You know your patient has a personality disorder. He tells you, 'You are the best nurse. I am so glad you are here today and not that mean nurse who was here yesterday.' Which personality disorder would be most associated with this statement?

Correct Answer: D

Rationale: In this scenario, the most appropriate personality disorder associated with the patient's statement is Borderline Personality Disorder (BPD). Individuals with BPD often have intense and unstable interpersonal relationships, marked by idealization and devaluation. The patient's extreme praise of the nurse followed by negative comments about another nurse is characteristic of this pattern. Option A) Paranoid Personality Disorder is characterized by pervasive distrust and suspicion of others. The patient's statement does not reflect paranoia but rather fluctuating idealization and devaluation. Option B) Antisocial Personality Disorder involves a disregard for the rights of others and a lack of empathy. While individuals with this disorder may manipulate others, the patient's statement does not demonstrate the typical callousness associated with antisocial behavior. Option C) Passive-Aggressive Personality Disorder involves indirect expressions of hostility and resistance to demands. The patient's statement is more about idealization and devaluation rather than passive-aggressive behavior. Educationally, understanding the nuances of personality disorders is crucial for healthcare professionals to provide effective care and support to individuals with these conditions. Recognizing patterns of behavior and communication can help nurses tailor their approach to meet the unique needs of each patient, promoting therapeutic relationships and positive outcomes in their care.

Correct Answer: B

Rationale: The correct answer is B) Diplopia. In the context of MAOIs and hypertensive crisis, diplopia, or double vision, is a sign of severe elevated blood pressure that can occur due to the interaction of MAOIs with other drugs like epinephrine. This visual disturbance can be a warning sign of impending hypertensive crisis which requires immediate medical attention. Option A) Orthostatic hypotension is a decrease in blood pressure that occurs upon standing up. This is the opposite of hypertensive crisis and is not a typical sign of this condition. Option C) Delay in ejaculation is a common side effect of some medications, but it is not directly related to hypertensive crisis. Option D) Hair loss is also not a characteristic sign of hypertensive crisis. Hair loss can be caused by various factors but is not a typical manifestation of acute severe hypertension. Educationally, understanding the signs and symptoms of hypertensive crisis in patients taking MAOIs is crucial for healthcare professionals, especially those prescribing or administering psychotropic medications. Recognizing these signs early can lead to prompt intervention and prevention of serious complications for the patient. It is essential to be aware of potential drug interactions and adverse effects to ensure safe medication management.

Correct Answer: D

Rationale: In the context of administering methylphenidate (Ritalin) to an 8-year-old child for ADHD treatment, monitoring height and weight is crucial. The correct answer, option D, is essential because stimulant medications like methylphenidate can potentially affect a child's growth and appetite. Regular monitoring of height and weight helps healthcare providers assess the medication's impact on the child's physical development and overall health. Option A, deep tendon reflex, is not typically monitored during psychotropic medication therapy for ADHD. This assessment is more relevant in neurological exams or when evaluating certain conditions like spinal cord injuries. Option B, intake and output, focuses on fluid balance and is important in conditions like kidney disease or heart failure where fluid management is critical. In the context of ADHD medication monitoring, it is not a primary concern. Option C, monitoring temperature and breath sounds, is more relevant in assessing respiratory or infectious conditions. While it is important in general patient care, it is not directly related to monitoring the effects of psychotropic medications like methylphenidate for ADHD. Educationally, understanding the rationale behind monitoring height and weight in children receiving ADHD medication is crucial for healthcare providers and nurses. It emphasizes the importance of comprehensive care and regular assessments to ensure the medication's effectiveness while monitoring potential side effects on growth and nutrition. This knowledge enhances patient safety and quality of care in pediatric psychopharmacology.

Correct Answer: A

Rationale: In this scenario, the appropriate nursing diagnosis for a client with schizophrenia receiving antipsychotic medication is "Ineffective protection related to blood dyscrasias" (Option A). Rationale for Option A (Correct Answer): - Antipsychotic medications can lead to blood dyscrasias, such as agranulocytosis or leukopenia, which compromise the body's ability to fight infections. This places the client at risk for potential harm due to decreased immune response. Therefore, monitoring for signs of blood dyscrasias and implementing measures to protect the client from infections is crucial. Rationale for Incorrect Options: - Option B (Urinary frequency related to adverse effects of antipsychotic medication): While antipsychotic medications can cause side effects like urinary frequency, this is not a priority nursing diagnosis compared to the risk of blood dyscrasias. - Option C (Risk for injury related to a severely decreased level of consciousness): This option is not directly associated with the side effects of antipsychotic medications; it may be relevant to other conditions but not specific to this client's situation. - Option D (Risk for injury related to electrolyte disturbances): While antipsychotic medications can sometimes lead to electrolyte imbalances, the risk of blood dyscrasias is a more immediate concern and takes precedence in this case. Educational Context: Understanding the potential side effects of psychotropic medications and their implications for nursing care is crucial in providing safe and effective care to clients with mental health disorders. By prioritizing nursing diagnoses based on the client's specific needs and the effects of their medication regimen, nurses can implement appropriate interventions to ensure client safety and well-being.

Correct Answer: B

Rationale: The correct answer is B: These side effects can be lessened with practical steps, such as sipping water, increasing dietary fiber, and moving more slowly when standing. Explanation: Dry mouth, constipation, and orthostatic hypotension (lightheadedness when standing) are common side effects of desipramine, a tricyclic antidepressant. These side effects are due to the medication's anticholinergic properties and its effects on blood pressure regulation. Practical steps like sipping water to alleviate dry mouth, increasing dietary fiber to manage constipation, and moving slowly when standing to prevent dizziness can help mitigate these side effects without discontinuing the medication. Why others are wrong: A) These symptoms are likely side effects of the medication, not the underlying disorder. Discontinuing the medication based on this assumption could lead to improper treatment. C) While these side effects can be uncomfortable, they are not indicative of a serious problem that requires immediate cessation of medication. D) Positive effects of desipramine may take weeks to manifest, and side effects may persist initially before potentially subsiding with continued use. Immediate resolution of side effects should not be expected. Educational context: Understanding the common side effects of psychotropic medications is crucial for healthcare providers and patients to manage treatment effectively. Educating patients on practical strategies to address these side effects can improve medication adherence and overall treatment outcomes. Monitoring for and addressing side effects early can enhance patient comfort and safety during psychotropic medication therapy.