An 11-year-old diagnosed with ODD becomes angry over the rules at a residential treatment program and begins cursing at the nurse. Select the best method for the nurse to defuse the situation.

Correct Answer: C

Rationale: The correct answer is C because taking the child to the gym and engaging in an activity can help redirect their negative energy into a positive outlet. Physical activity can help release tension and improve mood. It also provides a distraction from the triggering situation and allows the child to calm down in a non-confrontational manner. This approach promotes positive behavior reinforcement and builds a rapport with the child. Ignoring the behavior (A) may escalate the situation. Sending the child to time-out for 2 hours (B) is excessive and may lead to further resistance. Role-playing a more appropriate behavior with the child (D) is beneficial but may not be effective in the heat of the moment.

Correct Answer: A

Rationale: The correct answer is A: Second-generation antipsychotic. For a patient with CD exhibiting aggression, impulsivity, hyperactivity, and mood symptoms, second-generation antipsychotics are often prescribed due to their efficacy in managing these symptoms. These medications help regulate dopamine and serotonin levels in the brain, addressing the behavioral and emotional issues commonly seen in CD. Antianxiety medications (B) primarily target anxiety symptoms and may not adequately address the other symptoms present. Calcium channel blockers (C) are typically used for hypertension and heart conditions, not for CD symptoms. β-blockers (D) are more commonly used for conditions like hypertension and performance anxiety, and are not typically indicated for the symptoms associated with CD.

Correct Answer: D

Rationale: The correct answer is D because the client's behavior of being agitated, pacing, and expressing grandiosity aligns with symptoms of mania. The mood lability also reflects the client's fluctuating moods. Choice A is incorrect as it does not mention the presence of grandiosity or pacing. Choice B is incorrect because euthymic mood does not match the described behavior. Choice C is incorrect because delusions of reference are not mentioned, and hyperactivity alone does not fully capture the client's behavior.

Correct Answer: B

Rationale: The correct answer is B: Valproic acid (Depakote). Valproic acid is a mood stabilizer commonly used in bipolar disorder. It helps control manic episodes and can be an alternative to lithium. Valproic acid works by affecting neurotransmitters in the brain, stabilizing mood. Sertraline (A) and Paroxetine (D) are antidepressants, which can worsen manic episodes in bipolar disorder. Trazodone (C) is primarily used for treating depression and insomnia, not for mood stabilization in bipolar disorder.

Correct Answer: D

Rationale: The correct answer is D: Lithium carbonate toxicity. The symptoms of severe diarrhea, blurred vision, and tinnitus are indicative of lithium toxicity. Severe diarrhea can lead to dehydration, which can exacerbate lithium toxicity. Blurred vision and tinnitus are neurological symptoms associated with lithium toxicity. It is important for the nurse to recognize these symptoms as signs of lithium toxicity and take appropriate action. A: Consumption of foods high in tyramine is not related to the symptoms described. Tyramine is not known to cause severe diarrhea, blurred vision, or tinnitus. B: Common side effects of lithium carbonate typically include mild gastrointestinal upset, tremors, and increased thirst, not the severe symptoms described in the question. C: Lithium carbonate tolerance refers to the body's ability to withstand higher doses of lithium over time. It does not present with the acute, severe symptoms described in the question.