Which of the following meal choices indicates the patient understands the diet restrictions when taking an MAOI?

Correct Answer: C

Rationale: The correct answer is option C, which includes fried fish, rice, and cola. When taking MAOIs (Monoamine Oxidase Inhibitors), it is essential to follow specific dietary restrictions to avoid a dangerous interaction known as hypertensive crisis. Foods high in tyramine, such as aged, fermented, or pickled foods, can trigger this reaction. Fried fish and rice are low in tyramine, making them safe choices for individuals on MAOIs. Cola is also a safe beverage option. Option A, pepperoni pizza, and beer contain high levels of tyramine due to the aged pepperoni and alcohol content in beer, which can potentially lead to a hypertensive crisis. Option B, roast chicken, baked potato, and beer, also contains beer which is not recommended due to its alcohol content that can interact with MAOIs and cause adverse effects. Option D, pickled herring, eggs, and coffee, includes pickled herring which is high in tyramine and should be avoided by individuals on MAOIs. Eggs and coffee are generally safe to consume with MAOIs unless the individual has specific sensitivities. Understanding the dietary restrictions associated with psychotropic medications like MAOIs is crucial for patient safety and medication efficacy. This question highlights the importance of patient education and adherence to dietary guidelines to prevent harmful drug interactions.

Correct Answer: A

Rationale: The most important goal for a 28-year-old hospitalized manic client, in collaboration with the RN, is option A) Protection from self-inflicted harm. This is the priority because individuals experiencing mania may engage in impulsive and risky behaviors that can lead to self-harm or harm to others. Ensuring the client's safety is paramount in managing their condition and preventing any potential harm that may result from their current state. Option B) Meals in excess of metabolic requirement is not the most important goal in this scenario. While nutrition is important, the immediate focus should be on the client's safety and stabilization of their mental health condition. Option C) Strict participation in unit activities may be beneficial for the client's routine and structure, but it is not as critical as ensuring their safety from self-inflicted harm. Option D) Enforced medication compliance is essential for managing manic episodes, but without ensuring the client's safety first, the effectiveness of the medication may be compromised if the client is at risk of harming themselves or others. In an educational context, understanding the hierarchy of needs in mental health care is crucial. Safety and risk management take precedence over other goals when working with clients experiencing acute episodes of mental illness. By prioritizing the client's safety, healthcare professionals can create a foundation for effective treatment and support the client in their recovery journey.

Correct Answer: A

Rationale: In the treatment of bipolar disorder, the drug of choice is lithium carbonate (Option A). Lithium has been a mainstay in the management of bipolar disorder for decades due to its mood-stabilizing effects. It helps to reduce the frequency and severity of manic episodes, as well as the risk of suicide. Valium (Option B) is a benzodiazepine primarily used for anxiety disorders and is not a first-line treatment for bipolar disorder. Paxil (Option C) is an antidepressant commonly used to treat depression and anxiety disorders, but it is not typically indicated for bipolar disorder as it can potentially induce manic episodes. Haldol (Option D) is an antipsychotic medication used for conditions like schizophrenia and severe agitation, but it is not a first-line treatment for bipolar disorder. Educationally, understanding the rationale behind selecting the appropriate medication for bipolar disorder is crucial for healthcare providers, especially those working in mental health settings. Knowing the specific pharmacological actions and indications of each medication option allows for individualized treatment plans that can optimize patient outcomes and minimize adverse effects. It is essential for healthcare professionals to have a solid foundation of psychotropic medications to provide safe and effective care for patients with mental health conditions.

Correct Answer: A

Rationale: In the context of a patient experiencing side effects from psychotropic medication, the most important question to ask next is option A) Does he have a suicide plan now? This is crucial because certain side effects of psychotropic medications, such as increased agitation, impulsivity, or worsening of depressive symptoms, can elevate the risk of suicidal ideation or behavior. Assessing the presence of a suicide plan allows healthcare providers to determine the immediate safety of the patient and take necessary precautions to prevent harm. Option B) What is his psychiatric diagnosis? while important for overall treatment planning and understanding the patient's mental health history, is not as urgent as assessing the risk of suicide in this scenario. Option C) Who does he live with? though relevant for assessing the patient's support system and living environment, does not take precedence over immediate safety concerns like suicidal ideation. Option D) What type of psychiatric therapy has he had recently? although important for understanding the patient's treatment history, is not as critical as addressing the potential risk of suicide, especially when side effects of medication could be exacerbating the situation. In an educational context, this question highlights the significance of prioritizing patient safety and immediate risk assessment in the context of psychotropic medication management. It underscores the importance of recognizing and addressing potential side effects that can impact a patient's mental health and well-being. Healthcare providers must be vigilant in assessing and managing these risks to ensure the best possible outcomes for their patients.

Correct Answer: A

Rationale: In this scenario, the most important response for a nurse when evaluating suicide risk in a newly admitted depressed patient is option A) The patient's plans for the immediate future after discharge. This is the correct answer because assessing the patient's immediate future plans can provide critical insights into their current mindset, level of hopelessness, and potential for self-harm. It allows the nurse to gauge whether the patient has any suicidal ideation or intention, as well as the presence of a safety plan or protective factors. Option B) How long the person has felt depressed, while important in understanding the patient's history and chronicity of depression, does not directly address the acute risk of suicide at the present moment. Option C) How many personal problems the patient lists as stressors is relevant to understanding the patient's stressors but may not be the most immediate factor contributing to suicidal ideation. Option D) How the patient plans to handle the upcoming anniversary of his or her spouse's death is specific to a potential trigger and may not capture the broader risk factors and protective factors that influence suicide risk evaluation comprehensively. Educationally, this question highlights the importance of conducting thorough suicide risk assessments in patients with depression. It emphasizes the significance of assessing immediate risk factors and future plans in evaluating suicide risk, enabling healthcare professionals to intervene effectively and provide appropriate support and care.