The wife of a client who has delusions of infidelity asks the ...

[bcretired]

The wife of a client who has delusions of infidelity asks the nurse if any circumstances exist under
  which the treatment team is justified in violating the client's right to confidentiality.
 
  The nurse must
  reply that confidentiality may be violated
  a. under no circumstances.
  b. at the discretion of the psychiatrist.
  c. when questions are asked by law enforcement.
  d. if the client threatens the life of another person.

Question 2

A client who has been taking fluoxetine (Prozac) 60 mg daily for the past 6 months tells the nurse at
  the medication follow-up clinic that he is considering stopping pharmacotherapy.
 
  He states his mood
  is fine, and now that he is living normally his wife is concerned that he has no sexual drive. The
  nurse's response should be predicated on knowledge that
  a. sexual dysfunction is an expected side effect to which the client must adjust.
  b. morning dosing will alleviate the problem and foster late evening sexual activity.
  c. the problem is usually relationship-oriented and requires couples therapy.
  d. switching to mirtazapine (Remeron) may restore sexual function.

[polinasid]

Answer to Question 1

ANS: D
The duty to warn a person whose life has been threatened by a psychiatric client overrides the
client's right to confidentiality. The right to confidentiality is not suspended at the discretion of the
therapist or for legal investigations.

Answer to Question 2

D
Mirtazapine, an atypical antidepressant that blocks serotonin, is an a2 adenoreceptor antagonist that
blocks histamine, thus enhancing both nonadrenergic and serotonergic transmitters. It is often
effective in restoring SSRI-induced sexual dysfunction. The other options reflect incorrect
information.

[bcretired]

Excellent

[ryhom]

TYSM