Correct Answer: D

Rationale: Diazepam (Valium) is a benzodiazepine used for anxiety. While benzodiazepines can cause sedation and might carry a risk of dependence, they are not typically associated with an increased risk of suicidal ideation compared to antidepressants. Diphenhydramine (Benadryl) is an antihistamine that might cause drowsiness and sedation. It's not primarily used for anxiety disorders, and it's less associated with increased suicidal risk compared to antidepressants. Propranolol (Inderal) is a beta-blocker used for treating conditions like hypertension and anxiety disorders. It's not typically associated with an increased risk of suicide compared to antidepressants. A client who has obsessive-compulsive disorder and takes fluoxetine (Prozac). Fluoxetine (Prozac) is an antidepressant that belongs to the class of medications called selective serotonin reuptake inhibitors (SSRIs). While it's effective for treating OCD, when initiating or adjusting the dosage of an antidepressant like fluoxetine, there can be an increased risk of suicidal ideation or behavior, especially in younger individuals. This risk is particularly prevalent in the initial weeks of treatment or when there are dosage changes.

Correct Answer: B

Rationale: Diphenhydramine is an antihistamine and is not typically used to manage opiate withdrawal. It may help with certain symptoms like insomnia or mild anxiety but is not a primary treatment for opioid withdrawal. Methadone is commonly used in the treatment of opioid withdrawal. It is a long-acting opioid agonist that helps manage withdrawal symptoms and cravings, providing a more controlled tapering process. Methadone is often used in medication-assisted treatment (MAT) for opioid use disorder. Benzodiazepines are not typically used as the first-line treatment for opioid withdrawal. They may be considered in specific situations, such as when there is severe anxiety or agitation, but they are generally not the primary choice due to the risk of dependence. Naloxone is an opioid antagonist used to reverse opioid overdose. It is not used in the routine management of opioid withdrawal but rather in emergency situations where opioid overdose is suspected.

Correct Answer: A

Rationale: Offer the client high-calorie foods that he/she can eat with their hands and fluids frequently. Clients experiencing acute mania often have increased energy levels and may engage in hyperactive behaviors, leading to a high calorie expenditure. Offering high-calorie foods that can be eaten with hands and fluids frequently can help meet the increased energy needs of the client. It's important to ensure proper nutrition and hydration during the manic episode. Playing loud music for the client in her room may exacerbate the heightened arousal and agitation associated with mania. It is important to create a calm and structured environment. Engaging the client in a small group activity may be overwhelming and contribute to increased stimulation. Individual activities or smaller, quieter groups may be more appropriate for a client in acute mania. Instructing the client to avoid napping during the day may not be practical. Clients in acute mania often have reduced need for sleep, and forcing them to avoid napping may increase agitation and restlessness. It's essential to balance rest with activity and monitor for signs of exhaustion.

Correct Answer: C,B

Rationale: The client is at risk for developing Serotonin syndrome due to the Client's intake of St. John's wort. St. John's wort is an herbal supplement that can interact with certain medications, including selective serotonin reuptake inhibitors (SSRIs) and other medications that increase serotonin levels. Serotonin syndrome is a potentially life-threatening condition characterized by an excess of serotonin in the body. In the given scenario, the nurse should identify: Condition: The client's intake of St. John's wort; Client Finding: At risk for developing serotonin syndrome. This is because the use of St. John's wort, combined with medications that affect serotonin levels, increases the risk of serotonin syndrome. The nurse should monitor for symptoms of serotonin syndrome, such as changes in vital signs, hyperthermia, altered mental status, and neuromuscular abnormalities. If serotonin syndrome is suspected, medical attention should be sought promptly.

Correct Answer: C

Rationale: Everyone has trouble sleeping at times' minimizes the client's concerns and may not address the underlying issues contributing to their anxiety. 'Why do you think you are so anxious?' might come across as judgmental or confrontational, and it may not create a supportive environment for the client to open up about their feelings. 'Have you talked to your provider about this yet?' This response encourages the client to seek professional help and addresses the issue of increasing anxiety and difficulty sleeping. It is supportive and guides the client toward discussing their concerns with a healthcare provider who can assess the situation and provide appropriate interventions. 'It sounds like you're having a difficult time' acknowledges the client's distress but does not guide them toward seeking professional help. Encouraging a conversation with a healthcare provider is a more direct and helpful approach.