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A client has been compliant with antidepressant therapy but states, "The meds don't seem to be working anymore." They have no immediate family in the vicinity and are estranged from siblings, saying, "They got over me a long time ago." The client acknowledges having a few friends but expresses, "I don't want to burden them with my stuff. I'm not worth that." Which factors should the nurse consider when evaluating the client's support systems? (Select all that apply.)

Physical health

Mental health support

Alcohol consumption

Feelings of self-worth

Family history

Access to lethal means

Answer and Explanation

Correct Answer : B,D,E,F

Choice A reason: Physical health is a critical component of overall well-being and can affect mental health recovery.

Choice B reason: Mental health support, including therapy and support groups, is essential for managing depression and preventing relapse.

Choice C reason: Alcohol consumption can interfere with antidepressant efficacy and may worsen depression symptoms.

Choice D reason: Feelings of self-worth are often impacted in depression and can influence the client's motivation and engagement in treatment.

Choice E reason: Family history may provide insights into genetic predispositions and patterns that could affect the client's mental health.

Choice F reason: Access to lethal means is a significant risk factor for suicide and must be addressed in the safety planning for clients with depression.

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Correct Answer is ["B","D","E"]

Explanation

Choice A reason: Sharing personal feelings openly with the client can blur the professional boundaries necessary for a therapeutic relationship and is not typically encouraged.

Choice B reason: Establishing boundaries is crucial in maintaining a professional and therapeutic relationship, ensuring that both the nurse and client understand the limits and expectations of their interactions.

Choice C reason: While offering advice can be part of the therapeutic process, it is more important for the nurse to guide clients in finding their own solutions rather than providing direct advice.

Choice D reason: A therapeutic relationship should be professional and not based on personal feelings. The nurse's concern should be on the client's well-being rather than being liked.

Choice E reason: Maintaining a client focus at all times ensures that the care provided is centered on the client's needs, which is essential in a therapeutic relationship.

A. Children are naturally active, energetic, and spontaneous. B. The diagnosis of Bipolar Disorder cannot be assigned prior to the age of 18. C. Symptoms of bipolar disorder are similar to those of attention deficit-hyperactivity disorder (ADHD). D. Neurotransmitter levels vary considerably in accordance with age. E. Genetic predisposition is not a reliable diagnostic determinant.

Correct Answer is ["A","C","D","E"]

Explanation

Choice A reason: Children's natural activity levels and spontaneity can mimic the hyperactivity of bipolar mania, making it challenging to differentiate between typical behavior and symptoms of a mood disorder.

Choice B reason: This statement is incorrect; bipolar disorder can be diagnosed before the age of 18. Early-onset bipolar disorder is recognized and can be diagnosed in children and adolescents.

Choice C reason: ADHD and bipolar disorder share common symptoms such as impulsivity and inattention, which can complicate the differential diagnosis, especially in younger populations.

Choice D reason: Neurotransmitter levels do indeed vary with age, which can affect mood and behavior, thereby complicating the diagnosis of bipolar disorder in young individuals.

Choice E reason: While genetic predisposition plays a role in bipolar disorder, it alone is not a definitive diagnostic determinant due to the complex interplay of genetic and environmental factors.

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Naxlex Comprehensive Predictor Exams

The nurse maintains a therapeutic relationship with several clients on the behavioral health unit. Which characteristics will be most important for the nurse to foster to maintain these relationships? Select all that apply.

Correct Answer is ["B","D","E"]

Explanation

Which of the following explanations should the nurse include when teaching parents why it is difficult to diagnose a child or adolescent exhibiting symptoms of bipolar disorder? Select all that apply.

Correct Answer is ["A","C","D","E"]

Explanation

The nurse is talking with a client diagnosed with histrionic personality disorder. Which statement made by the client does the nurse identify as correlating with this diagnosis?

A nurse is caring for a client who is extremely suspicious of the nursing staff and other clients. Which of the following nursing approaches is appropriate when establishing a therapeutic relationship with this client?

The nurse is educating a client and family about strategies to minimize the side effects of antipsychotic drugs. Which will be included in the plan? Select all that apply.

A nurse is planning discharge for a client who has borderline personality disorder. Which of the following interventions should be included for this client?

A home-health nurse is assessing a client who has obsessive-compulsive disorder (OCD) and observes that the client demonstrates constant repetitive cleaning. The nurse knows that this behavior is an attempt to accomplish which of the following?

Which statement(s) made by the spouse indicates that they are exhibiting enabling behaviors? Select all that apply.

A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect?