Correct Answer: A

Rationale: Anxiety is characterized by feelings of worry, fear, and apprehension about future events or uncertain outcomes. In this situation, the client's concerns about her husband's chronic illness diagnosis, his treatment, and financial implications (due to his inability to work) indicate that she is experiencing anxiety. These worries are typical responses to stressful life events and uncertainties. Shock is a sudden and intense emotional reaction typically experienced immediately after a traumatic or unexpected event. While the client may initially experience shock upon hearing her husband's diagnosis, ongoing worry about treatment and financial concerns suggests a more prolonged state of anxiety rather than acute shock. Withdrawal refers to a disengagement or retreat from social interactions or activities. There is no indication in the scenario that the client is withdrawing from social interactions. Rather, she is actively expressing concerns and seeking support, which is inconsistent with withdrawal. Anger involves feelings of hostility, frustration, or resentment towards others or situations. While anger could potentially arise in response to the stressors described, the primary emotion expressed by the client in this scenario is worry and concern, which aligns more closely with anxiety than anger.

Correct Answer: B

Rationale: Lorazepam is a benzodiazepine used primarily for its anxiolytic (anti-anxiety) effects. It is not an SSRI and is not typically prescribed as a first-line treatment for depression. Sertraline is a commonly prescribed SSRI used to treat depression, anxiety disorders, obsessive-compulsive disorder (OC
D), and other conditions. It works by increasing the levels of serotonin in the brain, which helps improve mood and reduce symptoms of depression. Amitriptyline is a tricyclic antidepressant (TC
A), not an SSRI. TCAs are older antidepressants that work on multiple neurotransmitter systems, including serotonin, but they are less commonly prescribed as first-line treatment due to their side effect profile. Clonazepam is also a benzodiazepine used for treating anxiety disorders and certain types of seizures. Like lorazepam, it is not an SSRI and is not typically used as a first-line treatment for depression.

Correct Answer: D

Rationale: Dissociative fugue involves sudden, unexpected travel away from home or one's customary place of activities, accompanied by an inability to recall one's past. It is usually associated with amnesia for personal information and is not characterized by depersonalization symptoms. DID involves the presence of two or more distinct personality states or identities within an individual, which alternate and take control of behavior. Each identity may have its own unique way of perceiving and interacting with the environment, which differs from the symptoms described in the scenario. Dissociative amnesia involves the inability to recall important personal information, usually related to stressful or traumatic events. While depersonalization symptoms can occur in dissociative amnesia, the hallmark feature is memory loss rather than the feeling of detachment from one's body. Depersonalization disorder is a dissociative disorder where individuals feel detached from themselves, as if they are observing their own thoughts, feelings, sensations, or actions from outside their body. This can lead to a sense of unreality or detachment from the environment or one's own experiences. It is often triggered by stressful events or trauma, and it can occur in individuals experiencing grief or loss, such as the surviving husband in this scenario.

Correct Answer: D

Rationale: When someone assumes the sick role, their engagement in social responsibilities typically decreases or is temporarily suspended. This is because the focus shifts towards managing the illness, seeking treatment, and recovering. Social interactions may be reduced due to physical limitations or the need to avoid spreading illness to others. Denial of illness is not characteristic of assuming the sick role. Assuming the sick role involves acknowledging and recognizing the presence of illness, which prompts seeking medical attention and adopting behaviors conducive to recovery. On the contrary, assuming the sick role often involves a change in duties and responsibilities. The individual may need to delegate tasks or take a break from their usual obligations to focus on recuperation and treatment. When someone assumes the sick role, society typically grants them permission to prioritize their health and well-being. This often includes being excused from work, school, or other responsibilities to focus on recovery. Rest is an important aspect of recuperation during illness.

Correct Answer: A

Rationale: Lithium is excreted primarily by the kidneys, and its clearance can be affected by changes in fluid balance. It's important for clients taking lithium to maintain a stable and adequate fluid intake to help regulate lithium levels in the body. Stable fluid intake helps maintain electrolyte balance, which is crucial for the proper function of lithium and prevention of adverse effects. Lithium can affect sodium reabsorption in the kidneys. High levels of sodium intake can alter lithium levels in the body, potentially leading to toxicity.
Therefore, clients on lithium therapy are often advised to maintain a consistent and moderate level of sodium intake. Excessive dietary salt can interfere with lithium's therapeutic effects. Restricting fluid intake is not recommended unless there are specific medical reasons to do so. Lithium therapy generally requires adequate hydration to maintain kidney function and prevent dehydration, which can affect lithium levels. Exercising in hot weather can lead to increased sweating and fluid loss, which can potentially affect lithium levels by altering hydration status. However, the primary concern during exercise in hot weather is maintaining adequate hydration rather than restricting it.