The nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed mirtazapine. The nurse interprets this information, identifying this agent as which type?

Correct Answer: D

Rationale: The correct answer is D: Alpha-2 antagonist. Mirtazapine is classified as a noradrenergic and specific serotonergic antidepressant (NaSSA), which acts as an alpha-2 adrenergic receptor antagonist. This mechanism of action increases the release of norepinephrine and serotonin in the brain, leading to its antidepressant effects. Selective serotonin reuptake inhibitors (SSRIs) inhibit the reuptake of serotonin, cyclic antidepressants primarily inhibit reuptake of norepinephrine and serotonin, and norepinephrine dopamine reuptake inhibitors (NDRIs) inhibit the reuptake of norepinephrine and dopamine. Thus, choices A, B, and C are incorrect in this context.

Correct Answer: B

Rationale: The correct answer is B because presenting information in a calm manner using simple language helps the patient with moderate anxiety better understand preoperative information. This approach acknowledges the patient's anxiety and promotes effective communication. Choice A is incorrect because it addresses postoperative care rather than preoperative information. Choice C is incorrect as it focuses on recovery rather than addressing the patient's anxiety and understanding of preoperative information. Choice D is incorrect because it encourages expression of feelings rather than directly addressing the patient's understanding of preoperative information.

Correct Answer: C

Rationale: The correct answer is C: A domain of information. In the multiaxial diagnostic system of the DSM-IV-TR, each axis represents a specific domain of information for assessing an individual's mental health. Axis I represents clinical disorders, Axis II represents personality disorders and mental retardation, Axis III represents general medical conditions, Axis IV represents psychosocial and environmental stressors, and Axis V represents global assessment of functioning. The other choices are incorrect because they do not accurately describe the purpose of the axes in the multiaxial diagnostic system. A does not align with the purpose of the axes being domains of information, B is not relevant as the axes are not experimental designs, and D is incorrect as the axes do not represent laboratory test findings.

Correct Answer: B

Rationale: The correct answer is B: Assess the patient for a history of renal problems. Elevated BUN and creatinine levels indicate possible renal dysfunction, which can manifest as psychiatric symptoms. By assessing the patient for a history of renal problems, the nurse can gather important information to help determine the underlying cause of the symptoms. This step is crucial in identifying and addressing any potential medical issues contributing to the psychiatric presentation. Incorrect choices: A: Reporting the findings to the health care provider is important, but assessing the patient for a history of renal problems should be done first. C: Assessing the patient's family history for cardiac problems is not relevant to the elevated BUN and creatinine levels. D: Hospitalization on the psychiatric unit may not address the underlying medical issue causing the symptoms; assessing for renal problems is more appropriate.

Correct Answer: A

Rationale: Solution-focused brief therapy differs from other cognitive therapies by focusing on the functional aspects of the patient rather than solely on problems. This approach emphasizes strengths and solutions, aiming to help clients identify and build on their existing resources to achieve their goals. By focusing on the positive and functional aspects, solution-focused brief therapy promotes a forward-looking and goal-oriented approach. In contrast, other therapies may focus more on challenging the existence of problems (choice B), recognizing change as constant (choice C), or delving into past experiences (choice D).