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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.
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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.
The nurse is employed in a pediatric mental health clinic. Which statement made by the client is an indication of a clinical effect of selective serotonin reuptake inhibitors (SSRI)?
- A. I have gained 25 lb in the last year.
- B. I feel that I am so sleepy all of the time.
- C. No one cares about me. I just want to die.
- D. I have a difficult time concentrating.
Correct Answer: C
Rationale: In the pediatric client, clinical evidence has stated an ominous link between SSRI use and an increased risk of suicidal thoughts and behavior. Some side effects of medication use include nausea, weight loss, insomnia, nervousness, tremor, and headache.
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.
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.
Which type of therapy is facilitated by a bond that develops between the therapist and the client?
- A. Behavioral therapy
- B. Supportive psychotherapy
- C. Interpersonal psychotherapy
- D. Cognitive therapy
Correct Answer: C
Rationale: Interpersonal psychotherapy is facilitated by a bond that develops between the therapist and the client. Behavioral therapy endeavors to change unhealthy ways of behaving. Supportive psychotherapy helps clients learn about their disorder and treatment techniques, improve or develop new social skills, and gain encouragement to persevere. Cognitive therapy helps clients replace negative, and often illogical, ways of thinking with more positive outlooks.