Planning for patients diagnosed with mental illness is facilitated by understanding that inpatient hospitalization is generally reserved for a patient presenting with what characteristic?

Has no reliable support systems in the local community

Presents a clear danger to self or others

Develops new symptoms during the course of an illness

Consistently noncompliant with medications at home

Answer and Explanation

The Correct Answer is B

Choice A reason: Lack of support systems may warrant outpatient intervention, not hospitalization. Inpatient care targets acute risks, like suicidal ideation from serotonin deficits. Community support addresses social needs, not immediate safety, making this insufficient for justifying hospitalization in mental health care.

Choice B reason: Hospitalization is reserved for clear danger to self or others, like suicidal or aggressive behaviors from dopamine-driven psychosis. Inpatient settings stabilize acute neurobiological crises, ensuring safety and medication adherence, making this the correct criterion for psychiatric hospitalization.

Choice C reason: New symptoms may require evaluation, but hospitalization is prioritized for safety risks. Symptom changes, like increased anxiety, can often be managed outpatient unless dangerous. This criterion is secondary to immediate risk, making it incorrect for hospitalization justification.

Choice D reason: Medication non-compliance may exacerbate symptoms but does not automatically warrant hospitalization. Outpatient interventions can address adherence unless safety risks, like dopamine-driven aggression, arise. This is not the primary criterion for inpatient care, making it incorrect.

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Correct Answer is B

Explanation

Choice A reason: Suppressing anger ignores countertransference, which can impair therapeutic neutrality. Anger may stem from patient behaviors linked to dopamine-driven paranoia, but suppression risks unconscious bias affecting care. Addressing feelings through supervision maintains professionalism, making this response less effective for managing emotions.

Choice B reason: Discussing anger with a manager addresses countertransference, a reaction to patient behaviors like suspicion from dopamine dysregulation. This allows reflection, reducing bias and maintaining therapeutic neutrality. It supports professional care by processing emotions, aligning with evidence-based psychiatric nursing practices for managing countertransference.

Choice C reason: Expressing anger directly risks damaging the therapeutic alliance. Suspicion, tied to mesolimbic dopamine excess, may escalate with confrontation, increasing patient anxiety. This approach disregards professional boundaries and neurobiological sensitivities, making it inappropriate for maintaining effective psychiatric care.

Choice D reason: Reassigning the patient avoids addressing countertransference, neglecting professional growth. Suspicion, linked to neurobiological paranoia, requires consistent care. Reassignment disrupts continuity, potentially worsening patient trust and outcomes, making this an ineffective response compared to processing feelings through supervision.

A. The client should not stop this medication abruptly to avoid discontinuation syndrome B. The client may experience frequent constipation and should increase their intake of dietary fiber C. This medication takes 4-6 months to be effective, the client should be told to be patient D. This medication can cause addiction, so the client should not take more than prescribed

Correct Answer is A

Explanation

Choice A reason: Abruptly stopping fluoxetine, an SSRI, disrupts serotonin levels, causing discontinuation syndrome with symptoms like dizziness and irritability due to rapid neurotransmitter imbalance in the brain. Gradual tapering stabilizes serotonin, preventing withdrawal, making this critical teaching for safe medication management in anxiety treatment.

Choice B reason: Constipation is not a common side effect of fluoxetine, which primarily causes nausea or diarrhea via serotonin modulation. Anticholinergic drugs, not SSRIs, typically cause constipation. This teaching is inaccurate, as fluoxetine’s side effect profile does not emphasize gastrointestinal slowing, making it incorrect.

Choice C reason: Fluoxetine takes 4-8 weeks, not months, to reach efficacy by increasing serotonin in the prefrontal cortex and amygdala. Overstating the timeline discourages adherence, as patients expect faster relief from anxiety symptoms, making this teaching point scientifically inaccurate and misleading.

Choice D reason: Fluoxetine is not addictive, as it lacks the reinforcing GABA effects of benzodiazepines. It modulates serotonin for anxiety without dependence risk. This teaching is incorrect, as it misrepresents fluoxetine’s pharmacological profile, potentially causing unnecessary fear about its safe use in treatment.

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Planning for patients diagnosed with mental illness is facilitated by understanding that inpatient hospitalization is generally reserved for a patient presenting with what characteristic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient. What is the nurse’s best response to these feelings?

Correct Answer is B

Explanation

After a client has been prescribed fluoxetine (Prozac) for a diagnosis of anxiety disorder, which of the following information should the nurse be sure to include in the client teaching?

Correct Answer is A

Explanation

A patient is taking a first-generation antipsychotic medication. What should the nurse teach about the drug’s strong dopaminergic effect?

After teaching a class about the rights of persons receiving mental health services, the nurse determines a need for additional discussion when the group wrongly identifies which as a right?

When assessing patients at a mental health clinic, how should their current level of overall functioning be judged?

A client is prescribed a serotonin-norepinephrine reuptake inhibitor. The nurse would identify that which of the following will be prescribed?

Which of the following side effects is associated with the blockade of attachment of norepinephrine to alpha-1 receptors?

A nurse uses Maslow’s hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority?

After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?