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The spouse of a client diagnosed recently with a mood disorder calls the nurse therapist to report a change in the client's mood. The spouse states, "My spouse is clearly in a better mood than usual. I would say my spouse seems mildly elated. They are functioning fine at work and home. My spouse is energetic, up and doing things at 500 a.m. and really confident again. It seems fantastic, but unusual. Is this something to worry about?"

Which potential response by the nurse accurately assesses the situation?

"It sounds as though the antidepressants are working well. Just ask the client if the client is experiencing any side effects and let me know."

"I'm concerned. Sometimes depressed people seem contented when they have decided to commit suicide. Let's schedule an appointment for tomorrow."

"Since the client is eating, sleeping, and not behaving inappropriately, there's nothing to worry about. Just let me know if the client starts getting irritable or has trouble sleeping."

"The client sounds hypomanic. Let's schedule an appointment for this week for an evaluation. The client may need additional or different medication."

Answer and Explanation

The Correct Answer is D

A. "It sounds as though the antidepressants are working well. Just ask the client if the client is experiencing any side effects and let me know." This response does not adequately address the change in mood and the potential for hypomania. It assumes the change is solely due to the antidepressants.

B. "I'm concerned. Sometimes depressed people seem contented when they have decided to commit suicide. Let's schedule an appointment for tomorrow." While it's important to assess for suicidality, the description provided does not indicate immediate suicidal intent. The client's behavior is more indicative of hypomania.

C. "Since the client is eating, sleeping, and not behaving inappropriately, there's nothing to worry about. Just let me know if the client starts getting irritable or has trouble sleeping." This response downplays the significance of the mood change and does not address the potential for hypomania.

D. "The client sounds hypomanic. Let's schedule an appointment for this week for an evaluation. The client may need additional or different medication." This response correctly identifies the potential for hypomania and takes appropriate action by scheduling an evaluation. Adjusting the client's medication may be necessary to address the change in mood.

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Correct Answer is A

Explanation

A. "As depression lifts, physical energy becomes available to carry out suicide." This statement highlights a critical consideration in the care of severely depressed clients. When a client's depression starts to improve due to antidepressant therapy, there may be a period where they have increased energy but have not yet gained full relief from their depressive thoughts. This can potentially increase the risk of carrying out suicidal thoughts or plans.

B. "Suicide may be precipitated by a variety of internal and external events." While this statement is true, it does not specifically address the importance of monitoring a client during antidepressant therapy.

C. "Suicidal clients have difficulty using social supports." This statement acknowledges a potential challenge for clients who are experiencing suicidal thoughts, but it does not directly relate to the need for close monitoring during antidepressant therapy.

D. "Suicide is an impulsive act that has no warning." This statement is not entirely accurate. While some suicides can be impulsive, many individuals give warning signs or exhibit changes in behavior before attempting suicide.

A. The client can accomplish all activities of daily living. B. The client is smiling and happy with their current lifestyle. C. The client has been experiencing hallucinations and delusions for less than six months. D. The client is euphoric with excessive energy.

Correct Answer is C

Explanation

A) Incorrect. The ability to accomplish activities of daily living is not specific to the diagnosis of schizophreniform disorder.

B) Incorrect. The client's emotional state or demeanor is not a specific indicator of schizophreniform disorder.

C) Correct. Schizophreniform disorder is characterized by the presence of hallucinations,
delusions, and other psychotic symptoms for less than six months. It is considered a provisional diagnosis while the condition is still in its early stages.

D) Incorrect. Euphoria and excessive energy are not specific features of schizophreniform disorder.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement provides the best rationale for why a nurse should closely monitor a severely depressed client during antidepressant therapy?

Correct Answer is A

Explanation

The nurse is admitting a client with the diagnosis of schizophreniform disorder. What should the nurse expect to find?

Correct Answer is C

Explanation

A client is showing symptoms of alcohol intoxication. What question should the nurse ask first?

The nurse is building a discharge teaching plan with a client diagnosed with substance use disorder. Which of the following relapse prevention strategies will be included in the teaching? (Select all that apply)

What intervention is a priority when the client is experiencing auditory hallucinations?

An 80 year-old client, together with his daughter, arrived at the medical surgical unit for diagnostic confirmation and management of probable delirium. Which statement by the client's daughter best supports the diagnosis?

What are the possible physiological changes in the brain of a client diagnosed with Alzheimer's disease? (Select all that apply)

A client has been diagnosed with major depression and placed on amitriptyline. Which is a side effect of amitriptyline?

When a client diagnosed with schizophrenia was discharged 6 months ago, haloperidol was prescribed. The client now says, "I stopped taking those pills. They made me feel like a robot." What are common side effects the nurse should validate with the client?

Which of the following is the most therapeutic response by the nurse when a client states, "I no longer need my medication since I do not hear voices"?