After teaching a patient who is prescribed imipramine about the drug, the nurse determines that the teaching was effective when the patient states which of the following?

Correct Answer: A

Rationale: Rationale for Correct Answer A: The statement "I need to be careful because the drug can make me sleepy" demonstrates understanding of a common side effect of imipramine, which is sedation. This shows that the patient comprehends the need to be cautious while taking the medication to prevent accidents or injuries due to drowsiness. Incorrect Choices: B: This statement is incorrect because imipramine can cause orthostatic hypotension, leading to dizziness when changing positions. C: This statement is incorrect because excess saliva is not a common side effect of imipramine. D: This statement is incorrect because imipramine can actually cause constipation rather than diarrhea, so avoiding fiber is not necessary.

Correct Answer: B

Rationale: The correct answer is B: Manage the patient's withdrawal symptoms well. This is crucial as effective management of withdrawal symptoms is essential in the early days of rehabilitation to ensure the patient's success. By addressing withdrawal symptoms promptly and effectively, the patient is more likely to remain engaged in the treatment process and have a smoother transition into the rehabilitation program. A: Restricting visitors to family members only may not be the most critical initial intervention and could potentially isolate the patient from important sources of support. C: Providing a low stimulus environment is important but may not be as immediately impactful as managing withdrawal symptoms, which directly addresses the patient's physical and psychological discomfort. D: Advocating for at least 3 months of treatment is important for long-term success, but managing withdrawal symptoms should take precedence in the initial days after admission.

Correct Answer: A

Rationale: The correct answer is A: The importance of using therapeutic communication was stressed by Nightingale. Florence Nightingale, considered the founder of modern nursing, emphasized the significance of therapeutic communication in nursing practice. Nightingale's focus was on creating an environment conducive to healing through effective communication with patients. Explanation: Nightingale's emphasis on therapeutic communication laid the foundation for psychiatric-mental health nursing. Incorrect Answers: B: The use of self-care to enhance the immune system was taught by Dorothea Dix. Dorothea Dix was a mental health advocate, not known for teaching self-care to enhance the immune system. C: The moral treatment of mental illness was a primary focus of deinstitutionalization. Deinstitutionalization aimed to shift care from mental hospitals to community-based settings, not primarily focusing on moral treatment. D: Peplau was the first nurse to stress the importance of therapeutic communication. While Peplau made significant contributions to psychiatric nursing, Night

Correct Answer: C

Rationale: The correct answer is C: "Documenting this puts you at risk for defamation of character." This is because the nurse's statement could harm the client's reputation by implying they have no regard for legal or ethical standards. Defamation of character involves making false statements that harm someone's reputation. The nurse's documentation could be seen as libel if it's in writing. A: "Documenting this breaches the client's right to confidentiality." This is incorrect because the issue is not about breaching confidentiality but rather about potentially harming the client's reputation. B: "Documenting this puts you at risk for malpractice." This is incorrect because malpractice typically involves a failure to meet the standard of care, not necessarily defamation of character. D: "Documenting this breaches the client's right to informed consent." This is incorrect as informed consent relates to the client's understanding and agreement to treatment, not to the nurse's documentation of behavior.

Correct Answer: B

Rationale: The correct answer is B because antisocial personality disorder requires the individual to be at least 18 years of age for a diagnosis according to the DSM-5 criteria. This age requirement is essential as the disorder is characterized by a persistent pattern of disregard for the rights of others, deceitfulness, impulsivity, irritability, and aggressiveness, which typically manifest in late adolescence or early adulthood. Choice A is incorrect because antisocial personality disorder is more commonly diagnosed in men than in women. Choice C is incorrect as the disorder is not specific to any particular ethnic or racial group. Choice D is incorrect because individuals with antisocial personality disorder often have a higher likelihood of substance abuse, including alcohol abuse, as a co-occurring condition.

Correct Answer: D

Rationale: The correct answer is D: Ramelteon. Ramelteon is a melatonin receptor agonist, specifically targeting the MT1 and MT2 receptors to regulate the sleep-wake cycle. This mechanism of action helps in promoting sleep onset and regulating the circadian rhythm. Trazodone (A) is a serotonin antagonist and reuptake inhibitor used off-label for insomnia. Estazolam (B) is a benzodiazepine used as a hypnotic. Mirtazapine (C) is an antidepressant with sedating effects but does not act as a melatonin receptor agonist.

Correct Answer: B

Rationale: The correct answer is B: Check for an allergy to eggs. This is crucial because some fat emulsions used in TPN solutions are derived from egg phospholipids, potentially causing an allergic reaction in patients with egg allergies. By checking for an egg allergy before administering the TPN with fat supplements, the nurse can prevent a serious allergic reaction in the client. A: Piggyback 0.9 sodium chloride with TPN solution - Incorrect. This is not necessary for administering TPN with fat supplements. C: Discuss the TPN solution for 12 hours - Incorrect. There is no need to discuss the TPN solution for such a long duration. D: Monitor for hypoglycemia - Incorrect. While monitoring for hypoglycemia is important with TPN administration, checking for an egg allergy is more directly related to the addition of fat supplements in the TPN solution.

Correct Answer: B

Rationale: The correct answer is B: glutamate. Glutamate is the primary excitatory neurotransmitter in the brain and plays a crucial role in the pathophysiology of schizophrenia. Research has shown abnormalities in glutamatergic neurotransmission in individuals with schizophrenia, including NMDA receptor hypofunction. GABA (A) is an inhibitory neurotransmitter and is not directly implicated in schizophrenia. Norepinephrine (C) and acetylcholine (D) are not the primary neurotransmitters associated with schizophrenia.

Correct Answer: A

Rationale: Rationale for Correct Answer A: The statement "I need to be careful because the drug can make me sleepy" demonstrates understanding of a common side effect of imipramine, which is sedation. This shows that the patient comprehends the need to be cautious while taking the medication to prevent accidents or injuries due to drowsiness. Incorrect Choices: B: This statement is incorrect because imipramine can cause orthostatic hypotension, leading to dizziness when changing positions. C: This statement is incorrect because excess saliva is not a common side effect of imipramine. D: This statement is incorrect because imipramine can actually cause constipation rather than diarrhea, so avoiding fiber is not necessary.