Question 1

The nurse is caring for a client suspected of having bipolar disorder. Which assessment findings that have occurred over the period of a week support the nurse's suspicion?

Accepted Answer

Abnormal eating patterns, feelings of despair, and flight of ideas are all symptoms of bipolar disorder.

Question 2

A parent of an 8-year-old child prescribed methylphenidate (Ritalin) tells the nurse the child will not eat. Which response should the nurse provide the parent?

Accepted Answer

Methylphenidate is a stimulant medication that can suppress appetite. Administering the medication after meals and encouraging snacks between meals may help the child maintain adequate nutrition while on the medication. Option A may not necessarily be true and should be further evaluated by a healthcare provider. Option C may not be necessary in this situation as appetite usually returns to normal once the medication wears off. Option D may be unnecessary and may not address the immediate concern of the child's poor appetite.

Question 3

A client is to be prescribed an antidepressant. Which question is most important when performing the initial assessment?

Accepted Answer

The most important question when initially assessing a client to be prescribed an antidepressant is if they have had any thoughts about killing themselves. This is essential information to ensure the safety of the client and to determine the appropriate treatment plan. Questions about alcohol consumption and medication allergies are also important but not as crucial as assessing for suicide ideation. Asking about the duration of depression can provide some useful information, but it is not the most important question to ask initially.

Question 4

A client asks the nurse about bipolar disorder. Which response should the nurse provide?

Accepted Answer

Bipolar disorder involves cycles of depression and episodes of hyperactivity or mania. It is separate from unipolar depression and often requires different treatment approaches. AD/HD symptoms and seasonal affective disorder are separate conditions.

Question 5

A client prescribed lithium (Eskalith) asks the nurse why they should continue to use salt. Which response should the nurse provide the client?

Accepted Answer

Lithium levels in the body can be affected by sodium levels due to their similar pathways of renal excretion. A decrease in sodium intake can lead to increased lithium reabsorption by the kidneys, potentially resulting in lithium toxicity. Therefore, maintaining a consistent intake of table salt (sodium chloride) helps prevent fluctuations in lithium levels and reduces the risk of toxicity.

Question 6

Which statement is accurate regarding attention-deficit/hyperactivity disorder (ADHD)?

Accepted Answer

ADHD symptoms can manifest differently by gender, with girls more often exhibiting internalizing symptoms such as anxiety and social withdrawal. Statement A describes bipolar disorder, not ADHD. Statement C is incorrect because ADHD is more commonly diagnosed in boys. Statement D is incorrect as ADHD is typically diagnosed in childhood.

Question 7

The nurse has completed medication education for a client prescribed phenelzine (Nardil). Which statements made by the client indicate an understanding of the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

Phenelzine (Nardil) is a monoamine oxidase inhibitor (MAOI) antidepressant. MAOIs interact with certain foods and beverages, including those containing tyramine, which can cause a hypertensive crisis. Foods high in tyramine include aged cheeses, processed meats, beer, and yeast extracts.

Question 8

Which classification of prescription used to treat depression works by preventing enzymatic destruction of the neurotransmitter norepinephrine?

Accepted Answer

Monoamine oxidase inhibitors (MAOIs) work by inhibiting the action of monoamine oxidase, an enzyme responsible for breaking down neurotransmitters such as norepinephrine. This results in increased levels of norepinephrine and other neurotransmitters in the brain, which can help alleviate symptoms of depression.

Question 9

Which food items should the nurse advise a client taking a monoamine oxidase inhibitor (MAOI) to avoid?

Accepted Answer

MAOIs inhibit the breakdown of tyramine, which can lead to dangerous levels of tyramine in the body. Foods that are high in tyramine should be avoided. Chocolate, wine, and fava beans are all high in tyramine and should be avoided while taking MAOIs.

Question 10

Which classification of prescription is often used as a first-line treatment for depression due to their safety profile?

Accepted Answer

SSRIs are often used as a first-line treatment for depression due to their safety profile. They have a lower risk of side effects than other antidepressants such as TCAs and MAOIs. Beta-adrenergic blockers are not typically used as a first-line treatment for depression.

Question 11

A client tells the nurse they feel depressed during the winter. Which type of depression should the nurse suspect the client is experiencing?

