Ch 14) Bipolar disorders
A nurse is planning care for a client who has bipolar disorder and is experiencing a manic episode. Which of the following interventions should the nurse include in the plan of care? Select all that apply.
provide flexible client Behavior expectations
offer concise explanations
establish consistent limits
disregard clients concerns
use a firm approach with communication
offer concise explanations
A nurse is teaching a client who has a new prescription for alprazolam for generalized anxiety disorder. Which of the following information should the nurse provide?
Three to six weeks of tx is required to achieve therapeutic benefit
Combining alcohol with alprazolam will produce a paradoxical response.
Alprazolam has a lower risk for dependence than other anti anxiety meds.
Report confusion as potential indication of toxicity.
Report confusion as potential indication of toxicity.
A nurse is providing teaching to a client who has a new prescription for amitriptyline. Which of the following statements by the client indicates an understanding of the teaching?
“I can expect to experience diarrhea while taking this medication.”
“I may feel drowsy for a few weeks after starting this medication.”
“I cannot eat my favorite pizza with pepperoni while taking this medication.”
“This medication will help me lose the weight that I have gained over the last year.”
“I may feel drowsy for a few weeks after starting this medication.”
A nurse is collecting an admission history for a client who has acute stress disorder. which of the following clients Behavior should the nurse expect
the clan members many details about the traumatic incident
the client expresses heightened Elation about what is happening
the client members first noticing manifestations of the disorder six weeks after the traumatic incident occurred
The client expresses a Sense of unreality about the traumatic incident
Answer: The client expresses a Sense of unreality about the traumatic incident
Increasing GABA causes? Decrease in GABA causes
increase= depression
decrease= Anxiety, insomnia, tremors, seizures, schizophrenia
A nurse is teaching a newly-licensed nurse about the use of electroconvulsive therapy (ECT) for the treatment of bipolar disorder. Which of the following statements by the newly-licensed nurse indicates understanding?
ECT is the recommended initial treatment for bipolar disorder
ECT is contraindicated for client who have suicidal ideation
ECT is effective for clients who are experiencing severe Mania
ECT is prescribed to prevent relapse of bipolar disorder
ECT is effective for clients who are experiencing severe Mania
A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity. Which of the following actions is the nurse’s priority?
Administer flumazenil.
Identify the client’s level of orientation.
Infuse IV fluids.
Prepare the client for gastric lavage.
Identify the client’s level of orientation
A nurse is reviewing the medical record of a client who has a new prescription for bupropion for depression. Which of the following findings is the priority for the nurse to report to the provider?
The client has a family history of seasonal pattern depression.
The client currently smokes 1.5 packs of cigarettes per day.
The client had a motor vehicle crash last year and sustained a head injury.
The client has a BMI of 25 and has gained 10 lb over the last year.
The client had a motor vehicle crash last year and sustained a head injury.
A nurse is caring for a client who has derealization disorder. which of the following findings should the nurse identify as an indication of derealization?
The client describes a feeling of floating above the ground
The client has suspicions of being targeted in order to be killed and robbed
The client states that the furniture in the room seems to be small and far away.
The client cannot recall anything that happened during the past 2 weeks.
Answer: The client states that the furniture in the room seems to be small and far away.
Decrease in serotonin, NE, and dopamine causes…?
increase in serotonin, NE, and dopamine causes…?
decrease= DEPRESSION
increase= mania, anxiety, schizophrenia
A nurse is caring for a client who has bipolar disorder. Which of the following is the priority nursing action?
Set consistent limits for expected client behavior
Administer prescribed medication as scheduled
provide the client with step-by-step instructions during hygiene activities
Monitor the client for escalating behavior
Monitor the client for escalating behavior
A nurse is caring for a client who is to begin taking fluoxetine for treatment of panic disorder. Which of the following statements indicated the client understands the use of this medication?
“I will take the medication at bedtime.”
“I will follow a low-sodium diet while taking this medication.”
“I will need to discontinue this medication slowly.”
I will be at risk for weight loss with long-term use of this medication.”
“I will need to discontinue this medication slowly.”
A charge nurse is discussing mirtazapine with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicated understanding?
