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SSRIs are more effective in relieving manifestations. Both SSRIs and TCAs are effective in treating depression, but SSRIs are often preferred due to their more favorable side effect profile. TCAs may actually be more effective for some individuals, especially in severe depression, but their side effects limit their widespread use. SSRIs are not necessarily more effective in all cases.

SSRIs produce a more sedative effect. SSRIs generally do not have strong sedative properties. In contrast, TCAs often cause significant sedation due to their antihistaminic effects. Some SSRIs, like fluvoxamine and paroxetine, can cause mild drowsiness, but overall, TCAs are more sedating.

TCAs have fewer cardiovascular effects. TCAs have more pronounced cardiovascular side effects, including orthostatic hypotension, tachycardia, and QT prolongation, due to their effects on alpha-adrenergic and sodium channels. In contrast, SSRIs have minimal cardiovascular impact, making them safer for clients with heart conditions.

Flight of ideas. Flight of ideas refers to rapid, continuous speech with abrupt topic changes that may be loosely connected. Though the speech may be difficult to follow, it often retains some logical thread. The client's statement lacks any meaningful connection between words, making flight of ideas an incorrect choice.

Neologisms. Neologisms are newly created or made-up words that have meaning only to the individual using them. While people with schizophrenia may invent words, the client's statement does not contain unfamiliar or fabricated terms, ruling out this option.

Clang associations. Clang associations involve speech patterns where words are linked based on sound rather than meaning, such as rhyming or alliteration. The client’s statement does not show this pattern, as the words do not share similar sounds or rhythms.

"I check my breasts for lumps every day, but I'm still really scared about getting breast cancer." This statement suggests illness anxiety disorder (formerly hypochondriasis), where a person is excessively worried about having a serious illness despite medical reassurance. While anxiety is present, this condition is classified separately from generalized anxiety disorder or other common anxiety disorders.

"I have had several negative pregnancy tests, but I know they are all wrong." This response indicates delusional thinking, which is more characteristic of a psychotic disorder such as delusional disorder rather than an anxiety disorder. People with anxiety disorders typically have excessive worry but remain in touch with reality.

"I double-check my pills because I think the pharmacist may be putting poison in them." This statement reflects paranoia and persecutory delusions, which are more commonly seen in psychotic disorders such as schizophrenia or paranoid personality disorder. Anxiety disorders typically do not involve persistent false beliefs of being harmed.

"ECT is contraindicated in clients who have psychotic symptoms." ECT is actually an effective treatment for severe depression with psychotic features, as well as treatment-resistant schizophrenia. It is not contraindicated in these cases; rather, it is often recommended when medications are ineffective.

"ECT cannot be administered to clients who have suicidal ideation." ECT is commonly used in individuals with severe suicidal ideation, particularly when rapid symptom relief is needed. It can be life-saving in cases of severe, treatment-resistant depression, making this statement incorrect.

"ECT is conducted under regional anesthesia." ECT is performed under general anesthesia, not regional anesthesia. The client receives short-acting anesthesia along with a muscle relaxant to prevent injury during the induced seizure.

"This medication can cause my child to have low blood sugar." Risperidone is more commonly associated with metabolic side effects such as weight gain and an increased risk of high blood sugar (hyperglycemia), rather than low blood sugar (hypoglycemia). Regular monitoring of weight and blood glucose levels may be necessary.

"This medication won't require my child to have routine lab tests." While risperidone does not require frequent lab monitoring like some other antipsychotics (e.g., clozapine), periodic assessments of metabolic parameters, including blood glucose, cholesterol, and liver function, may be necessary due to its potential side effects.

"This medication might need to be increased if my child has muscle spasms." Muscle spasms, or extrapyramidal symptoms (EPS), can be a side effect of risperidone. If EPS occur, the medication might need to be reduced or adjusted, rather than increased. Additional medications, such as benztropine, may also be considered to manage EPS.

A nurse posted private information on social media about a client who has a substance use disorder. This is an intentional tort, specifically invasion of privacy. Sharing a client’s personal health information without consent violates confidentiality laws, such as HIPAA, and is a breach of professional ethics.

A nurse placed a client in mechanical restraints without obtaining a prescription, resulting in injury. This is an intentional tort, specifically false imprisonment. The improper use of restraints without authorization or justification violates a client’s rights and can lead to legal consequences, especially if harm occurs.

A nurse threatened a client with physical harm after the client became verbally abusive to staff members. This is an intentional tort, specifically assault. Assault occurs when a person is threatened with harm, causing fear, even if physical contact does not occur. Verbal threats of physical harm meet this definition.

"I agree with you. I'm sure this will never happen again." This response dismisses the seriousness of the situation and fails to assess the child's safety. Abuse often recurs, and the nurse must take all suspected cases seriously by gathering more information before making assumptions.

"This is awful. You should file charges against your partner." While the situation is concerning, this response is judgmental and directive, which may make the parent defensive. The nurse’s role is to assess, support, and report suspected abuse, not to instruct the parent on legal action.

"This is clearly child endangerment I will have to call the police." While the nurse has a legal obligation to report suspected child abuse, an immediate accusation may shut down communication. A more effective approach is to gather details while maintaining a nonjudgmental stance before escalating the situation to child protective services.

A client who has a new diagnosis of major depressive disorder. A new diagnosis of major depressive disorder (MDD) can often be managed through outpatient therapy and medication. Assertive Community Treatment (ACT) is typically reserved for individuals with severe, persistent mental illness, particularly those with frequent hospitalizations or difficulty adhering to treatment.

A client who has requested family therapy following the death of a family member. Family therapy is beneficial for grief counseling, but it does not require ACT services. ACT focuses on individuals with chronic psychiatric disorders who need multidisciplinary, long-term support.

A client who has physical injuries following an incident of partner violence. Survivors of intimate partner violence may require medical care, counseling, and support services, but ACT is not the appropriate intervention. Instead, referrals to domestic violence shelters, crisis counseling, or legal assistance may be more suitable.