Nokea
Anticonvulsants enhance which neurotransmitter in clients diagnosed with bipolar disorder?
- A. Serotonin
- B. Dopamine
- C. GABA
- D. Acetylcholine
Correct Answer: C
Rationale: Anticonvulsants may achieve their therapeutic effects by enhancing the action of GABA in much the same way that benzodiazepines reduce anxiety. Anticonvulsants do not enhance serotonin, dopamine, or acetylcholine.
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The nurse is caring for a client with a disturbance in thought process who is disoriented and aggressive. What nursing action may produce further agitation?
- A. Speaking in slow, brief sentences
- B. Presenting the reality of the situation
- C. Allowing the client freedom in a confined area
- D. Being present without speaking
Correct Answer: B
Rationale: When caring for a client with a disturbed thought process, presenting the reality of a situation may create conflict and confusion. Also, this can lead to a verbal exchange and escalation in agitation by the client. Actions by the nurse include attempts to decrease tension and anxiety such as speaking in slow, brief sentences so the client can comprehend instructions. Allow the client freedom when maintaining a safe environment. Being present to support and assist the client without speaking is less likely to produce agitation.
Which observation(s) is helpful in determining a client's mood? Select all that apply.
- A. Client appearance
- B. Body language
- C. Speech
- D. Energy level
- E. Work history
Correct Answer: A,B,C,D
Rationale: The nurse can gather observational data using the assessment skill of inspection. Client appearance that is disheveled indicates signs of personal neglect. Body language may indicate evidence of anxiety, anger, or depression. Pace of speaking and energy level indicates mania or depression. Work history can be helpful in determining information related to a client's ability to fit in socially but is not included in observational data.
What mood disorder has alternating sad and elated mood, resembling bipolar disorder, but less extreme mood shifts?
- A. Euthymia
- B. Dysthymia
- C. Cyclothymia
- D. Psychotic depression
Correct Answer: C
Rationale: Cyclothymia, alternating sad and elated moods, resembling bipolar disorder, but the extremes of mood are less pronounced. People with normal moods are referred to as euthymic. Dysthymia is a feeling of unremitting sadness and is similar to but less severe than major depression. Psychotic depression encompasses an extreme form of depressive disorder and some persons experience hallucinations and delusions.
During the assessment of a client with mood disorder, the nurse observes that the client experiences hallucinations and delusions. What form of depressive disorders does the client experience?
- A. Reactive depression
- B. Mania
- C. Psychotic depression
- D. Seasonal affective disorder (SAD)
Correct Answer: C
Rationale: In psychotic depression, an extreme form of depressive disorder, some persons experience hallucinations and delusions. A reactive or secondary depression is a sad feeling that can be directly attributed to a situation or cause. Mania refers to the frenzied state of euphoria exhibited by persons during the manic phase of bipolar disorder. SAD is a mood disorder characterized by depressive feelings that develop during winter months and then disappear in the spring.
The nurse is caring for a client who has selected transcranial magnetic stimulation to treat depression. For which side effect would the nurse provide preprocedural instructions?
- A. Headache
- B. Blurred vision
- C. Hearing loss
- D. Vertigo
Correct Answer: A
Rationale: The most frequent side effect following transcranial magnetic stimulation to treat depression is headache. Preprocedural instruction would include the most common symptom (headache) and interventions (pain management). Blurred vision, hearing loss, and vertigo are not common side effects.