A nurse who works in a psychiatric unit is caring for a client diagnosed with bipolar disorder. The client comes to the nurse's station at 0300, demanding that the nurse call the provider immediately. Which of the following responses should be an appropriate response by the nurse?
"I can't call a doctor in the middle of the night unless it's an emergency."
"You must be very upset about something."
"Go back to your room, and I'll try to get in touch with your doctor."
"You are being unreasonable, and I will not call your doctor at this hour."
The Correct Answer is B
Choice A: "I can't call a doctor in the middle of the night unless it's an emergency."
This response may seem reasonable, but it could escalate the situation if the client feels their concerns are not being taken seriously. It's important to validate the client's feelings and find a solution that respects both their needs and the realities of the situation.
Choice B: "You must be very upset about something."
This response validates the client's feelings and opens up a dialogue. It shows empathy and understanding, which can help de-escalate the situation.
Choice C: "Go back to your room, and I'll try to get in touch with your doctor."
This response acknowledges the client's request and provides a clear action plan. However, it's important to follow through on this promise to maintain trust.
Choice D: "You are being unreasonable, and I will not call your doctor at this hour."
This response is confrontational and likely to escalate the situation. It's important to remain calm and professional, even when dealing with difficult behavior.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A: Isolate the client for a period of time.
Isolation can lead to increased anxiety and may not be beneficial for a client with OCD. It does not address the underlying issue of the compulsive behaviors and may even exacerbate them.
Choice B: Plan the client's schedule to allow time for rituals.
This is generally the most effective approach. By allowing time for rituals, the nurse acknowledges the client's need for these behaviors and reduces anxiety. Over time, the goal would be to gradually reduce the time spent on these rituals as the client develops more effective coping strategies.
Choice C: Set strict limits on the behaviors so that the client can conform to the unit rules and schedules.
While it's important to have a structured environment, setting strict limits on compulsive behaviors can increase anxiety and resistance. It's more beneficial to work with the client to gradually decrease these behaviors rather than attempting to stop them abruptly.
Choice D: Confront the client about the senseless nature of the repetitive behaviors.
Confrontation is not typically helpful for clients with OCD. These clients are usually well aware that their behaviors are irrational, but they feel compelled to perform them anyway. Confrontation can lead to increased anxiety and defensiveness.
Correct Answer is A
Explanation
Choice A reason:
This statement is accurate and reflects effective teaching. Bupropion, like many antidepressants, can take several weeks to reach its full therapeutic effect. Informing patients about this delay is important to set realistic expectations and to encourage adherence to the medication regimen.
Choice B reason:
This statement is not entirely accurate. While moderate alcohol consumption may be permissible for some patients taking bupropion, it is generally advised to avoid or limit alcohol intake due to the risk of seizures and other side effects. Alcohol can also worsen depression symptoms and interact with the medication.
Choice C reason:
This statement is incorrect. Bupropion does not typically cause bradycardia (slow heartbeat). Instead, it can cause tachycardia (fast heartbeat) as a side effect. Patients should be informed about the potential cardiovascular effects of bupropion, including an increased heart rate.
Choice D reason:
This statement is incorrect. Increased salivation and drooling are not common side effects of bupropion. The medication is more commonly associated with dry mouth. Effective teaching would include informing the patient about the more likely side effects, such as dry mouth, insomnia, and headaches.
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