Question 1

Older adults can be given the lowest dosage of psychotropic drugs because:

Accepted Answer

Older adults have a decreased ability to metabolize and eliminate drugs, which increases their susceptibility to adverse reactions and toxicity. Therefore, they should receive the lowest dose possible to minimize the risk of adverse reactions. The other answer choices do not provide an accurate explanation as to why older adults should receive the lowest dosage of psychotropic drugs.

Question 2

During the assessment of a client with mood disorder, the nurse observes that the client experiences hallucinations and delusions. Which of the following forms of depressive disorders does the client experience?

Accepted Answer

Psychotic depression is a form of major depressive disorder that is characterized by the presence of hallucinations and delusions. Reactive depression is not typically associated with psychosis, and mania is a symptom of bipolar disorder, not a depressive disorder. SAD is a type of depression that is related to changes in seasons, and is not typically associated with psychosis.

Question 3

A client is receiving Lithium therapy for a bipolar disorder. The nurse teaches the client that which of the following medications increase serum lithium levels?

Accepted Answer

Lasix (a diuretic) can increase serum lithium levels by reducing the kidney's ability to excrete lithium, leading to increased levels in the body.

Question 4

Which of the following is an example of subacute symptoms that may be observed in the older adult who may be depressed?

Accepted Answer

Lack of energy is a common subacute symptom of depression in older adults, often manifesting as fatigue or a general sense of being slowed down, which can be less overt than acute symptoms like profound sadness or crying.

Question 5

Which type of therapy is facilitated by a bond that developed between the therapist and the client?

Accepted Answer

The answer of Which type of therapy is facilitated by...

Question 6

Which of the following is a true statement regarding SSRIs?

Accepted Answer

SSRIs generally have milder side effects compared to other classes of antidepressants, making them a popular choice for treating depression.

Question 7

What clinical manifestation should the nurse periodically monitor for while a client is being administered valproic acid?

Accepted Answer

Valproic acid can cause hepatotoxicity, so the nurse should monitor liver function tests periodically to detect any liver damage. The other options are not common side effects of valproic acid.

Question 8

Which neurotransmitter helps explain the psychomotor retardation seen with clients diagnosed with depression?

Accepted Answer

Norepinephrine is a neurotransmitter that is involved in stimulating the brain and body to action. In depression, there is a decrease in norepinephrine activity, which can lead to psychomotor retardation, a slowing down of physical and mental processes.

Question 9

Which antidepressant is highly lethal if taken in an overdose?

Accepted Answer

Imipramine belongs to a class of antidepressants called tricyclic antidepressants (TCAs) and is known to be highly lethal if taken in an overdose. TCAs have a narrow therapeutic window, meaning that the difference between a therapeutic dose and a toxic dose is small, and even slight increases in dosage can lead to severe toxicity. Paroxetine, Fluoxetine, and Sertaline are all selective serotonin reuptake inhibitors (SSRIs) and are generally considered to be much safer in overdose compared to TCAs.

Question 10

A client with major depression is having a disturbed sleep pattern. Which of the following nursing interventions will help the client to get maximum sleep during the night?

Accepted Answer

Keeping the client busy during the day can help promote better sleep at night by reducing daytime napping and increasing the need for rest.

Question 11

Administering an MAOI with food containing tyramine may develop a potentially fatal condition known as:

Accepted Answer

Administering an MAOI with food containing tyramine may develop a potentially fatal condition known as hypertensive crisis, which can lead to severe headache, palpitations, and increased blood pressure. This is due to the inhibition of the enzyme that breaks down tyramine, which can cause the buildup of the compound in the body and lead to an excessive release of norepinephrine, resulting in a hypertensive crisis. Therefore, patients taking MAOIs must avoid foods containing tyramine, such as aged cheeses, cured meats, and alcoholic beverages.

Question 12

During the assessment of a client with major depression, the nurse observes that the client experiences psychomotor agitation. Which of the following manifestations of psychomotor agitation is seen in the client?

Accepted Answer

Distractibility is a manifestation of psychomotor agitation, which refers to excess physical and mental activity that is usually purposeless and unrelated to the environment. The other options listed are manifestations of depression but not specifically related to psychomotor agitation.

Question 13

Which of the following is a true statement regarding Lithium therapy?

Accepted Answer

Lithium has a narrow therapeutic range. It has to be carefully monitored and dosage adjusted based on serum lithium levels to avoid toxicity. A level above 1.5 mmol/L is considered toxic.

Answer: B 
 Oliguria (reduced urine output) is a possible side effect of Lithium therapy. It is important to monitor renal function and electrolyte levels while on Lithium therapy.

Answer: A 
 This statement is false. Lithium can cross the placental barrier and has been associated with several fetal and neonatal complications.

Answer: D 
 This statement is false. Lithium typically takes 1-3 weeks to achieve a therapeutic effect. It is not an immediate response.

Question 14

It is important for a nurse periodically to monitor serum drug levels and leukocyte counts in clients who have been prescribed carbamazepine for depression because of:

Accepted Answer

Carbamazepine can cause leukopenia (a decrease in white blood cells) which can increase the risk for infections. Therefore, monitoring leukocyte counts periodically is important to catch any potential risk for infection early on.

Question 15

A client with bipolar disorder is having a disturbed thought process. Which of the following nursing interventions can help the client to be oriented and accurately perceive circumstances surrounding admission?

Accepted Answer

Reducing distracting stimuli can help the client focus better and become more oriented to their surroundings, which is crucial for someone experiencing a disturbed thought process.

Question 16

Which of the following nursing interventions should a nurse perform when caring for a female client with mood disorder who is prescribed lithium?

Accepted Answer

Lithium can be excreted in breast milk and may pose a risk to the nursing infant, so breastfeeding should be avoided.

Question 17

Why should a nurse reinforce the need for a client to observe dietary and drug restrictions for 2 weeks after stopping administration of a monoamine oxidase inhibitor (MAOI)?

Accepted Answer

Monoamine oxidase inhibitors (MAOIs) can interact with foods and certain medications to cause a hypertensive crisis. Therefore, clients need to follow dietary and drug restrictions for 2 weeks after stopping MAOI therapy to avoid this.

Question 18

Which of the following mood disorders has alternating sad and elated mood, resembling bipolar disorder, but less extreme mood shifts?

Accepted Answer

Cyclothymia is a mood disorder characterized by alternating periods of hypomanic and depressive symptoms, but less extreme than the mood shifts seen in bipolar disorder. Euthymia refers to a balanced or stable mood, dysthymia is a chronic low-grade depression, and psychotic depression involves severe depressive symptoms along with psychosis.

Question 19

Anticonvulsants enhance which neurotransmitter in clients diagnosed with bipolar disorder?

Accepted Answer

Anticonvulsants such as valproate and lamotrigine work by enhancing the inhibitory neurotransmitter GABA in clients diagnosed with bipolar disorder. This helps to stabilize mood and reduce symptoms of mania and depression.

Question 20

Which of the following is an example of a tricyclic antidepressant?

Accepted Answer

Amitriptyline (Elavil) is a tricyclic antidepressant. Ohenelzine (Nardil) is a monoamine oxidase inhibitor, Sertaloine (Zoloft) and Paroxetine (Paxil) are selective serotonin reuptake inhibitors.

Quiz 69: Caring for Clients With Mood Disorders