A nurse is caring for patients receiving clozapine, lithium, fluoxetine, and venlafaxine. Which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance?

Choice A reason: Basic-level nurses, such as LPNs or RNs, can teach coping skills, a standard intervention within their scope. This involves education on stress management, aligning with psychiatric nursing roles to support patient and family well-being, making this the correct choice.

Choice B reason: Treating major depressive disorder requires advanced skills, like prescribing or managing complex therapies, which is beyond a basic-level nurse’s scope. This is typically reserved for advanced practice nurses or physicians, making this choice incorrect.

Choice C reason: Prescribing antidepressants is restricted to advanced practice nurses or physicians, not basic-level nurses. This task involves medical decision-making outside the scope of RNs or LPNs, making it unsafe and inappropriate, thus incorrect.

Choice D reason: Assessing suicide risk requires advanced clinical judgment, often reserved for advanced practice nurses or psychiatrists. While basic-level nurses can observe and report, formal assessment exceeds their scope, making this choice incorrect for their role.

Choice A reason: Trust versus mistrust occurs in infancy (0–1 year), focusing on trust in caregivers. Failure leads to suspicion, not regret over life accomplishments. This stage is irrelevant to a 52-year-old’s reflections on life achievements, making this choice incorrect for the described crisis.

Choice B reason: Generativity versus stagnation (middle adulthood, 40–65 years) involves contributing to society versus feeling unproductive. While related, the woman’s regret over past accomplishments aligns more with reflecting on life’s meaning, typical of a later stage, making this choice less precise.

Choice C reason: Integrity versus despair (late adulthood, 65+ years, but relevant in late middle age) involves reflecting on life’s achievements. Failure leads to despair and regret, matching the woman’s statement about unaccomplished goals, making this the correct choice for her psychosocial crisis.

Choice D reason: Industry versus inferiority (6–12 years) focuses on competence in tasks. Failure leads to feelings of inadequacy in skills, not regret over life’s broader accomplishments. This stage is irrelevant to the woman’s current reflections, making this choice incorrect.