The patient tells the nurse, 'I thought I was just depressed, but my doctor says I have bipolar disorder. What is that?' What is the best response by the nurse?

Correct Answer: D

Rationale: The best response by the nurse to the patient's question, "I thought I was just depressed, but my doctor says I have bipolar disorder. What is that?" is option D) Bipolar disorder means you have cycles of depression as well as hyperactivity, or mania. This response is correct because it succinctly and accurately explains that bipolar disorder involves both depressive episodes and periods of heightened mood or mania. It clarifies the key feature of bipolar disorder, which is the cycling between these two states. Option A is incorrect because it oversimplifies bipolar disorder as just another type of depression, failing to address the crucial aspect of mania present in bipolar disorder. Option B is incorrect as it inaccurately associates bipolar disorder with attention deficit disorder symptoms, which are not a defining feature of bipolar disorder. Option C is incorrect because it inaccurately suggests that bipolar disorder is solely linked to seasonal mood changes, which is not the defining characteristic of the disorder. From an educational perspective, it's important for nurses to provide accurate and clear information to patients about their conditions to promote understanding and engagement in their treatment. Understanding the differences between depression and bipolar disorder is crucial for appropriate treatment planning and management.

Correct Answer: D

Rationale: The correct answer is D) requests prescriptions for pain medication and a sleeping aid. In the context of assessing suicide risk in a patient with depression, the patient requesting prescriptions for pain medication and a sleeping aid is concerning because it may indicate a desire to self-harm or overdose. Pain medication and sleeping aids are commonly used in suicide attempts due to their potential lethality. This behavior suggests that the patient may be actively planning to harm themselves. Option A, stating that 'suicide is always an option,' is a concerning statement but does not indicate an immediate risk of suicide. It may reflect the patient's thought process in dealing with depression. Option B, describing a previous unsuccessful suicide attempt by aspirin overdose, is a significant risk factor for suicide. However, in this scenario, the patient is not actively describing a plan or seeking means to harm themselves currently. Option C, stating that the prescribed medication is not working and feelings of depression are worse, is a common experience in the treatment of depression and does not necessarily indicate an imminent risk of suicide. In an educational context, it is crucial for healthcare providers, especially nurses, to be able to recognize warning signs and risk factors for suicide in patients with depression. Assessing suicidal ideation and behaviors accurately is essential for implementing appropriate interventions and ensuring patient safety. Understanding the nuances of patient statements and behaviors can help healthcare professionals provide necessary support and prevent potential harm.

Correct Answer: C

Rationale: The correct answer is C) You could try splinting for discomfort. This option is the best instruction by the nurse for a pregnant client with arthritis because splinting is a non-pharmacological intervention that can help alleviate joint pain and discomfort without posing any risk to the developing fetus. Option A) Avoid using heat on the joint is incorrect because heat therapy can actually provide relief for arthritis symptoms and is generally considered safe during pregnancy. However, splinting is a more appropriate non-pharmacological intervention in this scenario. Option B) Hydroxychloroquine (Plaquenil) is not recommended during pregnancy as it may have potential risks to the fetus and should be avoided unless the benefits outweigh the risks. Option D) Glucocorticoids, while effective for managing arthritis symptoms, are not generally considered safe during pregnancy due to their potential adverse effects on fetal development. In an educational context, it is crucial for healthcare professionals to be knowledgeable about safe and appropriate treatment options for pregnant clients with arthritis. Non-pharmacological interventions, such as splinting, should be considered first-line options to manage symptoms while minimizing risks to both the mother and the developing baby. It is important to weigh the benefits and risks of pharmacological treatments during pregnancy and always consult with a healthcare provider for individualized care.

Correct Answer: D

Rationale: In the context of a client receiving therapy for gout, the nurse should provide information regarding the importance of increasing fluid intake to 2 to 4 liters each day. This is the correct answer (Option D) because adequate hydration helps to prevent the formation of uric acid crystals in the joints, which can exacerbate gout symptoms. By increasing fluid intake, the client can help flush out excess uric acid from the body, reducing the likelihood of gout attacks. Option A, advising the client to not drink alcohol, is a common recommendation for gout management as alcohol can increase the production of uric acid. However, it is not as crucial as ensuring proper hydration in this context. Option B, suggesting an increase in fatty fish intake, is not directly related to gout management. While foods high in omega-3 fatty acids like salmon can have anti-inflammatory effects, there is no direct evidence to support their significant impact on gout treatment. Option C, recommending a vitamin C supplement, could potentially be beneficial for some individuals with gout as vitamin C may help lower uric acid levels. However, it is not as universally important as staying well-hydrated, which is crucial for all individuals with gout. In an educational context, it is essential for nurses to understand the rationale behind specific recommendations for clients with gout. By emphasizing the importance of hydration in gout management, nurses can empower clients to take an active role in their treatment and potentially reduce the frequency and severity of gout attacks.

Correct Answer: D

Rationale: The correct answer is D) 5 L. The apparent volume of distribution (Vd) is a pharmacokinetic parameter that helps us understand the extent of drug distribution throughout the body. A higher Vd indicates that the drug is distributed extensively beyond the plasma. In this case, with a peak plasma concentration of 20 mg/L after a 100 mg dose of fluconazole, the Vd is calculated as dose divided by concentration, which equals 100 mg / 20 mg/L = 5 L. Option A) 0.5 L is incorrect because it is too low for the Vd of fluconazole, indicating limited distribution in the body which is not the case for this drug. Option B) 1 L is also incorrect as it is too low to represent the extensive distribution seen with fluconazole. Option C) 3 L is incorrect as well because it falls short of the calculated Vd of 5 L for fluconazole in this scenario. Understanding pharmacokinetic parameters like volume of distribution is crucial for healthcare providers to optimize drug dosing regimens and ensure therapeutic effectiveness while minimizing adverse effects. In clinical practice, knowledge of these concepts helps in tailoring treatments to individual patients based on drug distribution characteristics to achieve desired outcomes.