Emily is a 28-year-old nurse who works on a psychiatric unit. She is assigned to work with Jenna, a 27-year-old who was admitted with major depressive disorder. Emily and Jenna realize that they graduated from the same high school and each has a 2-year-old daughter. Emily and Jenna discuss getting together for a play date with their daughters after Jenna is discharged. This situation reflects:

Correct Answer: C

Rationale: The correct answer is C: Boundary blurring. This situation reflects boundary blurring because Emily, as a nurse, is crossing professional boundaries by engaging in a personal and social relationship with Jenna, her patient. This can lead to ethical concerns, compromised therapeutic effectiveness, and potential harm to both parties. It is important for healthcare professionals to maintain clear boundaries to uphold professionalism, trust, and the therapeutic nature of the nurse-patient relationship. A: Successful termination is incorrect as it refers to the conclusion of the therapeutic relationship, which is not the case here. B: Promoting interdependence is incorrect as it involves fostering mutual reliance and support between individuals, which is not the focus of the situation described. D: A strong therapeutic relationship is incorrect as it describes a positive and therapeutic connection between a healthcare provider and patient, which is not the issue in this scenario due to boundary blurring.

Correct Answer: C

Rationale: The correct answer is C because the nurse has violated confidentiality laws by sharing information about a patient's condition, even without using the patient's name. Patient confidentiality extends to all identifiable information, not just names. Sharing details about a patient's medical condition on social media breaches their right to privacy and confidentiality. The Health Insurance Portability and Accountability Act (HIPAA) strictly prohibits the disclosure of any identifiable patient information without authorization. Choices A, B, and D are incorrect because the absence of the patient's name does not exempt the nurse from maintaining confidentiality, being the primary nurse is not a determining factor for liability, and social media posts are not exempt from confidentiality laws.

Correct Answer: C

Rationale: The correct answer is C) It is an atypical neuroleptic that reduces positive and negative symptoms without exacerbating the underlying Parkinson’s disease. Quetiapine is chosen for this patient because it is an atypical antipsychotic that has a lower risk of worsening Parkinson's symptoms compared to typical antipsychotics. It targets serotonin and dopamine receptors in a more balanced way, making it effective for treating schizophrenia without aggravating Parkinson's symptoms. Option A is incorrect because while quetiapine does reduce positive and negative symptoms of schizophrenia, its effect on decreasing Parkinson’s symptoms is not the primary reason for its selection in this case. Option B is incorrect because it mentions blocking D2 and 5-HT2 receptors but fails to emphasize the importance of not exacerbating Parkinson's symptoms in this patient. Option D is incorrect because it suggests that quetiapine may potentially worsen Parkinson's symptoms, which is not the case with this atypical antipsychotic. Educationally, understanding the rationale behind selecting specific psychotropic medications for patients with comorbid conditions is crucial for healthcare providers to provide safe and effective treatment. It highlights the importance of considering drug interactions and side effects when managing complex cases like this one.

Correct Answer: B

Rationale: In assessing a patient with major depression for disturbances in circadian rhythms, the nurse should ask the patient about their worst and best times of the day (Option B). This question is pertinent because disturbances in circadian rhythms, such as sleep disturbances, are common in individuals with major depression. By inquiring about the patient's best and worst times of the day, the nurse can gather valuable information about the patient's sleep-wake cycle, energy levels, mood fluctuations, and overall functioning throughout the day. Option A is incorrect because it pertains to hallucinations, which are not directly related to circadian rhythm disturbances in major depression. Option C focuses on thinking patterns and Option D on memory issues, which are not the primary concerns when assessing circadian rhythm disruptions in major depression. In an educational context, understanding the rationale behind asking specific questions during patient assessments is crucial for nursing students. It helps them develop critical thinking skills, clinical reasoning, and the ability to prioritize assessment techniques based on the patient's condition. This question highlights the importance of assessing circadian rhythms in patients with major depression and how certain questions can provide valuable insights into their symptoms and overall well-being.

Correct Answer: D

Rationale: The correct answer is D) Benzodiazepines. In the scenario provided, where the patient is experiencing acute anxiety following an automobile accident, benzodiazepines are the most appropriate choice for managing acute anxiety symptoms. Benzodiazepines work quickly to reduce anxiety, calm the individual, and promote relaxation by enhancing the effects of GABA, a neurotransmitter that reduces brain activity. This rapid onset of action is crucial in acute situations like the one described. Option A) Tricyclic antidepressants are not the best choice for acute anxiety due to their slower onset of action and the need for longer-term use to achieve therapeutic effects. They are more commonly used in conditions like depression and chronic anxiety disorders. Option B) Antipsychotic drugs are primarily used to manage psychotic symptoms such as hallucinations and delusions in conditions like schizophrenia. They are not the first-line treatment for acute anxiety. Option C) Antimanic drugs are used to treat bipolar disorder and are not indicated for acute anxiety management. In an educational context, it is important for nurses and healthcare professionals to understand the appropriate use of psychotropic medications based on the patient's presentation and symptoms. This knowledge helps ensure safe and effective treatment interventions for individuals experiencing mental health challenges. Understanding the mechanisms of action and indications for different classes of psychotropic medications is essential for providing quality care to patients with varying mental health needs.