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A client states they have been compliant with antidepressant therapy, but "the meds don't seem to be working anymore." They have no immediate family in the vicinity and are estranged from siblings, saying, "They got over me a long time ago." The client acknowledges having a few friends but expresses, "I don't want to burden them with my stuff. I'm not worth that." Which factors should the nurse consider when evaluating the client's support systems? (Select all that apply.)

Support systems

Physical health

Mental health support

Alcohol consumption

Feelings of self-worth

Family history

Access to lethal means

Answer and Explanation

Correct Answer : A,B,C,E,F,G

Choice A reason: Support systems are crucial for emotional and practical support, especially when dealing with mental health issues.

Choice B reason: Physical health can significantly impact mental health, and vice versa; it's important to consider the client's overall well-being.

Choice C reason: Mental health support, such as therapy or support groups, is essential for someone struggling with the effectiveness of their medication.

Choice D reason: While alcohol consumption can affect mental health, it is not mentioned in the client's statement and therefore cannot be assumed.

Choice E reason: Feelings of self-worth are directly related to mental health and can influence the client's perspective on their value and the burden they perceive themselves to be to others.

Choice F reason: Family history can provide insight into potential hereditary patterns of mental health issues and the client's support network.

Choice G reason: Access to lethal means is a critical safety concern, especially for clients expressing feelings of worthlessness or experiencing severe depression.

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Correct Answer is A

Explanation

Choice A reason: Weight gain is indeed a known side effect of lithium treatment, and acknowledging this can validate the client's experience.

Choice B reason: This response could be perceived as blaming and does not acknowledge that weight gain can be a side effect of lithium.

Choice C reason: This statement is misleading as weight gain can occur beyond the first month of treatment with lithium.

Choice D reason: This statement is incorrect as weight loss is not the typical pattern associated with lithium; weight gain is more common.

A. An adolescent client with alogia, anhedonia, and a flat or blunted affect. B. A client who has a first cousin with bipolar I disorder. C. A client with an exacerbation of hallucinations and delusions 2 years after diagnosis. D. An older adult client with an onset of positive symptoms at age 35.

Correct Answer is A

Explanation

Choice A reason: This client presents with negative symptoms of schizophrenia, which are often associated with a poorer prognosis. Negative symptoms like alogia and anhedonia indicate a diminished emotional response and lack of motivation, which can severely impact the client's ability to function and respond to treatment.

Choice B reason: Having a first cousin with bipolar I disorder may suggest a genetic predisposition to mood disorders but does not directly influence the prognosis of a client already diagnosed with schizophrenia.

Choice C reason: While an exacerbation of hallucinations and delusions indicates a worsening of symptoms, it is the positive symptoms of schizophrenia that are often more responsive to treatment. Therefore, this client may not necessarily have the worst outcomes.

Choice D reason: An older adult with a late onset of schizophrenia typically has a better prognosis than those with an earlier onset. Late-onset schizophrenia is often less severe and may respond better to treatment.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client began taking lithium for the treatment of bipolar disorder approximately one month ago. The client asks if it is normal to have gained 12 pounds in this time frame. Which is the appropriate nursing reply?

Correct Answer is A

Explanation

The nurse is evaluating several clients with a diagnosis of schizophrenia. Which client will be assessed as having the worst potential outcomes?

Correct Answer is A

Explanation

A nurse observes a client's spouse sitting alone in the waiting room crying. When approached, the spouse says, "I am really concerned about my husband." Which of the following is a therapeutic nursing response?

The nurse is educating a client and family about strategies to minimize the side effects of antipsychotic drugs. Which will be included in the plan? Select all that apply.

A client has a history of excessive fear of water. Which term should the nurse use to describe this specific phobia, and under what subtype is this phobia identified?

A nurse at a college campus mental health counseling center is caring for a student who just failed an examination. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as which of the following defense mechanisms?

Laboratory results reveal elevated levels of prolactin in a client diagnosed with Schizophrenia. Which symptoms should the nurse expect to observe? Select all that apply.

The nurse has established a therapeutic relationship with a client. Which behaviors indicate that the client has entered into the identification phase of the nurse-client relationship?

During an assessment of family dynamics for a client with an eating disorder, which observed issue could indicate a reason for the client's eating disorder?