Madelyn, a 29-year-old patient recently diagnosed with depression, comes to the mental health clinic complaining of continued difficulty sleeping. One week ago she was started on a selective serotonin reuptake inhibitor (SRRI), fluoxetine (Prozac), for her depressive symptoms. When educating Madelyn your response is guided by the knowledge that:

Correct Answer: C

Rationale: The correct answer is C because neurotransmitters involved in sleep and wakefulness are targeted by many psychiatric medications, including SSRIs like fluoxetine. The difficulty sleeping may be a temporary side effect as Madelyn's body adjusts to the medication. This explanation is supported by the fact that changes in neurotransmitter levels can impact sleep patterns. Choice A is incorrect because while SSRIs can cause side effects like hypersomnolence, difficulty sleeping is also a known side effect. Choice B is incorrect because while depression can affect sleep, starting a new medication like fluoxetine can also impact sleep patterns. Choice D is incorrect because discontinuing the medication without consulting a healthcare provider can have negative consequences for Madelyn's mental health. Addressing the sleep issue through education and monitoring is a more appropriate approach.

Correct Answer: A

Rationale: The correct answer is A: assessment. In the assessment stage of the nursing process, the nurse gathers information about the client's personal strengths, weaknesses, and resources. By identifying the client's strengths during assessment, the nurse can tailor the care plan to utilize these strengths effectively. Choice B: analysis, comes after assessment and involves interpreting the data collected. Choice C: planning, is where the nurse develops goals and interventions based on the assessment data. Choice D: implementation, is the stage where the nurse carries out the care plan developed during planning. These choices are incorrect as they occur after the assessment stage in the nursing process.

Correct Answer: C

Rationale: The correct diagnosis suspected in this case is C: schizophreniform disorder. This is because the client is experiencing psychotic symptoms such as hallucinations, delusions, disorganized speech, and behavior for a period of five months. Schizophreniform disorder is characterized by similar symptoms to schizophrenia but with a duration of at least one month but less than six months. Delusional disorder (A) involves persistent delusions without other psychotic symptoms. Brief psychotic disorder (B) lasts less than one month. Schizophrenia (D) requires symptoms to be present for at least six months.

Correct Answer: C

Rationale: The correct answer is C because it demonstrates focusing by redirecting the conversation back to a specific topic or issue, encouraging the client to elaborate on their thoughts and feelings. By asking the client to recount their experience in Vietnam and their emotions after being wounded, the therapist is helping the client concentrate on a particular aspect of their story. Choices A, B, and D are incorrect: A: This statement does not exemplify focusing as it points out a discrepancy between the client's words and body language, which may lead to defensiveness and does not encourage the client to delve deeper into their thoughts or feelings. B: This statement does not involve focusing but rather reflects a literal interpretation of the client's words without guiding the conversation towards a specific topic or emotion. D: While this statement acknowledges the client's behavior, it does not guide the conversation towards a specific topic or emotion, thus not demonstrating the focusing technique.

Correct Answer: B

Rationale: The correct answer is B because reporting consistently sad, discouraged, and hopeless mood is a key indicator of a mental illness, specifically depression. This finding suggests a persistent negative emotional state that goes beyond occasional sleeplessness and anxiety (choice A), the ability to describe differences in perceptions (choice C), or difficulty in making decisions related to job changes (choice D). The persistent nature of the mood described in choice B aligns more closely with symptoms of mental illness, indicating the need for further assessment and potential intervention.