Which of the following would indicate to the nurse that fluoxetine (Prozac) is effective for the client with major depressive disorder?
1. The client remained up all night discussing negative life situations with the nursing staff.
2. The client ate 100% of breakfast and lunch and ate 25% of the evening meal the past two days.
3. The client remained in the room reading and watching listening to music 90% of the day.
4. The client slept 60% of the night while remaining in bed from 11 p.m. to 5 a.m.
2
Rationale: An improvement in appetite is a sign of an improvement in a symptom of major depressive disorder. Ruminating on negative life events, not sleeping, and isolating are symptoms of depression and do not show an improvement from the medication.
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A patient in the anger stage of illness has become argumentative and demanding. The nursing staff is becoming frustrated with the behaviors. What actions by the nurse are indicated?
1. The nurse should accept the behaviors and attempt to open the lines of communication. 2. Rotate the nursing assignments frequently to limit each nurse's exposure to the behaviors. 3. Confront the patient about his demeanor. 4. Consolidate care so the nurse is in the room for shorter periods.
The nurse working with a patient diagnosed with borderline personality disorder expects
a. grief and social isolation. b. withdrawal and social avoidance. c. mood shifts, impulsivity, and manipulation. d. seductiveness, grandiosity, and overreaction.
The spouse of a client with Parkinson's disease expresses frustration with trying to communicate with the client. Which of the following should the nurse do to facilitate communication between the client and spouse?
1. Suggest the spouse obtain a hearing aid 2. Recommend that the client and spouse learn sign language 3. Consult with speech therapy for exercises to aid with speech and language 4. Remind the spouse that silence is not necessarily a bad thing
Which location does the nurse use to assess S1?
1) Base left 2) Base right 3) Apex 4) Left lower sternal border