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","D","E"]

Explanation

A. Sleeping for long periods of time would typically indicate depression, not mania.

B. Dressing in black or grey clothing is not typically associated with mania; this could be a symptom of depression, which tends to cause social withdrawal and lack of energy.

C. Rapid, continuous speech (pressured speech) is a common symptom of mania, where the individual is unable to control the flow of conversation.

D. Spending large sums of money without regard for the consequences is a typical behavior during manic episodes, often linked to impulsivity and poor judgment.

E. Flirtatious behavior can indicate impulsivity, another characteristic of mania, where the person may act inappropriately or without regard for social boundaries.

A. Ineffective coping B. Risk for impaired parenting C. Anxiety D. Risk for self-harm

Correct Answer is D

Explanation

A. Ineffective coping is important but secondary to addressing the immediate safety of the client.

B. While impaired parenting is a concern, the safety of the mother takes precedence over her ability to care for her child.

C. Anxiety is a symptom but does not pose as immediate a threat to the client’s well-being as the risk of self-harm.

D. Feelings of hopelessness in a mother diagnosed with postpartum depression can indicate a risk for self-harm or suicide. The priority is to ensure the client's safety, as these feelings are a critical sign of potential harm to themselves.

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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. Which of the following actions by the client should the nurse interpret as displaying manic behavior? (Select all that apply.)

Correct Answer is ["C","D","E"]

Explanation

A mother (G1 P1 T1 PO AO L1) diagnosed with postpartum depression expresses feelings of hopelessness. Which nursing diagnosis is the priority?

Correct Answer is D

Explanation

A nurse in an acute care mental health facility is assessing a client who has bipolar disorder. Which of the following findings indicates the client is at risk for suicide?

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

A client is to receive enoxaparin 30 mg subcutaneously. Available is enoxaparin 40 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Which patient is at the highest risk of developing postpartum depression?

A nurse is preparing a client who has chronic anxiety for discharge from the psychiatric unit. Which of the following instructions should the nurse include in the client's discharge plan?

A 35-year-old client with OCD spends several hours each day arranging and rearranging household items in a specific order. The client becomes extremely distressed if the items are not arranged correctly. Which nursing intervention is most appropriate?

A patient diagnosed with bipolar disorder is prescribed lithium carbonate. Which laboratory result should prompt the nurse to hold the medication and notify the healthcare provider?