“This medication increases the release of serotonin and norepinephrine.”
“I should tell the client about the likelihood of insomnia while taking this medication.”
This medication is contraindicated for clients who have an eating disorder.”
“Sexual dysfunction is a common adverse effect of this medication.
“This medication increases the release of serotonin and norepinephrine.”
A nurse in An acute mental facility is planning care for a client who has dissociative fugue. Which of the following interventions would the nurse add to the care plan?
Teach the client to recognize how stress brings on a personality change in the client
Repeatedly present the client with information about past events
make decisions for the client regarding routine daily activities
work with the client setting on grounding techniques
work with the client on setting grounding techniques
Increase levels of glutamate and aspartate cause what?
A nurse is caring for a client who has bipolar disorder. the client states, “ I am very rich and I feel I must give my money to you.” which of the following responses should the nurse make
Why do you think you feel the need to give money away
I am here to provide care and cannot accept this from you
I can request that your case manager discuss appropriate charity options with you
you should know that giving away your money is inappropriate
I am here to provide care and cannot accept this from you
A nurse is caring for a client who takes paroxetine to treat post traumatic stress disorder. The client states, “I grind my teeth during the night, which causes pain in my mouth.” The nurse should identify which of the following interventions as possible measures to manage the client’s bruxism? (Select all that apply.)
Concurrent administration of buspirone.
Administration of a different SSRI.
Use of a mouth guard.
Changing to a different class of antianxiety medication
Increasing the dose of paroxetine.
Concurrent administration of buspirone.
A nurse is teaching a client who has a new prescription for imipramine how to minimize anticholinergic effects. Which of the following instructions would the nurse include in the teaching? (Select all that apply.)
Void just before taking the medication.
Increase dietary intake of potassium.
Wear sunglasses when outside.
Change position slowly when getting up.
Chew sugarless gum.
Void just before taking the medication.
Wear sunglasses when outside.
A nurse is involved in a serious prolong mass casualty incident in an emergency department. Which of the following strategies should the nurse use to help prevent developing a trauma related disorder
avoid thinking about the incident so it is over
take breaks during the incident with food and water
debrief with others following the incident
avoid displays of emotion in the days following the incident
take advantage of offer counseling
Answer:
take breaks during the incident with food and water
debrief with others following the incident
take advantage of offer counseling
Increase in acetylcholine and decrease causes…
increase= depression
decrease=alzheimer's (memory deficit)
A nurse is discussing relapse prevention with a client who has bipolar disorder. Which of the following information should the nurse include in the teaching? Select all that apply.
Use caffeine in moderation to prevent relapse
difficulty sleeping can indicate a relapse
begin taking your medication as soon as a relapse begins
participating in psychotherapy can help prevent a relapse
anhedonia is a clinical manifestation of depressive relapse
difficulty sleeping can indicate a relapse
participating in psychotherapy can help prevent a relapse
anhedonia is a clinical manifestation of depressive relapse
A nurse is assessing a client 4 hr after receiving an initial dose of fluoxetine. Which of the following findings should the nurse report to the provider as indications of serotonin syndrome? (Select all that apply.)
Hypothermia
Hallucinations
Muscular flaccidity
Diaphoresis
Agitation
Hallucinations
Diaphoresis
Agitation
A nurse is caring for a client who is taking phenelzine. For which of the following manifestations would the nurse monitor as an adverse effect of this medication? (Select all that apply.)
Elevated blood glucose level
Orthostatic hypotension
Priapism
Hypomania
Bruxism
Orthostatic hypotension
Hypomania
A nurse working on a acute medical health unit is caring for a patient Who has post-traumatic stress disorder. which of the following findings should the nurse expect? ( select all that apply)
difficulty concentrating on tasks
obsessive need to talk about traumatic event
negative self-image
reoccurring nightmares
diminished reflexes
Answer: Difficulty concentrating on tasks, negative self-image, and reoccurring nightmares
Monoamine oxidase inhibitors avoid certain foods and drugs because… and which food do you avoid?
Trigger HYPRETENSIVE CRISIS,
Wine, chocolate, cheese salami, coffee, yeast