Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted's wife and his blood tests confirm. To reduce Ted's mania the psychiatric nurse practitioner recommends:

Correct Answer: D

Rationale: The correct answer is D: Lurasidone (Latuda). Lurasidone is an atypical antipsychotic commonly used to treat bipolar disorder. It helps stabilize mood and reduce symptoms of mania. Given Ted's history of bipolar I and manic episodes, lurasidone is an appropriate choice. Clonazepam (A) is a benzodiazepine used for anxiety, not mania. Fluoxetine (B) is an SSRI antidepressant, which can potentially worsen manic symptoms. Electroconvulsive therapy (C) is typically reserved for severe cases or when other treatments have failed, and may not be necessary in Ted's case. Lurasidone (D) is the most suitable option for managing Ted's mania while considering his medical history and current treatment.

Correct Answer: D

Rationale: The correct answer is D: Schizophrenia and alcohol abuse. This combination is appropriate for a dual-diagnosis group because it involves both a severe mental illness (schizophrenia) and a substance abuse issue (alcohol abuse). Patients with schizophrenia often have co-occurring substance abuse disorders, making them suitable for a dual-diagnosis group to address both issues simultaneously. This group can provide comprehensive treatment and support for individuals struggling with complex mental health and substance abuse issues. Choices A, B, and C are incorrect because they do not involve the combination of a severe mental illness and a substance abuse issue, which is essential for a dual-diagnosis group. Choice A (Depression and suicidal tendencies) may benefit from a different type of group focused on mood disorders and suicide prevention. Choice B (Anxiety and frequent migraine headaches) may require a group focused on stress management and pain coping strategies. Choice C (Bipolar disorder and anorexia nervosa) may benefit from a group addressing

Correct Answer: D

Rationale: The correct answer is D: somatic. This client is experiencing a somatic delusion, which involves a false belief about the body or its functions. In this case, the client believes their uterus was removed despite evidence to the contrary. This delusion is specific to bodily functions or sensations. A: Grandiose delusions involve an exaggerated sense of importance or power, not related to bodily functions. B: Jealous delusions involve unfounded beliefs about a partner's infidelity, not related to bodily functions. C: Persecutory delusions involve beliefs of being targeted or persecuted, not related to bodily functions. In summary, the client's persistent belief about their uterus being removed despite evidence points to a somatic delusion, making it the correct choice over the other options.

Correct Answer: A

Rationale: The correct answer is A because prohibiting a patient from using the telephone violates their right to communication. Patients have the right to contact others for support or assistance. Choice B is incorrect because opening a package in the patient's presence is not a violation of their rights. Choice C is incorrect because maintaining close supervision of a patient with homicidal ideation is necessary for safety. Choice D is incorrect because allowing a patient with psychosis to refuse medication respects their autonomy and right to make informed decisions about their treatment.

Correct Answer: A

Rationale: The correct answer is A: Transaction. In King's model, the nurse-patient interaction is viewed as a transaction where both parties influence each other. This is correct as the nurse and patient exchange information, thoughts, and feelings during the interaction. Choice B, Adaptation, focuses more on the patient adapting to changes, not the interaction itself. Choice C, Transpersonal caring, emphasizes the nurse's caring relationship with the patient but doesn't capture the interactive nature of the model. Choice D, Self-system, refers to the patient's perception of self, which is not the main focus of King's model.

Correct Answer: D

Rationale: Desensitization aims to reduce anxiety and fear associated with sexual activity in male orgasmic dysfunction. By gradually exposing the client to sexual stimuli and teaching relaxation techniques, anxiety and fear decrease, leading to improved sexual function. Choices A, B, and C are incorrect as desensitization primarily targets anxiety and fear, not pressure to perform, pleasure awareness, or spectatoring.

Correct Answer: B

Rationale: The correct answer is B: Implement positive pressure ventilation. This action is appropriate because the client's respiratory rate of 9/min indicates hypoventilation, which can lead to hypoxemia and respiratory arrest. Positive pressure ventilation helps support adequate oxygenation and ventilation. Placing the client in a prone position (choice A) can further compromise breathing. Nasopharyngeal suctioning (choice C) is not indicated unless airway obstruction is confirmed. Administering flumazenil (choice D) is contraindicated in clients with significant respiratory depression due to the risk of precipitating seizures.

Correct Answer: B

Rationale: The correct answer is B because clarification involves seeking understanding by asking for more information or explaining a vague statement. In this case, the statement "I'm not sure what you mean when you use the word fragile" demonstrates the use of clarification by seeking clarity on the meaning of a term used by the client. This technique helps the client to express themselves more clearly and aids in effective communication. Choices A, C, and D are incorrect because they do not involve seeking clarification or further explanation from the client. Choice A focuses on exploring emotions related to a specific topic, choice C reflects an observation rather than seeking clarification, and choice D compares the client's mood without seeking clarification on any specific term or concept.

Correct Answer: A

Rationale: The correct answer is A because smoking cessation success often requires a combination of interventions like counseling, medication, and support. This approach addresses physical and psychological aspects of addiction, increasing the chances of success. Choice B is incorrect as relapse rates are high in the first year after quitting. Choice C is incorrect as ear acupressure lacks strong scientific evidence for smoking cessation. Choice D is incorrect as education alone is usually insufficient for successful smoking cessation.