The family of a child diagnosed with an impulse control disorder needs help to function more adaptively. Which aspect of the child's plan of care will be provided by an advanced practice nurse rather than a staff nurse?

Correct Answer: D

Rationale: The correct answer is D, providing dialectical behavioral therapy (DBT). Advanced practice nurses have specialized training and skills to provide psychotherapy interventions like DBT. DBT is an evidence-based therapy specifically designed to help individuals with impulse control disorders. Leading an activity group (choice A) and providing positive feedback (choice B) can be done by both advanced practice and staff nurses. Formulating nursing diagnoses (choice C) is within the scope of both roles but does not directly address the therapeutic intervention needed for impulse control disorders.

Correct Answer: C

Rationale: The correct answer is C because reduced gray matter in the cortex and dysfunction of the amygdala can lead to decreased feelings of empathy. The adolescent's lack of remorse for stealing and wrecking the neighbor's motorcycle suggests a deficit in empathy, which is controlled by the amygdala and the cortex. The amygdala is responsible for processing emotions, including empathy, while the cortex plays a role in higher cognitive functions like decision-making and understanding consequences. Dysfunction in these areas can result in a lack of emotional response or understanding of the impact of one's actions, leading to a lack of remorse. Choice A is incorrect because while serotonin dysregulation and increased testosterone activity can affect behavior, they are not directly linked to remorse. Choice B is incorrect as neuron destruction in the hippocampus is associated with memory and learning, not empathy. Choice D is incorrect because disturbances in the occipital lobe are related to visual processing, not empathy or remorse.

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.