Nokea
A patient with bipolar disorder asks the nurse, 'Why did I get this illness? I don't want to be sick.' The nurse would best respond with,
- A. People who develop mental illnesses often had very traumatic childhood experiences.
- B. There is some evidence that contracting a virus during childhood can cause mental disorders.
- C. Sometimes people with mental illness have an overactive immune system.
- D. We don't fully understand the cause, but mental illnesses do seem to run in families.
Correct Answer: D
Rationale: Current theories and studies indicate that several mental disorders may be linked to a specific gene or combination of genes, but that the source is not solely genetic; nongenetic factors also play important roles. Traumatic childhood experiences, viral infections, and immune system activity may contribute to mental illness in genetically predisposed individuals, but these are not definitive causes.
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Which one of the following types of antipsychotic medications is most likely to produce extrapyramidal effects?
- A. Atypical antipsychotic drugs
- B. First-generation antipsychotic drugs
- C. Third-generation antipsychotic drugs
- D. Dopamine system stabilizers
Correct Answer: B
Rationale: First-generation antipsychotic drugs are potent antagonists of D2, D3, and D4 receptors, making them effective but producing many extrapyramidal side effects due to D2 receptor blockade. Atypical antipsychotics have a lower incidence of these effects.
A client with bipolar disorder has been taking lithium, and today his serum blood level is 1.8 mEq/L. The client reports nausea. Which of the following interventions by the nurse is indicated?
- A. Constipation and postural hypotension
- B. Fever, muscle rigidity
- C. Nausea
- D. None, the serum level is in therapeutic range
Correct Answer: C
Rationale: A lithium level of 1.8 mEq/L is above the therapeutic range (0.5-1.5 mEq/L) and indicates potential toxicity, with nausea being a common symptom. The nurse should notify the physician for further evaluation.
A nurse is leading a medication education group for patients with depression. A patient states he has read that herbal treatments are just as effective as prescription medications. The best response is,
- A. When studies are published they can be trusted to be accurate.
- B. We need to look at the research very closely to see how reliable the studies are.
- C. Your prescribed medication is the best for your condition, so you should not read those studies.
- D. Switching medications will alter the course of your illness. It is not advised.
Correct Answer: B
Rationale: Often, reports in the media regarding new research and studies are confusing, contradictory, or difficult for clients and their families to understand. The nurse must ensure that clients and families are well informed about progress in these areas and must help them to distinguish between facts and hypotheses.
Which drug classification is the primary medication treatment for schizophrenia?
- A. Anticoagulants
- B. Antidepressants
- C. Antimanics
- D. Antipsychotics
Correct Answer: D
Rationale: Antipsychotic drugs are the primary medical treatment for schizophrenia, addressing psychotic symptoms effectively.
A patient with depression has been taking paroxetine (Paxil) for the last 3 months and has noticed improvement of symptoms. Which of the following side effects would the nurse expect the patient to report?
- A. A headache after eating wine and cheese
- B. A decrease in sexual pleasure during intimacy
- C. An intense need to move about
- D. Persistent runny nose
Correct Answer: B
Rationale: Sexual dysfunction is a common side effect of SSRIs like paroxetine due to enhanced serotonin transmission. Headaches from tyramine interactions are associated with MAOIs, not SSRIs. An intense need to move about is an extrapyramidal side effect of antipsychotics, and runny nose is not typical.