A nurse is caring for an adolescent who has a history of violent behavior and has asked the nurse to keep confidential information about he desire to kill several classmates and a school teacher. Which of the following responses by the nurse is appropriate to give?

"I can see that you trust me, but you should share those feelings with your psychiatrist, not me."

I will not violate our nurse-client relationship. The information we discuss will remain confidential between us."

"Because you are a minor, I have to share any information that I feel is important with your parents."

"I cannot promise that. I must share this information with other members of the team who are responsible for planning your care,"

Answer and Explanation

The Correct Answer is D

A. "I can see that you trust me, but you should share those feelings with your psychiatrist, not me."

While encouraging the client to discuss their feelings with a mental health professional is important, this response does not address the immediate safety concern presented by the client's intent to harm others.

B. "I will not violate our nurse-client relationship. The information we discuss will remain confidential between us."

This response is inappropriate because it implies that the nurse will keep the information confidential, even though the client's statement raises concerns about the safety of others.

C. "Because you are a minor, I have to share any information that I feel is important with your parents."

While parents may have the right to be informed about their minor child's well-being, this situation goes beyond parental involvement. The nature of the threat requires immediate intervention from appropriate professionals and authorities.

"D. I cannot promise that. I must share this information with other members of the team who are responsible for planning your care."

Explanation: The client's statement about having a desire to harm others, especially classmates and a school teacher, raises significant concerns about the safety and well-being of not only the client but also the potential victims. In cases where the client poses a risk of harm to themselves or others, the nurse has a duty to breach confidentiality to ensure the safety of all involved parties. This response conveys the nurse's ethical obligation to involve other members of the treatment team and appropriate authorities to address the potential threat.

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

Explanation

A. Lithium: Lithium is a mood stabilizer commonly used in the treatment of bipolar disorder. It helps to control mood swings and prevent the recurrence of manic and depressive episodes.

B. Carbamazepine: Carbamazepine is an anticonvulsant medication that has been found effective in managing mood swings in bipolar disorder. It can help stabilize mood and prevent manic episodes.

C. Valproate (Valproic acid or Divalproex sodium): Valproate is another anticonvulsant medication that is used as a mood stabilizer in bipolar disorder. It can help control manic and mixed episodes.

The following options are not used to treat bipolar disorder:

D. Paroxetine: SSRIs, including paroxetine, carry a risk of inducing mania or hypomania in individuals with bipolar disorder. This risk is why these medications are usually avoided or used cautiously, always in conjunction with a mood stabilizer like lithium, valproate, or atypical antipsychotics. Before initiating paroxetine, it’s crucial that the client is stabilized with a mood stabilizer to minimize the risk of mood switching (i.e., moving from depression to mania or hypomania).

E. Donepezil: Donepezil is a medication used to treat Alzheimer's disease and other forms of dementia. It is not used to treat bipolar disorder.

A. "This medication may increase your blood pressure." B. "Flu-like symptoms are an expected adverse effect of this medication." C. "Avoid becoming overheated while taking this medication." D. "Muscle twitches can occur the first few weeks while taking this medication."

Correct Answer is C

Explanation

A. "This medication may increase your blood pressure."

This statement is incorrect. Risperidone is not typically associated with significant increases in blood pressure. One of the potential side effects of risperidone is orthostatic hypotension, which is a drop in blood pressure when changing positions (e.g., standing up quickly). Therefore, this choice is not the best instruction to include in the teaching.

B. "Flu-like symptoms are an expected adverse effect of this medication."

This statement is incorrect. While risperidone can have side effects, flu-like symptoms are not commonly associated with it. Common side effects of risperidone may include dizziness, drowsiness, weight gain, and movement disorders. Flu-like symptoms are not a typical adverse effect of this medication.

C. "Avoid becoming overheated while taking this medication."

This statement is correct. Risperidone, like many other antipsychotic medications, can interfere with the body's ability to regulate temperature. This can lead to an increased risk of overheating, especially in hot weather or during vigorous physical activity. Therefore, it's important for patients taking risperidone to be cautious and avoid becoming overheated, as this could potentially lead to heat-related complications.

D. "Muscle twitches can occur the first few weeks while taking this medication."

This statement is incorrect. Muscle twitches are not a common side effect of risperidone. While it's true that some movement disorders can occur with antipsychotic medications, the statement is too specific to muscle twitches and does not accurately reflect the typical side effect profile of risperidone.

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A nurse is caring for an adolescent who has a history of violent behavior and has asked the nurse to keep confidential information about he desire to kill several classmates and a school teacher. Which of the following responses by the nurse is appropriate to give?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing medication records for several clients who have bipolar disorder. The nurse should recognize that which of the following medications are used to treat clients who have bipolar disorder? (Select all that apply.)

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

Explanation

A nurse is providing discharge teaching to a client who is taking risperidone. Which of the following instructions should the nurse include in the teaching?

Correct Answer is C

Explanation

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