A patient demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action should the staff take initially to prevent this issue?

Confer with the health care provider to consider use of seclusion for this patient.

Hold a staff meeting to discuss consistency and limit-setting approaches.

Explain to the patient that the behavior is unacceptable.

Conduct a meeting with all staff and patients to discuss the behavior.

Answer and Explanation

The Correct Answer is B

A. Seclusion is a last-resort intervention, not an initial step.
B. Staff meetings to ensure consistent approaches, structure, and limit-setting prevent staff fatigue, reduce defensiveness, and provide therapeutic consistency for the client.
C. Confronting the patient directly about unacceptable behavior may escalate agitation and is not the most effective prevention strategy.
D. Group discussions with patients about one individual’s behavior would be inappropriate and non-therapeutic.

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Correct Answer is B

Explanation

A. Suicide precautions should never be discontinued at this time; in fact, suicide risk is highest when energy improves before mood fully stabilizes.
B. Increased energy after starting antidepressants raises suicide risk, as the patient may now have the ability to act on suicidal thoughts. Continuous supervision is the priority for safety.
C. Discharge planning is premature at this stage; safety comes first.
D. Art and music therapy may be beneficial long-term but do not address the immediate suicide risk.

A. drink twice the usual dally amount of fluid. B. double the lithium dose if diarrhea or vomiting occurs. C. maintain normal salt and fluids in the diet. D. avoid eating aged cheese, processed meats, and red wine.

Correct Answer is C

Explanation

A. Patients do not need to double fluid intake, just maintain adequate hydration (2–3 L/day). Drinking twice the usual amount could lead to fluid overload or dilute sodium balance.

B. Lithium should never be doubled. In fact, vomiting and diarrhea increase risk of lithium toxicity, so the provider must be notified instead.

C. Lithium excretion is closely tied to sodium and fluid balance. A stable diet with normal salt and adequate fluid intake helps prevent fluctuations in lithium levels and reduces risk of toxicity.

D. Avoiding aged cheese, processed meats, and red wine is teaching for MAOI therapy (to prevent hypertensive crisis due to tyramine), not for lithium.

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A patient demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action should the staff take initially to prevent this issue?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

It has been 5 days since a suicidal patient was hospitalized and prescribed an antidepressant medication. The patient is now more talkative and shows increased energy. Select the highest priority nursing intervention.

Correct Answer is B

Explanation

A health teaching plan for a patient taking lithium should include instructions to

Correct Answer is C

Explanation

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Which assessment finding most clearly indicates that a patient may be experiencing a mental illness? The patient

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Which action by a psychiatric nurse best applies the ethical principle of autonomy?

A patient undergoing diagnostic tests says. "Nothing is wrong with me except a stubborn chest cold." The spouse reports the patient smokes, coughs daily. lost 15 pounds and is easily fatigued. Which defense mechanism is the patient using?

A patient demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action should the staff take initially to prevent this issue?

A nurse assesses a patient who reports a 3-week history of depression and periods of uncontrolled crying. The patient says. "My business is bankrupt and was served with divorce papers." Which subsequent statement by the patient alerts the nurse to a covert suicidal message?