A patient with major depressive disorder is struggling to cope. Which intervention is most appropriate to help the patient develop better coping skills?

Correct Answer: D

Rationale: The correct answer is D: Providing the patient with a structured daily routine. This intervention is most appropriate as it helps the patient establish a sense of stability, predictability, and purpose in their daily life, which can be beneficial in managing depressive symptoms. By having a routine, the patient can develop a sense of accomplishment and control, improve sleep patterns, and reduce feelings of hopelessness and helplessness. Encouraging the patient to express their feelings through art (A) may be helpful as a supplementary intervention, but it may not provide the necessary structure and consistency needed for coping skills development. Providing information about the diagnosis (B) is important but may not directly address coping skills. Keeping a journal of thoughts and feelings (C) can be beneficial, but a structured routine provides more tangible support for developing coping skills.

Correct Answer: B

Rationale: The correct answer is B: Duloxetine. Duloxetine is a serotonin-norepinephrine reuptake inhibitor used to treat both major depressive disorder and neuropathic pain by increasing the levels of these neurotransmitters in the brain. Gabapentin (A) is primarily used for neuropathic pain, Amitriptyline (C) is a tricyclic antidepressant used for depression and neuropathic pain, and Tramadol (D) is an opioid analgesic used for pain management but not typically for major depressive disorder.

Correct Answer: A

Rationale: The correct answer is A: Avoid driving until you know how the medication affects you. This is crucial because alprazolam can cause drowsiness and impair cognitive function. It is important to prioritize safety and prevent accidents. Choice B is incorrect as alprazolam does not necessarily need to be taken with food. Choice C is incorrect as alprazolam is typically taken during the day due to its sedative effects. Choice D is incorrect as increasing the dose without medical guidance can lead to overdose and adverse effects.

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: Aged cheese. MAOIs interact with tyramine in certain foods like aged cheese, leading to dangerous hypertensive crisis. Aged cheese contains high levels of tyramine, which can cause a sudden increase in blood pressure when combined with MAOIs. Fresh vegetables (B), grilled chicken (C), and fruit juices (D) do not have high levels of tyramine and can be safely consumed with MAOIs. It is crucial for patients taking MAOIs to avoid foods rich in tyramine to prevent adverse reactions.

Correct Answer: B

Rationale: The correct answer is B: Lithium. Lithium is often prescribed for patients with bipolar disorder because it helps stabilize mood by regulating neurotransmitter activity. It is a mood stabilizer that is effective in reducing manic episodes and preventing relapses. Sertraline (A) is an antidepressant and can potentially trigger manic episodes in patients with bipolar disorder. Haloperidol (C) is an antipsychotic used for treating psychotic symptoms but not specifically for stabilizing mood in bipolar disorder. Diazepam (D) is a benzodiazepine used for anxiety and not indicated for mood stabilization in bipolar disorder.

Correct Answer: D

Rationale: The correct answer is D: Nausea. Sertraline, a selective serotonin reuptake inhibitor (SSRI), commonly causes gastrointestinal side effects like nausea. This occurs due to increased serotonin levels affecting the digestive system. Dry mouth (A) is more common with other medications like anticholinergics. Weight gain (B) is a potential side effect of some antidepressants but not typically with sertraline. Insomnia (C) can occur with SSRIs, but it is less common than nausea as an initial side effect. Monitoring for nausea is essential to ensure the patient's adherence to treatment and well-being.

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: Monitoring for signs of neuroleptic malignant syndrome. This is because neuroleptic malignant syndrome is a potentially life-threatening side effect of haloperidol, characterized by fever, muscle rigidity, altered mental status, and autonomic dysfunction. It requires immediate medical intervention. Assessing for tardive dyskinesia (A) is important but not as urgent as monitoring for neuroleptic malignant syndrome. Checking for signs of depression (C) is relevant but not a priority when the patient is at risk of a serious adverse reaction. Monitoring changes in appetite (D) is less critical than assessing for neuroleptic malignant syndrome, as it is a common side effect that does not pose an immediate threat to the patient's life.