Accepted Answer

Seasonal affective disorder (SAD) is a type of depression that occurs in the fall and winter months, due to reduced daylight and changes in the body's circadian rhythm. Baby blues refers to a temporary mood fluctuation after giving birth, bipolar disorder is characterized by episodes of mania and depression not specific to a particular season, and obsessive-compulsive disorder involves intrusive thoughts and compulsive behaviors that do not necessarily have a seasonal pattern.

Question 12

A client prescribed sertraline (Zoloft) reports to the nurse that he is experiencing delayed ejaculation. Which response should the nurse provide the client?

Accepted Answer

Delayed ejaculation is a known side effect of sertraline, and the healthcare provider may consider changing the prescription to address this issue while still effectively managing the client's depression.

Question 13

Which is the priority outcome for a 6-year-old child that has been prescribed methylphenidate (Ritalin)?

Accepted Answer

The priority outcome for a 6-year-old child that has been prescribed methylphenidate (Ritalin) is to use age-appropriate play with peers. This is because methylphenidate is a stimulant medication that is used to treat attention deficit hyperactivity disorder (ADHD). ADHD is a neurodevelopmental disorder that can cause difficulty paying attention, impulsivity, and hyperactivity. Methylphenidate can help to improve attention and focus, and reduce impulsivity and hyperactivity. This can lead to improved social skills and peer relationships.

Question 14

A parent tells the nurse they are concerned because their child is easily distracted in school, cannot complete assignments on time, and interrupts other children while they are speaking. Which response should the nurse provide the parent?

Accepted Answer

The symptoms described by the parent are consistent with ADHD. The nurse should suggest that the child be tested for this condition. The other options are not appropriate based on the information given.

Question 15

The patient has bipolar disorder and is in a manic phase. The physician prescribes lithium (Eskalith). The client's current lithium level is 0. 4) Which assessment findings should the nurse anticipate?

Accepted Answer

Lithium is commonly used to treat bipolar disorder and stabilize mood. In a client with bipolar disorder who is in a manic phase, lithium helps to reduce mood swings and manic behavior. A lithium level of 0.4 is within the therapeutic range, which means it is likely to be effective in reducing manic symptoms but may also cause side effects such as nausea, tremors, and increased thirst. Therefore, the nurse should anticipate hyperactivity and pressured speech, which are common symptoms of mania that may persist despite treatment with lithium. A return to baseline behavior or signs and symptoms of depression are not expected outcomes at this time, and a decrease in manic behavior would be ideal but cannot be guaranteed with just one lithium level reading.

Question 16

A client is brought to the emergency department suspected of overdosing on imipramine (Tofranil). Which is the nurse's priority assessment?

Accepted Answer

Imipramine is a tricyclic antidepressant that can cause significant cardiac toxicity. The nurse's priority assessment should be to monitor the client's cardiac function, including vital signs, heart rate, rhythm, and ECG. The client may develop ECG changes, such as prolongation of the QRS interval, which can progress to ventricular arrhythmias and cardiac arrest.

Question 17

The nurse has provided education for a patient with depression. Which statement made by the patient indicates an understanding of the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

Statements A and B are correct and demonstrate an understanding of current beliefs about the possible causes of depression. Statement C is incorrect as there are known risk factors and possible causes of depression, although the exact etiology may vary among individuals. Statements D and E are incorrect as they are outdated and unsupported theories about the causes of depression.

Question 18

A client prescribed sertraline (Zoloft) calls the clinic reporting increased moodiness and feeling disconnected from life. Which response should the nurse provide the client?

Accepted Answer

These symptoms can indicate a potential adverse reaction to sertraline and warrant a timely evaluation by a healthcare provider. The nurse should encourage the client to come into the clinic as soon as possible for further assessment and adjustment of the medication regimen, if necessary. It is important to avoid recommending over-the-counter medications or altering the prescribed dose without a provider's guidance.

Question 19

A client taking amitriptyline (Elavil) for 2 weeks tells the nurse the prescription is not working. Which response should the nurse provide the client?

Accepted Answer

Amitriptyline (Elavil) is a tricyclic antidepressant that can take up to 4-6 weeks to see the full therapeutic effect. Therefore, it is best for the nurse to inform the client that it may take several weeks for the prescription to show its effect.

Question 20

The nurse has completed the education for a client prescribed lithium (Eskalith). Which should the nurse anticipate is a priority outcome of the treatment?

Accepted Answer

The answer of The nurse has completed the education for...

Quiz 16: Drugs for Emotional Mood and Behavioral Disorders