Parents of an adolescent diagnosed with a CD say, 'We don't know how to respond when our child breaks the rules in our house. Is there any treatment that might help us?' Which therapy is likely to be helpful for these parents?

Correct Answer: A

Rationale: The correct answer is A: Parent-child interaction therapy (PCIT). PCIT focuses on improving parent-child communication and interactions, teaching parents effective discipline strategies, and enhancing the parent-child relationship. This therapy is specifically designed to help parents manage disruptive behaviors in children, such as conduct disorder (CD). By participating in PCIT, parents can learn skills to respond to rule-breaking behavior in a positive and effective manner, ultimately improving the child's behavior and family dynamics. Incorrect choices: B: Behavior modification therapy focuses on changing specific behaviors through reinforcement and punishment, but may not address the underlying parent-child relationship issues. C: Multi-systemic therapy (MST) targets various systems influencing the adolescent's behavior, but may not directly address the parents' need for guidance on managing rule-breaking behavior at home. D: Pharmacotherapy involves medication treatment, which may be used in conjunction with therapy but does not directly address the parents' need for guidance on responding to rule-breaking behavior.

Correct Answer: C

Rationale: The correct answer is C: Remains free from injury. This is the first priority because during a manic episode, clients may engage in risky behaviors that can lead to harm. Ensuring the client's safety and preventing injury is crucial before addressing other needs. Choices A, B, and D are important but not as urgent as safety. Maintaining nutritional status, interacting appropriately with peers, and achieving proper sleep can be addressed once the client's safety is ensured.

Correct Answer: C

Rationale: The correct answer is C: Weight gain is a common but troubling side effect. Weight gain is a well-known side effect of lithium, commonly seen in individuals taking this medication for bipolar disorder. It is essential for the nurse to acknowledge the client's concern and provide accurate information about the medication's potential side effects. Choices A, B, and D are incorrect because weight gain is a known side effect of lithium, and denying or downplaying the client's experience could lead to misunderstanding and lack of trust in the healthcare provider.

Correct Answer: C

Rationale: Rationale: The correct answer is C because the recommended dosage range for lamotrigine in bipolar I disorder is typically 100-400 mg/day. Since the client is prescribed 400 mg three times a day, the total daily dose would be 1200 mg, which is more than twice the upper limit of the recommended range. This high dosage may increase the risk of adverse effects, such as skin rash or dizziness. Summary: A: Incorrect - The dosage is higher than the recommended range. B: Incorrect - The dosage is not lower but higher than the recommended range. D: Incorrect - The dosage is not four times higher but more than twice the recommended range.

Correct Answer: B

Rationale: The correct answer is B: Take the child swimming at the facility's pool. This is the priority action because the client is exhibiting signs of agitation and potential aggression, and physical activity like swimming can help release pent-up energy and reduce stress. It can also serve as a distraction and help de-escalate the situation. A: Asking the child about their feelings may not be effective in this moment of agitation. C: Establishing a behavioral contract requires a calm and cooperative state from the client, which is not the case currently. D: Administering an anxiolytic medication should not be the initial response unless the client's behavior becomes a safety concern and other interventions have failed.