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The nurse has been working with a client who has difficulty controlling mood. The client continues to experience anger outbursts, which makes it difficult to maintain employment. When explaining this dysfunction to the client's family members, which area of the brain does the nurse identify as being the site for mood generation?
- A. The central nervous system
- B. The autonomic nervous system
- C. The limbic system
- D. The peripheral nervous system
Correct Answer: C
Rationale: The limbic system is responsible for mood generation, as it regulates emotions and related behaviors. The central nervous system includes the brain and spinal cord but is too broad to specifically address mood. The autonomic nervous system controls involuntary functions like heart rate, not mood. The peripheral nervous system handles sensory and motor functions outside the central nervous system.
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Which nursing consideration is most important when administering medications to a suicidal client?
- A. Do not leave any syringe unattended.
- B. Watch the client place all pills in the mouth.
- C. View the inside of the mouth to make sure that all medications are swallowed.
- D. Remove all medications and medication administration equipment from client area.
Correct Answer: C
Rationale: It is most important for the nurse to view the inside of the mouth when administering medications. This is done by inspecting the client's mouth and under the tongue because clients may 'cheek' medications to stockpile and use the medications. Not leaving syringes unattended, watching the client place the pills in their mouth, and removing all medications and equipment are all appropriate nursing actions, but the most important is not allowing the opportunity for the client to overdose on medications.
The nurse understands that clients who eat which of the following foods experience a food-drug interaction when taking phenelzine?
- A. Tangerines
- B. Fresh fish
- C. Yogurt
- D. Spinach and feta salad
Correct Answer: D
Rationale: The nurse understands that phenelzine is a monoamine oxidase inhibitor (MAOI). Clients who eat foods containing tyramine experience a food-drug interaction. When a MAOI is combined with foods containing tyramine (alcohol or aged cheese), a hypertensive crisis can occur. Feta cheese is an aged cheese. The other foods do not contain tyramine.
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.
What is an example of sub-acute symptoms that may be observed in the older adult who may be depressed?
- A. Weight gain
- B. Lack of energy
- C. Memory loss
- D. Increased sleep
Correct Answer: B
Rationale: The examples of sub-acute symptoms that may be observed in the older adult who may be depressed are loss of appetite, trouble sleeping, lack of energy, and weight loss.
The nurse is assessing a client's affect while discussing common issues such as the weather and family. The client appears sad with a slow speech pattern. The nurse considers that this may be a sign of depression but understands that the physician will want to rule out which medical condition first?
- A. Mania
- B. Hypothyroidism
- C. A pituitary deficiency
- D. A cerebral vascular accident
Correct Answer: B
Rationale: When a nurse identifies that a client is experiencing symptoms of depression, it is essential that other conditions, which may produce similar symptoms, be ruled out. One condition that mimics depression is hypothyroidism. Mania increases and exaggerates actions and speech patterns. Common symptoms of a pituitary deficiency include a deficiency in hormones such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH) and growth hormones. A cerebrovascular accident exhibits physical and mental changes.