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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.
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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 caring for a female client with mood disorder who is prescribed lithium. What interventions should the nurse perform?
- A. Instruct to resume regular activities.
- B. Administer lithium before meals.
- C. Withhold if serum level is less than 1.5 mEq.
- D. Instruct to avoid becoming pregnant.
Correct Answer: D
Rationale: Lithium crosses the placental barrier; therefore, its use is contraindicated in pregnant women. The client should use caution when resuming activities such as driving as drowsiness is a common side effect of lithium. The nurse should withhold the administration of lithium if the serum level is greater than 1.5 mEq. Lithium should be administered with meals.
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 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 is caring for a client who is receiving valproic acid. What clinical manifestation should the nurse periodically monitor for?
- A. Hepatotoxicity
- B. Hypertensive crisis
- C. Orthostatic hypotension
- D. Hyper alertness
Correct Answer: A
Rationale: The nurse should closely monitor a client on valproic acid, Depakote or Depakene, for hepatotoxicity. Frequent liver function tests and serum ammonia concentrations may be ordered. When a monoamine oxidase inhibitor is mixed with foods containing tyramine, clients are likely to develop a potentially fatal hypertensive crisis, not when taking valproic acid. Risk for orthostatic hypotension from psychotropic drugs is increased in older adults because of decreased functioning of the blood pressure-regulating mechanism. Some clients administered valproic acid experience sedation and ataxia.