Nokea
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.
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The nurse is completing a plan of care for a client on lithium therapy to manage bipolar symptoms. Which nursing intervention(s) will be included? Select all that apply.
- A. Monitor for symptoms of nausea, vomiting, muscle weakness, and lack of coordination.
- B. Increase fluid intake to 5000 mL/day.
- C. Limit sodium intake daily.
- D. Monitor kidney and liver functioning.
- E. Instruct client that it may take up to 6 weeks to reach therapeutic level.
- F. Monitor intake and output.
Correct Answer: A,B,D,F
Rationale: The nurse is correct to place in the plan of care interventions that include monitoring for symptoms of lithium toxicity, increasing fluid intake to maintain fluid balance, monitoring kidney and liver function, and monitoring intake and output. Salt intake is important to regulate lithium levels in the body. A therapeutic lithium level is accomplished in a few days to a week.
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 admitting a client to a mental health clinic following a recent suicide attempt and hospitalization. In assessing the client's status, which question is most helpful?
- A. How are you currently feeling?
- B. What made you decide to commit suicide?
- C. Do you have a suicide plan or thoughts of harming yourself?
- D. What method did you choose for your suicide attempt?
Correct Answer: C
Rationale: In assessing the client's status, it is best to evaluate suicide risk factors. A client who is at the highest risk for suicide is the client who verbalizes a desire to end life and has a plan. The other questions are relevant but not the best question for gaining essential information.
The nurse is caring for a middle-aged client prescribed a selective serotonin reuptake inhibitor (SSRI). Which side effect of medication therapy leads to the most common cause of noncompliance?
- A. Hypertension
- B. Dizziness
- C. Hallucinations
- D. Sexual dysfunction
Correct Answer: D
Rationale: When taking a selective serotonin reuptake inhibitor, the nurse must instruct on the most common side effect, which is sexual dysfunction. Unfortunately, sexual dysfunction (reduced desire for sex, erectile and ejaculatory dysfunction, and the inability to orgasm) is a frequent and undesirable side effect that leads to noncompliance in medication regimen. The other side effects are not associated with use of SSRIs.
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.