Nokea
The nurse is monitoring a patient closely for signs and symptoms of Stevens-Johnson syndrome. Which medication is likely the trigger for such a syndrome?
- A. Clonazepam
- B. Risperidone
- C. Lamotrigine
- D. Aripiprazole
Correct Answer: C
Rationale: Lamotrigine is associated with Stevens-Johnson syndrome, a rare but serious dermatological reaction. Other medications listed are not linked to this complication.
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A patient experiencing acute mania waves a newspaper and says, 'I must have my credit card and use the computer right now. A store is having a big sale and I need to order 10 dresses and four pairs of shoes.' What is the nurse's most appropriate intervention?
- A. Suggesting to the patient to ask a friend to do the shopping and bring purchases to the unit
- B. Inviting the patient to sit with the nurse and look at new fashion magazines
- C. Telling the patient that computer use is not allowed until self-control improves
- D. Asking whether the patient has enough money to pay for the purchases
Correct Answer: B
Rationale: Distraction with fashion magazines leverages the patient's distractibility to avoid power struggles and reduce impulsive behavior. Other options may escalate frustration.
A patient diagnosed with bipolar disorder commands other patients, 'Get me a book. Take this stuff out of here,' and other similar demands. What is the best initial approach by the nurse to interrupt this behavior without entering into a power struggle?
- A. Distraction: 'Let's go to the dining room for a snack.'
- B. Humor: 'How much are you paying servants these days?'
- C. Limit setting: 'You must stop ordering other patients around.'
- D. Honest feedback: 'Your controlling behavior is annoying others.'
Correct Answer: A
Rationale: Distraction leverages the patient's distractibility to redirect behavior constructively, avoiding power struggles. Other options may incite anger or seem confrontational.
A patient prescribed lithium telephones the nurse at the clinic to say, 'I've had severe diarrhea 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?' What instructions should the nurse provide?
- A. Restrict oral fluids for 24 hours and stay in bed.'
- B. Have someone bring you to the clinic immediately.'
- C. Drink a large glass of water with 1 teaspoon of salt added.'
- D. Take an over-the-counter antidiarrheal medication hourly until the diarrhea subsides.'
Correct Answer: B
Rationale: Symptoms suggest lithium toxicity, requiring immediate evaluation. Other options may worsen the condition or delay treatment.
The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. What response supported by research should the nurse provide?
- A. A high proportion of patients diagnosed with bipolar disorders are found among creative writers.'
- B. A higher rate of relatives diagnosed with bipolar disorder is found among patients with bipolar disorder.'
- C. Patients diagnosed with bipolar disorder have higher rates of relatives who respond in an exaggerated way to daily stresses.'
- D. More individuals diagnosed with bipolar disorder come from high socioeconomic and educational backgrounds.'
Correct Answer: B
Rationale: Higher incidence of bipolar disorder among relatives supports genetic transmission. Other options do not provide direct evidence for genetic links.
A patient diagnosed with bipolar disorder has rapid cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed?
- A. Phenytoin
- B. Clonidine
- C. Carbamazepine
- D. Chlorpromazine
Correct Answer: C
Rationale: Carbamazepine is effective for rapid-cycling bipolar disorder. Phenytoin and chlorpromazine are not used for mood stabilization, and clonidine is not an anticonvulsant for this purpose.