A patient with bipolar disorder is experiencing a depressive episode. Which intervention is most appropriate?

Correct Answer: D

Rationale: The correct answer is D because encouraging the patient to express their feelings and concerns is crucial in addressing depressive symptoms in bipolar disorder. This intervention can help the patient process their emotions, improve self-awareness, and facilitate therapeutic communication. It also promotes a supportive environment for the patient to receive appropriate care. Incorrect choices: A: While physical activities can be beneficial, they may not address the underlying emotional issues during a depressive episode. B: Providing a stimulating environment might overwhelm the patient and worsen their symptoms. C: Allowing the patient to isolate may exacerbate feelings of loneliness and hopelessness, and hinder recovery.

Correct Answer: A

Rationale: The correct answer is A because clozapine can suppress the immune system, increasing the risk of infections. Reporting signs of infection promptly can help prevent serious complications. Choice B is incorrect because stopping clozapine abruptly can lead to withdrawal symptoms or a relapse of symptoms. Choice C is incorrect because clozapine should be taken with food to reduce gastrointestinal side effects. Choice D is incorrect because alcohol can interact with clozapine, leading to increased sedation and potentially dangerous side effects.

Correct Answer: B

Rationale: The correct answer is B: Allowing the patient to wash hands at specified times. This option acknowledges the patient's need for hand washing while also setting boundaries. By allowing the patient to wash hands at specified times, the nurse can help establish a routine and gradually reduce the excessive hand washing behavior. Encouraging the patient to stop washing hands (A) may increase anxiety and resistance. Ignoring the behavior (C) can reinforce it. Setting strict limits (D) may cause distress and worsen the OCD symptoms. Option B strikes a balance between addressing the patient's needs and promoting healthier behaviors.

Correct Answer: C

Rationale: The correct answer is C: Weight gain. Lithium is known to cause weight gain as a common side effect in patients with bipolar disorder. This is due to its impact on the body's metabolism and hormonal balance. Monitoring for weight changes is crucial as it can affect the patient's overall health and well-being. Increased energy (A) is not a common side effect of lithium and can be a sign of hypomania or mania in bipolar disorder. Constipation (B) and dry mouth (D) are possible side effects of some medications, but they are not typically associated with lithium.

Correct Answer: A

Rationale: The correct answer is A because focusing on deep breathing exercises helps the patient regulate their breathing and reduce hyperventilation during a panic attack. This intervention promotes relaxation and helps calm the patient down. Encouraging avoidance of physical activity (B) is incorrect as it does not address the immediate physiological symptoms of a panic attack. Asking the patient to describe their feelings (C) may be helpful for assessment but does not directly address the urgent need to manage the panic attack. Providing detailed information about panic attacks (D) is important for education but is not the priority during an active panic attack.

Correct Answer: C

Rationale: The correct answer is C because the primary goal of cognitive processing therapy in PTSD is to help the patient understand the impact of trauma on their current thoughts and behaviors. This involves identifying and challenging maladaptive beliefs and cognitive distortions related to the trauma. By gaining insight into how the trauma has influenced their thoughts and behaviors, the patient can work towards changing these patterns and improving their psychological well-being. Choice A is incorrect because while processing the trauma and reducing avoidance behaviors are important aspects of therapy, they are not the primary goal in cognitive processing therapy. Choice B is incorrect as it focuses solely on confronting and processing the trauma, missing the crucial component of understanding its impact on thoughts and behaviors. Choice D is incorrect because avoidance of triggers is not the primary goal; rather, it is about addressing and modifying the cognitive responses to those triggers.

Correct Answer: B

Rationale: The correct answer is B: Diazepam. Diazepam is a benzodiazepine commonly used to treat panic disorder due to its anxiolytic properties. It works by enhancing the effects of GABA in the brain, reducing anxiety and promoting relaxation. Lithium (A) is typically used to treat bipolar disorder, not panic disorder. Haloperidol (C) and Clozapine (D) are antipsychotic medications primarily used for schizophrenia and other psychotic disorders, not panic disorder. Diazepam is the most suitable choice for treating panic disorder due to its anxiolytic effects and quick onset of action.

Correct Answer: D

Rationale: The correct answer is D: Impulsive and self-destructive behaviors. This is a common symptom of borderline personality disorder as individuals often engage in reckless behaviors without considering the consequences. They may have self-harming tendencies and engage in impulsive actions like substance abuse or risky sexual behavior. A: Obsessive-compulsive behaviors are more characteristic of obsessive-compulsive disorder, not borderline personality disorder. B: Fear of social situations is more indicative of social anxiety disorder, not borderline personality disorder. C: Grandiose sense of self-importance is a symptom of narcissistic personality disorder, not borderline personality disorder. In summary, impulsive and self-destructive behaviors are key features of borderline personality disorder, distinguishing it from other mental health conditions.

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.