Why is “respect for people” (core tenet of the lean construction philosophy) important in the development of a workable pull plan?

A long-term patient with depression finds that his current medication regimen is no longer sufficient to relieve his symptoms. He is currently on fluoxetine, which worked well until recently. Given the patient’s prior failure with many other antidepressants, his psychiatrist decides to switch him to an MAOI. However, because of his current use of fluoxetine, the physician must first discontinue its use to prevent serotonin syndrome. For how long should a patient stop use of fluoxetine (or other SSRIs) before beginning treatment with an MAOI? 

A 36-year-old woman with a history of bipolar disorder that has been managed with lithium for years presents because she has been feeling more depressed than usual lately and wants to investigate treatment options. During the examination, she reported that she has been feeling down, is fatigued, has trouble with her mental focus, and has not been eating much lately but has still gained almost 20 lbs in the past 6 months. Her vitals are normal, except for a heart rate of 52 bpm. Labwork reveals a moderately elevated thyroid-stimulating hormone level of 10.2 uIU/mL. What is the next step in her treatment? 

A 40-year-old woman in a locked inpatient psychiatric unit demonstrates pressured speech and flight of ideas. She appears restless and irritable and has not slept in 4 days. She has had multiple similar episodes throughout her life. She is currently on lithium. She is married and does not use birth control. Her medical history is positive for class 2 obesity and hyperlipidemia. Given the likely diagnosis, which of the following medications is best to treat the patient’s condition? 

Which of the following is the best reason for considering SSRIs among the first-line drug choices for treating symptoms of major depression?

A 67-year-old woman with a medical history of state III breast carcinoma is receiving palliative care. The patient has been bedridden for the past three months and has been taking increased amounts of morphine for pain relief over the last two weeks. The patient mentions that she is feeling miserable and requests medication that could accelerate her death. On further questioning, the PHQ-2 questionnaire score is 4, and the PHQ-9 questionnaire score is 10. Which of the following is the best next step in managing this patient? 

A 40-year-old man presents to his clinician for a follow-up appointment. For the last 2 months, he has had trouble concentrating, decreased appetite, loss of motivation, decreased energy, and difficulty waking up in the morning. He admits to having suicidal thoughts but states that he “does not intend to act on them.” He has been taking the first-line medication with long half-life for this illness for 6 weeks without any improvement. His clinician stops the first medication and prescribes a different medication for this illness that has been available for many years, and the patient immediately begins taking it. What serious adverse event is the patient at risk of developing? 

A 37-year-old man presents with a two-week history of sleeping only two hours per night and “feeling on top of the world.” His only medication is hydrochlorothiazide, which he takes for hypertension. Clinical evaluation is remarkable for pressured speech, racing thoughts, and frequent topic switching. Given the likely diagnosis, what is the most appropriate treatment?

An adult client expresses ambivalence about continuing therapy due to external stressors, but the counselor believes that stopping treatment at this stage could result in relapse. What is the most ethically appropriate action for the counselor to take in this situation? 

Which of the following best explains the concept of target symptom identification?