Nokea
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.
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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.
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 providing instruction to a community class regarding seasonal affective disorder (SAD). Which gland and hormone would the nurse stress is responsible?
- A. Thyroid gland and thyroxin
- B. Pineal gland and melatonin
- C. Pancreas and insulin
- D. Pituitary gland and oxytocin
Correct Answer: B
Rationale: The hypothalamus relays the light-sensing data from the sun to the pineal gland. The pineal gland regulates the hormone melatonin. Melatonin also affects the regulation of serotonin, which affects mood.
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.
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.