11.

One patient is prescribed the MAOI Emsam, 6mg per day, and another is taking
another MAOI, Nardil, 15 mg per day. Are the dietary restrictions different?

12. A patient who is taking an MAOI asks you to explain what will happen if she eats
pizza. Prepare a short teaching intervention-beginning with the action of the medication
and its consequences.

13. Explain how your nursing care would be different for a male patient taking lithium
carbonate than for a female patient.

14. Patient A is taking depakote for mood stabilization and Patient B is taking lamictal.
After comparing notes with each other, they ask you why Patient A has to have drug
blood levels and Patient B does not. How are these two drugs alike? How are they
different?

15. Two patients are getting their blood drawn. One patient is getting lithium and the
other clozapine. What laboratory tests are being ordered?

16. A patient who is depressed has been started on sertraline. During the assessment, she
tells you that she is also taking St. John’s Wort, lecithin, and a multiple vitamin. What is
your next step?

17. Compare different approaches that you might use with a patient with schizophrenia
who has decided to stop taking his or her medication because of intolerance to side
effects.

Ans.

CHAPTER 9: COMMUNICATION AND THE THERAPEUTIC RELATIONSHIP

1. Describe how you would do a suicide assessment on a distraught patient who comes
to the physician’s office expressing concerns about her ability to cope with her current
situation. Describe how you would approach this patient if you determined she was
suicidal. How might this assessment look different depending on the phase of the
therapeutic relationship?

2. Describe how you would communicate with a patient who is concerned that the
diagnosis of bipolar disorder will negatively affect his or her social and work
relationships.
3. Your depressed patient does not seem inclined to talk about the depression. Describe
the measure you would take to initiate a therapeutic relationship with him or her.

4. Think of a time that you would with a patient that you did not like. What was behind
the dislike? How did you handle the therapeutic relationship? What could you do
differently?

Ans.

CHAPTER 10 : THE NURSING PROCESS: ASSESSMENT, DIAGNOSES,

OUTCOMES, INTERVENTIONS, EVALUATION

1. A 23-year-old white woman is admitted to an acute psychiatric setting for depression

and suicidal gestures. This admission is her first, but she has experienced of depression
since early adolescence. She and her fiancé have just broken their engagement and moved
into separate apartments. She has not yet told anyone that she is pregnant. She said that
her mother had told her that she was “living in sin” and that she would “pay for it.” The
patient wants to “end it all!” From this scenario, develop three assessment questions for
each domain: biological, psychological, and social.

2. Identify normal laboratory values for sodium, blood urea nitrogen (BUN), liver
enzymes, leukocyte count and differential, and thyroid functioning. Why are these values
important to know?

3. Write a paragraph on your self-concept, including all three components: body-image,

self esteem, and personal identity. Explore the type of patient situations in which your
self-concept can help your interactions with patients. Explore the types of patient
situations in which your self-concept can hinder your interaction with patients.

4. Tom, a 25-year-old man with schizophrenia, lives with his parents, who want to retire
to Florida. Tom goes to work each day but relies on his mother for meals, laundry, and
remainders to take his medication. Tom believes that he can manage the home , but his
mother is concerned. She asks the nurse for advice about leaving her son to manage his
own. Generate a nursing diagnosis, outcomes, and interventions that would meet some of
Tom’s potential responses to his changing lifestyle.

5. Joan, a 35-year-old married woman, is admitted to an acute psychiatric unit for

stabilization of her mood disorder. She is extremely depressed but refuses to consider a
recommended medication change. She asks the nurse what to do. Using a nursing
prevention, explain how you would approach Joan’s problem.

6. A nurse reports to work for the evening shift. The unit is chaotic. The television in the
day room is loud; two patients are arguing about the program. Visitors are mingling in
patients’ rooms. The temperature of the unit is hot. One patient is running up and down
the hall yelling “Help me, help me.” Using milieu therapy approach, what would you do
to calm the unit”

Ans.