Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Integrate an understanding of the positive and negative effects of psychiatric medications into pharmacological treatment.

Question 11

Type: MCSA

The nurse instructs the clients to take the medications that are prescribed because the psychiatrist knows what is best for the client. How would the nurses supervisor evaluate the effectiveness of the nurses teaching?

1. The nurse is demonstrating a paternalistic attitude that may contribute to client nonadherence.

2. Teaching the client to take all medications should help keep the client out of the hospital.

3. The nurse is helping the client develop trust in the psychiatrist.

4. The nurse is giving simple instructions that will be readily accepted by the client.

Correct Answer: 1

Rationale 1: In order to promote adherence, the nurse should partner with the client and the clients family. Telling the client that someone else knows what is best for the client is paternalistic and interferes with partnering with clients. Although the nurses statement is simple, it is not one that is readily accepted by clients. One develops trust through actions, not by telling someone to trust.

Rationale 2: In order to promote adherence, the nurse should partner with the client and the clients family. Telling the client that someone else knows what is best for the client is paternalistic and interferes with partnering with clients. Although the nurses statement is simple, it is not one that is readily accepted by clients. One develops trust through actions, not by telling someone to trust.

Rationale 3: In order to promote adherence, the nurse should partner with the client and the clients family. Telling the client that someone else knows what is best for the client is paternalistic and interferes with partnering with clients. Although the nurses statement is simple, it is not one that is readily accepted by clients. One develops trust through actions, not by telling someone to trust.

Rationale 4: In order to promote adherence, the nurse should partner with the client and the clients family. Telling the client that someone else knows what is best for the client is paternalistic and interferes with partnering with clients. Although the nurses statement is simple, it is not one that is readily accepted by clients. One develops trust through actions, not by telling someone to trust.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Incorporate the different perspectives clients have about pharmacology into treatment regimens.

Question 12

Type: MCSA

The client tells the nurse that their spouse does not believe that medications are needed to improve depression. What nursing response would be most helpful in improving the clients medication adherence?

1. Suggest that the spouses views are not important

2. Ask the client to consider marriage counseling

3. Tell the client to ignore the spouse

4. Include the spouse in medication teaching

Correct Answer: 4

Rationale 1: Lack of support from significant others can contribute to medication nonadherence. Partnering with the family may help the family to be supportive. It is difficult to ignore ones spouse, and there is no evidence that marriage counseling is needed at this point. Usually the views of ones significant others are important.

Rationale 2: Lack of support from significant others can contribute to medication nonadherence.

Partnering with the family may help the family to be supportive. It is difficult to ignore ones spouse, and there is no evidence that marriage counseling is needed at this point. Usually the views of ones significant others are important.

Rationale 3: Lack of support from significant others can contribute to medication nonadherence. Partnering with the family may help the family to be supportive. It is difficult to ignore ones spouse, and there is no evidence that marriage counseling is needed at this point. Usually the views of ones significant others are important.

Rationale 4: Lack of support from significant others can contribute to medication nonadherence. Partnering with the family may help the family to be supportive. It is difficult to ignore ones spouse, and there is no evidence that marriage counseling is needed at this point. Usually the views of ones significant others are important.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Incorporate the different perspectives clients have about pharmacology into treatment regimens.

Question 13

Type: MCSA

What is the primary rationale for the nurse asking a client on antidepressant medication about changes in sexual functioning?

1. Antidepressants used frequently contributes to sexual promiscuity and tragic regrets.

2. A side effect of antidepressants may be sexual dysfunction that contributes to nonadherence.

3. Cultural attitudes about sexual functioning may impact the effectiveness of the antidepressant medication.

4. A lack of libido is a symptom of depression that may interfere with the clients relationships.

Correct Answer: 2

Rationale 1: Sexual dysfunctions are frequent side effects of antidepressants and the client may be too embarrassed to initiate this discussion and quit taking the medication. Even though loss of libido may be a symptom of depression, it does not address the issue of the medication side effect. Cultural attitudes about sexual functioning are not directly related to the question. Antidepressants do not frequently contribute to sexual promiscuity when given to a person with a depressive disorder.

Rationale 2: Sexual dysfunctions are frequent side effects of antidepressants and the client may be too embarrassed to initiate this discussion and quit taking the medication. Even though loss of libido may be a symptom of depression, it does not address the issue of the medication side effect. Cultural attitudes about sexual functioning are not directly related to the question. Antidepressants do not frequently contribute to sexual promiscuity when given to a person with a depressive disorder.

Rationale 3: Sexual dysfunctions are frequent side effects of antidepressants and the client may be too embarrassed to initiate this discussion and quit taking the medication. Even though loss of libido may be a symptom of depression, it does not address the issue of the medication side effect. Cultural attitudes about sexual functioning are not directly related to the question. Antidepressants do not frequently contribute to sexual promiscuity when given to a person with a depressive disorder.

Rationale 4: Sexual dysfunctions are frequent side effects of antidepressants and the client may be too embarrassed to initiate this discussion and quit taking the medication. Even though loss of libido may be a symptom of depression, it does not address the issue of the medication side effect. Cultural attitudes about sexual functioning are not directly related to the question. Antidepressants do not frequently contribute to sexual promiscuity when given to a person with a depressive disorder.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Incorporate the different perspectives clients have about pharmacology into treatment regimens.

Question 14

Type: MCSA

The nurse tells a psychotic client with alcohol dependence not to drink while taking the antipsychotic medication. How would the nurses supervisor evaluate this teaching statement?

1. There is no reason why the client cannot have one or two drinks per day.

2. It is not possible for a client with a psychotic disorder to be successful in staying sober.

3. It is a correct statement that should motivate the client to quit drinking.

4. Without treatment for the alcohol dependence, the client will be more likely to not take the medication.

Correct Answer: 4

Rationale 1: The alcohol dependence must be a part of the clients treatment plan or the client will likely not take the medication. Telling a client not to drink does not provide enough motivation to quit drinking. A person with alcohol dependence should not drink one or two drinks per day. It is possible for a client with a psychotic disorder to be successful at staying sober.

Rationale 2: The alcohol dependence must be a part of the clients treatment plan or the client will likely not take the medication. Telling a client not to drink does not provide enough motivation to quit drinking. A person with alcohol dependence should not drink one or two drinks per day. It is possible for a client with a psychotic disorder to be successful at staying sober.

Rationale 3: The alcohol dependence must be a part of the clients treatment plan or the client will likely not take the medication. Telling a client not to drink does not provide enough motivation to quit drinking. A person with alcohol dependence should not drink one or two drinks per day. It is possible for a client with a psychotic disorder to be successful at staying sober.

Rationale 4: The alcohol dependence must be a part of the clients treatment plan or the client will likely not take the medication. Telling a client not to drink does not provide enough motivation to quit drinking. A person with alcohol dependence should not drink one or two drinks per day. It is possible for a client with a psychotic disorder to be successful at staying sober.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity