A client with bipolar disorder is refusing to take mood stabilizers due to weight gain. To increase the patient’s adherence to a medication regimen, what measures could the nurse teach the client? (SELECT ALL THAT APPLY)

Have cut vegetables prepared for a snack instead of chips or cookies.

Extended-release forms of medications have fewer side effects when dissolved in water.

Weigh yourself once in the morning and once in the evening using the same scale.

Drink flavored water instead of soft drinks.

Walk 30 minutes per day, 5 days per week.

Answer and Explanation

Correct Answer : A,D,E

Choice A Reason:

Have cut vegetables prepared for a snack instead of chips or cookies. This choice is correct because it encourages healthier eating habits, which can help manage weight gain associated with mood stabilizers. Vegetables are low in calories and high in nutrients, making them a better alternative to high-calorie snacks like chips and cookies. This can help the client maintain a healthy weight while adhering to their medication regimen.

Choice B Reason:

Extended-release forms of medications have fewer side effects when dissolved in water. This choice is incorrect. Extended-release medications are designed to be released slowly over time and should not be dissolved in water. Dissolving them can alter their release mechanism, leading to potential side effects and reduced efficacy.

Choice C Reason:

Weigh yourself once in the morning and once in the evening using the same scale. This choice is incorrect. Weighing oneself multiple times a day can lead to unnecessary anxiety and obsession over weight fluctuations, which are normal throughout the day. It is generally recommended to weigh oneself once a week at the same time of day for a more accurate measure of weight trends.

Choice D Reason:

Drink flavored water instead of soft drinks. This choice is correct because it promotes healthier beverage choices. Soft drinks are high in sugar and calories, which can contribute to weight gain. Flavored water, on the other hand, can be a refreshing and low-calorie alternative, helping the client manage their weight while staying hydrated.

Choice E Reason:

Walk 30 minutes per day, 5 days per week. This choice is correct because regular physical activity is essential for maintaining a healthy weight and overall well-being. Walking is a low-impact exercise that can help burn calories, improve mood, and enhance adherence to a medication regimen by reducing the side effects of weight gain.

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Correct Answer is ["B","D"]

Explanation

b. Washes their hands before placing the eye drops

d. Puts the drop from inner to outer canthus

Explanation of Choices

Choice A Reason: Puts the Eye Drops in a Room with Low Lighting

Administering eye drops in a room with low lighting is not a recommended practice. Proper lighting is essential to ensure accurate placement of the drops and to avoid contamination or injury. Low lighting can make it difficult to see the eye and the dropper, increasing the risk of improper administration. Therefore, this action does not indicate correct performance of the skill.

Choice B Reason: Washes Their Hands Before Placing the Eye Drops

Washing hands before administering eye drops is a crucial step to prevent infection and contamination. Clean hands reduce the risk of transferring bacteria or other pathogens to the eye, which can cause infections or other complications. This action is a fundamental part of proper eye drop administration and indicates correct performance of the skill.

Choice C Reason: Uses the Patient’s Iris as a Landmark for Direct Placement of the Drop

Using the patient’s iris as a landmark for direct placement of the drop is incorrect. The proper technique involves pulling down the lower eyelid to create a small pocket (conjunctival sac) and placing the drop into this pocket. Directly aiming for the iris can cause discomfort and increase the risk of injury or contamination. Therefore, this action does not indicate correct performance of the skill.

Choice D Reason: Puts the Drop from Inner to Outer Canthus

Placing the drop from the inner to the outer canthus (corner of the eye) is a correct technique. This method helps ensure that the drop spreads evenly across the eye surface and reduces the risk of contamination. It also helps in preventing the dropper from touching the eye or eyelid, which can introduce bacteria. This action indicates correct performance of the skill.

Choice E Reason: Holds the Upper Eyelid Open When Placing the Drop

Holding the upper eyelid open when placing the drop is not the recommended technique. The proper method involves pulling down the lower eyelid to form a pocket and placing the drop into this pocket. Holding the upper eyelid open can cause discomfort and may not allow the drop to be placed accurately. Therefore, this action does not indicate correct performance of the skill.

A. Their full therapeutic potential may not be reached until 4 weeks. B. Aged cheese should not be eaten while taking them. C. They should not be given with antianxiety agents. D. They may cause hypomania or recent memory impairment.

Correct Answer is A

Explanation

Choice A Reason: Their full therapeutic potential may not be reached until 4 weeks

This statement is correct. Tricyclic antidepressants (TCAs) often take several weeks to reach their full therapeutic effect. Patients may start to notice some improvement within one to two weeks, but it can take up to four weeks or longer for the full benefits to be realized1. This delayed onset is due to the time it takes for the medication to build up in the system and exert its effects on neurotransmitter levels.

Choice B Reason: Aged cheese should not be eaten while taking them

This statement is incorrect. The dietary restriction of avoiding aged cheese is associated with monoamine oxidase inhibitors (MAOIs), not tricyclic antidepressants. MAOIs can cause dangerous interactions with tyramine, a substance found in aged cheese and other foods, leading to hypertensive crises. TCAs do not have this dietary restriction.

Choice C Reason: They should not be given with antianxiety agents

This statement is incorrect. Tricyclic antidepressants can be used in conjunction with antianxiety agents under medical supervision. However, it is important to monitor for potential interactions and side effects. The combination can be beneficial for patients with comorbid depression and anxiety disorders.

Choice D Reason: They may cause hypomania or recent memory impairment

This statement is partially correct but not the best indicator of understanding. While TCAs can cause side effects such as memory impairment and, in rare cases, hypomania, these are not the primary concerns when teaching about the medication. The focus should be on understanding the therapeutic timeline and common side effects.

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A client with bipolar disorder is refusing to take mood stabilizers due to weight gain. To increase the patient’s adherence to a medication regimen, what measures could the nurse teach the client? (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is observing a family member administer eye drops to the patient as part of medication teaching. Which action(s) indicate the family member is performing the skill correctly? (SELECT ALL THAT APPLY)

Correct Answer is ["B","D"]

Explanation

The nurse assesses that medication teaching about tricyclic antidepressants was understood when the client states:

Correct Answer is A

Explanation

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