A patient with a history of bipolar I disorder is prescribed fluoxetine (Prozac) for a depressive episode. What is the nurse's priority action?

Assess the patient for gastrointestinal side effects.

Monitor the patient closely for signs of mania.

Administer the medication as ordered

Educate the patient about potential weight gain

Answer and Explanation

The Correct Answer is B

A. While gastrointestinal side effects are common with fluoxetine, they are not the priority concern in the context of bipolar disorder.

B. Fluoxetine (Prozac) is an SSRI used to treat depression, but in patients with bipolar disorder, it can trigger a manic episode. Therefore, the nurse's priority is to monitor for signs of mania, such as increased energy, euphoria, or impulsivity.

C. Administering the medication as ordered is essential, but the nurse must be vigilant for signs of mania, especially with SSRIs in bipolar patients.

D. Educating about weight gain is important but does not address the immediate risk of precipitating mania with fluoxetine in a bipolar patient.

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Correct Answer is A

Explanation

A. Offering the client a milkshake while directing them to a different activity provides a way to meet the client's nutritional needs and addresses their manic energy by giving them a focus other than exercise. This approach maintains structure without creating confrontation.

B. Giving the client the autonomy to decide on their activities might not be appropriate in acute mania, where impulsivity and poor judgment can lead to further disorganization.

C. Telling the client to leave the dining room immediately could escalate the situation, as it may be seen as an authoritative and disruptive intervention. A more supportive approach is better.

D. Telling the client that exercise is not good for them can escalate the situation or worsen their distress. It may also reinforce negative self-image and discourage further participation in necessary eating and nutrition.

A. Reality testing B. Derealization C. Grandiosity D. Flight of ideas

Correct Answer is C

Explanation

A. Reality testing refers to the ability to distinguish between what is real and what is not. The client’s belief is a symptom of grandiosity, not a lack of reality testing.

B. Derealization refers to the sense that the external world is unreal or distorted, which is not the case here.

C. Grandiosity is an inflated sense of self-importance and unrealistic beliefs in one’s abilities, as demonstrated by the client’s statement about being able to fly and become a U.S. Senator.

D. Flight of ideas involves rapid, continuous speech with fragmented thoughts that jump from one topic to another. The client’s speech does not exhibit this pattern.

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A patient with a history of bipolar I disorder is prescribed fluoxetine (Prozac) for a depressive episode. What is the nurse's priority action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has bipolar disorder and is experiencing acute mania. The client is doing calisthenics in the client dining room during lunchtime instead of eating. Which of the following statements should the nurse make?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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