A patient with a history of bipolar I disorder is prescribed fluoxetine (Prozac) for a depressive episode. What is the nurse's priority action?

Assess the patient for gastrointestinal side effects.

Monitor the patient closely for signs of mania.

Administer the medication as ordered

Educate the patient about potential weight gain

Answer and Explanation

The Correct Answer is B

A. While gastrointestinal side effects are common with fluoxetine, they are not the priority concern in the context of bipolar disorder.

B. Fluoxetine (Prozac) is an SSRI used to treat depression, but in patients with bipolar disorder, it can trigger a manic episode. Therefore, the nurse's priority is to monitor for signs of mania, such as increased energy, euphoria, or impulsivity.

C. Administering the medication as ordered is essential, but the nurse must be vigilant for signs of mania, especially with SSRIs in bipolar patients.

D. Educating about weight gain is important but does not address the immediate risk of precipitating mania with fluoxetine in a bipolar patient.

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Correct Answer is C

Explanation

A. Reality testing refers to the ability to distinguish between what is real and what is not. The client’s belief is a symptom of grandiosity, not a lack of reality testing.

B. Derealization refers to the sense that the external world is unreal or distorted, which is not the case here.

C. Grandiosity is an inflated sense of self-importance and unrealistic beliefs in one’s abilities, as demonstrated by the client’s statement about being able to fly and become a U.S. Senator.

D. Flight of ideas involves rapid, continuous speech with fragmented thoughts that jump from one topic to another. The client’s speech does not exhibit this pattern.

A. "I will join a book club in my neighborhood." B. 1 plan to sit on a park bench for a few minutes each day." C. 1 can try participating in group therapy every week" D. "I should avoid entering elevators and other closed spaces."

Correct Answer is B

Explanation

A. Joining a book club may be too ambitious at the start of treatment for someone with agoraphobia.

B. Gradual exposure to feared situations is a common treatment for agoraphobia. This plan represents a reasonable and incremental goal, showing understanding of the treatment approach.

C. Participating in group therapy might be too overwhelming and may not directly address the client's fear of being outside.

D. Avoidance of elevators and closed spaces goes against the goal of treatment, which is to face fears gradually and safely.

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A patient with a history of bipolar I disorder is prescribed fluoxetine (Prozac) for a depressive episode. What is the nurse's priority action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has bipolar disorder. The client states, "I feel like Superman. I can do anything. I can fly home today and then become a U.S. Senator." Which of the following findings is this client exhibiting?

Correct Answer is C

Explanation

A nurse in a hospital is caring for a client who has agoraphobia. Which of the following statements by the client indicates understanding of the goals of treatment?

Correct Answer is B

Explanation

A nurse is caring for a client who has bipolar disorder. Which of the following actions by the client should the nurse interpret as displaying manic behavior? (Select all that apply.)

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