Garret's wife of 8 years is divorcing him because the marriage never developed a warm or loving atmosphere. Garrett states in therapy, 'I have always been a loner,' and was never concerned about what others think. The nurse practitioner suggests that Garrett try a trial of bupropion (Wellbutrin) to:

Correct Answer: C

Rationale: Rationale for Choice C (Increase the pleasure of living): Bupropion is an antidepressant that works by increasing dopamine and norepinephrine levels in the brain, which can help improve mood and overall sense of pleasure. Given Garrett's emotional flatness and lack of warmth in his relationships, bupropion can potentially enhance his ability to experience pleasure in life and improve his overall quality of life. Summary of Incorrect Choices: A: Improving flat emotions is a potential benefit of bupropion, but the primary goal is not just to improve emotions, but to increase the pleasure of living. B: While bupropion can sometimes help with sleep disturbances, the main reason for prescribing it in Garrett's case is to address his emotional flatness and lack of enjoyment in life. D: Bupropion is not specifically indicated to prepare someone for group therapy; its main purpose in this scenario is to improve Garrett's overall sense of pleasure and enjoyment in life.

Correct Answer: A

Rationale: The correct answer is A: referring the client for hypnosis. Hypnosis is an evidence-based nonpharmacologic intervention for chronic pain that can help manage pain perception and improve coping mechanisms. It is safe and effective for long-term pain management. Referring for hypnosis aligns with the holistic approach to chronic pain management. Choice B: administering pain medication as prescribed is a pharmacologic intervention, not nonpharmacologic. Choice C: removing all glaring lights and excessive noise can help create a comfortable environment but may not directly address chronic pain relief. Choice D: using over-the-counter transcutaneous electric nerve stimulation is a nonpharmacologic intervention, but it may not be as effective for chronic pain as hypnosis.

Correct Answer: A

Rationale: The correct answer is A: Risk for falls R/T right-sided weakness and sedation from risperidone. This is the priority nursing diagnosis because the client's physical aggression and right-sided weakness increase the risk of falls, which can lead to further injury. The sedative effect of risperidone can further impair the client's balance and coordination, exacerbating the risk. Addressing this risk is crucial to ensure the safety and well-being of the client. Summary of other choices: B: Activity intolerance R/T right-sided weakness - While this is a relevant concern, it is not the priority as the risk of falls takes precedence. C: Disturbed thought processes R/T acting-out behaviors - While the client's behavior may be a concern, addressing the immediate risk of falls is more critical. D: Anxiety R/T change in health status and dependence on others - While anxiety may be present, addressing the risk of falls is more urgent in this situation.

Correct Answer: B

Rationale: The correct response is B: "It must be frightening to feel like you're always been watched." This response validates the client's feelings without challenging the delusion directly. It shows empathy and builds rapport. Choice A may inadvertently reinforce the delusion. Choice C denies the client's experience and may lead to resistance. Choice D uses clinical jargon and may be too direct, potentially causing the client to become defensive.

Correct Answer: D

Rationale: The correct answer is D: Glass of milk. Milk contains tryptophan, an amino acid that helps in the production of serotonin, a neurotransmitter that contributes to mood regulation. Offering the patient a glass of milk can help increase serotonin levels, potentially decreasing irritability. A: Chocolate candy bar is high in sugar and may lead to a spike in blood sugar levels, followed by a crash, which can worsen irritability. B: Raisins are a source of natural sugars but lack the necessary nutrients to help regulate mood. C: Granola bar may contain added sugars and lack the specific components like tryptophan found in milk to help improve mood.