally, understanding trauma-related symptoms is crucial for healthcare professionals, especially psychiatric nurses, who work with individuals who have experienced traumatic events. Recognizing these symptoms can aid in providing appropriate care and support to help individuals cope and heal from their traumatic experiences effectively.