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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.
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The nurse is completing a medication history for a client diagnosed with bipolar disorder. When assessing the medications, which medication classification is noted as an adjunct to lithium therapy?
- A. Antidiabetics
- B. Antihypertensives
- C. Anticonvulsants
- D. Antianginals
Correct Answer: C
Rationale: Anticonvulsant therapy may be co-prescribed for a brief period to sedate the client and relieve bizarre thought processes faster than monotherapy with lithium. Anticonvulsants enhance the action of gamma-aminobutyric acid (GABA) in much the same way that benzodiazepines reduce anxiety and they are believed to inhibit glutamate.
The nurse is caring for a client diagnosed with seasonal affective disorder (SAD). When caring for the client, at which time of the year does the nurse limit nursing interventions due to an uplifting of mood?
- A. September/October
- B. February/March
- C. April/May
- D. December/January
Correct Answer: C
Rationale: Clients experience an uplifting of mood during the springtime in the months of April/May. During this time, daylight becomes longer. As the mood improves, fewer nursing interventions including phototherapy are needed. As days shorten in fall, the client's mood may begin to worsen until it reaches its lowest point in the dark winter months.
The nurse is providing teaching to a client starting monoamine oxidase inhibitor (MAOI) drug therapy. Which over-the-counter medications should the nurse instruct the client to avoid?
- A. Cold and allergy medications
- B. Antiulcer medications
- C. Multivitamins
- D. Laxatives
Correct Answer: A
Rationale: The nurse is correct to place cold and allergy medications on a clinical reference guide of over-the-counter medications to avoid. These preparations may have a drug-drug interaction. The client can use over-the-counter antiulcer medications, multivitamins, and laxatives per physician instruction.
Which of the following nursing instructions is most helpful to a client experiencing mild seasonal affective disorder symptoms?
- A. Use sunglasses when exposed to sunlight.
- B. Install skylights.
- C. Sleep in a darkened room.
- D. Stay indoors during the winter time.
Correct Answer: B
Rationale: Mild seasonal affective disorder symptoms can be improved by exposing the client to more sunlight. Sunlight stimulates the pineal gland, which releases serotonin. By installing skylights, natural sunlight can enter a room. Using sunglasses, sleeping in a darkened room, and staying indoors limit sunlight exposure.
The nurse is caring for an older adult client diagnosed with bipolar disorder. Which manifestation of the disease can the nurse anticipate?
- A. The disease remits as the client ages.
- B. The disease increases as the client ages.
- C. The depression increases as the client ages.
- D. The manic phase increases as the client ages.
Correct Answer: C
Rationale: Older adult clients with bipolar disorder typically experience depressive episodes that increase in frequency and last longer. The increase for functional decline occurs, which may necessitate further care.