Nokea
A patient with bipolar disorder has been prescribed lithium. Which dietary advice is important for the nurse to include?
- A. Avoid foods high in tyramine.
- B. Maintain a consistent salt intake.
- C. Increase protein intake.
- D. Avoid foods high in fat.
Correct Answer: B
Rationale: Patients prescribed lithium should maintain a consistent salt intake to prevent fluctuations in lithium levels. Salt intake can impact lithium levels, and sudden changes in salt intake can affect how the body absorbs and excretes lithium. Therefore, advising the patient to maintain a stable salt intake is crucial for the effectiveness and safety of lithium therapy. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients taking MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients on lithium therapy.
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Which therapeutic approach is most effective for managing obsessive-compulsive disorder (OCD)?
- A. Cognitive-behavioral therapy
- B. Psychoanalysis
- C. Medication management
- D. Group therapy
Correct Answer: A
Rationale: Cognitive-behavioral therapy (CBT), especially exposure and response prevention, is considered the most effective therapeutic approach for managing obsessive-compulsive disorder (OCD). CBT helps individuals identify and modify their distorted beliefs and behaviors related to OCD, while exposure and response prevention specifically target the core symptoms of OCD by gradually exposing the individual to feared stimuli and preventing compulsive responses. While medication management can be used as an adjunct to therapy, CBT has shown to have long-lasting benefits in reducing OCD symptoms and improving the overall quality of life. Psychoanalysis focuses more on exploring unconscious conflicts and childhood experiences, which may not be as effective for OCD. Group therapy can be beneficial as a supplemental treatment but is not typically as effective as individual CBT tailored to the specific needs of the individual with OCD.
Which neurotransmitter is primarily implicated in the development of schizophrenia?
- A. Serotonin
- B. Norepinephrine
- C. Dopamine
- D. Acetylcholine
Correct Answer: C
Rationale: The correct answer is dopamine. Dopamine dysregulation is a key factor in the development of schizophrenia. Excess dopamine activity in certain brain regions is associated with positive symptoms of schizophrenia, such as hallucinations and delusions. Dopaminergic medications that reduce dopamine levels are often used to manage these symptoms, further supporting the role of dopamine in schizophrenia. Serotonin (Choice A) is more commonly associated with mood regulation and is implicated in depression and anxiety disorders. Norepinephrine (Choice B) is involved in the body's 'fight or flight' response and is linked to conditions like anxiety and PTSD. Acetylcholine (Choice D) plays a role in muscle movement and memory but is not primarily implicated in schizophrenia.
When assessing a patient with major depressive disorder, which symptom would most likely be observed?
- A. Euphoria
- B. Anhedonia
- C. Increased energy
- D. Racing thoughts
Correct Answer: B
Rationale: Anhedonia, the inability to feel pleasure in activities that were once enjoyable, is a hallmark symptom of major depressive disorder. Patients with major depressive disorder often experience a pervasive feeling of emptiness and loss of interest in activities they used to find pleasurable. Euphoria, increased energy, and racing thoughts are more commonly associated with conditions like bipolar disorder rather than major depressive disorder.
Which therapeutic approach is most effective for managing borderline personality disorder?
- A. Dialectical behavior therapy
- B. Cognitive-behavioral therapy
- C. Psychoanalysis
- D. Supportive therapy
Correct Answer: A
Rationale: Dialectical behavior therapy (DBT) is considered the most effective therapeutic approach for managing borderline personality disorder. DBT is a specialized form of cognitive-behavioral therapy that focuses on providing skills to cope with intense emotions, improve relationships, and regulate behavior. It has been extensively studied and shown to be effective in reducing self-harm, suicidal behaviors, and improving overall functioning in individuals with borderline personality disorder. Cognitive-behavioral therapy (Choice B) is a common and effective treatment for many mental health conditions but is not as specifically tailored to address the core symptoms of borderline personality disorder as DBT. Psychoanalysis (Choice C) is a more intensive and long-term therapy that focuses on exploring unconscious patterns and early life experiences, which may not be as practical or effective for the impulsive and emotional dysregulation seen in borderline personality disorder. Supportive therapy (Choice D) provides emotional support but lacks the structured skills training and strategies that are essential in managing borderline personality disorder.
When assessing a patient with schizophrenia who exhibits disorganized speech and behavior, these symptoms are classified as:
- A. Positive symptoms
- B. Negative symptoms
- C. Cognitive symptoms
- D. Mood symptoms
Correct Answer: A
Rationale: Positive symptoms in schizophrenia refer to excesses or distortions in normal behavior and include symptoms like hallucinations, delusions, and disorganized speech and behavior. Disorganized speech and behavior are considered positive symptoms because they represent an excess or distortion of normal functions. Negative symptoms involve deficits in normal behavior, cognitive symptoms affect thinking processes, and mood symptoms relate to emotional experiences. Therefore, in this scenario, the disorganized speech and behavior exhibited by the patient are classified as positive symptoms.