Author Question: A highly agitated client paces the unit and states, I could buy and sell this place. The client's ... (Read 88 times)

fox · **on:** Jul 19, 2018

A highly agitated client paces the unit and states, I could buy and sell this place. The client's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client's behavior?

A. Rates mood 8/10. Exhibiting looseness of association. Euphoric.
B. Mood euthymic. Exhibiting magical thinking. Restless.
C. Mood labile. Exhibiting delusions of reference. Hyperactive.
D. Agitated and pacing. Exhibiting grandiosity. Mood labile.

Question 2

A client is prescribed phenelzine (Nardil). Which of the following client statements should indicate to a nurse that discharge teaching about this medication has been successful? Select all that apply.

A. I'll have to let my surgeon know about this medication before I have my cholecystectomy.
B. Guess I will have to give up my glass of red wine with dinner.
C. I'll have to be very careful about reading food and medication labels.
D. I'm going to miss my caffeinated coffee in the morning.
E. I'll be sure not to stop this medication abruptly.

lorealeza77 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

ANS: D
The nurse should document that this client's behavior is Agitated and pacing. Exhibiting grandiosity. Mood labile. The client is exhibiting signs of irritation accompanied by aggressive behavior. Grandiosity refers to an exaggerated sense of power, importance, knowledge, or identity.

Answer to Question 2

ANS: A, B, C, E
The nurse should evaluate that teaching has been successful when the client states that phenelzine (Nardil) should not be taken in conjunction with the use of alcohol or foods high in tyramine and should not be stopped abruptly. Phenelzine is a monoamine oxidase inhibitor (MAOI) that can have negative interactions with other medications. The client needs to tell other physicians about taking MAOIs because of the risk of drug interactions.