Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 74-year-old client is diagnosed with COVID and is admitted to an inpatient hospital. Days later, he is more energetic than before his diagnosis. He exhibits flights of ideas, delusions of grandeur, and is ready to leave the hospital because he feels "so incredible." Which of the medications used in the treatment of COVID could have induced mania in this client?
A. Remdesivir
Remdesivir is an antiviral and is not commonly associated with mood disturbances such as mania.
B. Albuterol
Albuterol can cause mild nervousness or tremor but rarely induces full manic episodes.
C. Famotidine
Famotidine is an H2 receptor antagonist and is not associated with mania.
D. Dexamethasone
Dexamethasone is a corticosteroid that can induce psychiatric side effects including mania, agitation, and psychosis, particularly in older adults or those with underlying vulnerabilities.
This question is an excerpt from Nurse Dive's nursing test bank - Mental Health Northern Kentucky University Proctored Exam 6. Take the full exam now
Full Explanation
Choice A reason: Remdesivir is an antiviral and is not commonly associated with mood disturbances such as mania.
Choice B reason: Albuterol can cause mild nervousness or tremor but rarely induces full manic episodes.
Choice C reason: Famotidine is an H2 receptor antagonist and is not associated with mania.
Choice D reason: Dexamethasone is a corticosteroid that can induce psychiatric side effects including mania, agitation, and psychosis, particularly in older adults or those with underlying vulnerabilities.
Similar Questions
A 24-year-old woman presents to the PMHNP for a psychiatric evaluation with a chief complaint of depression. Upon questioning, the client states that during certain periods of time, she has needed little sleep but still felt energetic. She has had "creative spurts” during these periods, during which she has started new projects, such as home decorating and writing a book. Which of the following assessment tools will the PMHNP use to assist in diagnosis?
A. Observer-Rated Scale for Mania
The Observer-Rated Scale for Mania is used by clinicians to assess manic symptoms but is less practical for initial self-reported screening in outpatient settings.
B. Mood Disorders Questionnaire (MDQ)
The Mood Disorders Questionnaire (MDQ) is a self-report screening tool designed to identify symptoms of bipolar disorder, including periods of elevated mood and increased energy, making it appropriate for this patient’s history.
C. Patient Health Questionnaire-9 (PHQ-9)
The PHQ-9 assesses depressive symptoms but does not screen for hypomanic or manic episodes.
D. Young Mania Rating Scale
The Young Mania Rating Scale (YMRS) is used for rating current manic severity but is not a screening tool for past hypomanic or manic episodes.
Full Explanation
Choice A reason: The Observer-Rated Scale for Mania is used by clinicians to assess manic symptoms but is less practical for initial self-reported screening in outpatient settings.
Choice B reason: The Mood Disorders Questionnaire (MDQ) is a self-report screening tool designed to identify symptoms of bipolar disorder, including periods of elevated mood and increased energy, making it appropriate for this patient’s history.
Choice C reason: The PHQ-9 assesses depressive symptoms but does not screen for hypomanic or manic episodes.
Choice D reason: The Young Mania Rating Scale (YMRS) is used for rating current manic severity but is not a screening tool for past hypomanic or manic episodes.
A 37-year-old man presents to the PMHNP based on a referral from his primary care physician, who suspects rapid cycling bipolar I disorder. Which of the following should be ordered to rule out an underlying medical etiology?
A. Dexamethasone suppression test
The dexamethasone suppression test is used primarily to assess for hypercortisolism or Cushing's syndrome, which is less commonly linked to mood cycling.
B. Liver function test
Liver function tests are important for monitoring medication metabolism but are not typically used to identify the etiology of rapid cycling bipolar disorder.
C. CSF 5-HIAA level
CSF 5-HIAA levels can reflect serotonin metabolism but are not standard for evaluating rapid cycling bipolar disorder and are rarely used in clinical practice.
D. Thyroid function tests
Thyroid dysfunction, including hyperthyroidism or hypothyroidism, can present with mood disturbances and contribute to rapid cycling in bipolar disorder; therefore, thyroid function tests are critical to rule out an underlying medical cause.
Full Explanation
Choice A reason: The dexamethasone suppression test is used primarily to assess for hypercortisolism or Cushing's syndrome, which is less commonly linked to mood cycling.
Choice B reason: Liver function tests are important for monitoring medication metabolism but are not typically used to identify the etiology of rapid cycling bipolar disorder.
Choice C reason: CSF 5-HIAA levels can reflect serotonin metabolism but are not standard for evaluating rapid cycling bipolar disorder and are rarely used in clinical practice.
Choice D reason: Thyroid dysfunction, including hyperthyroidism or hypothyroidism, can present with mood disturbances and contribute to rapid cycling in bipolar disorder; therefore, thyroid function tests are critical to rule out an underlying medical cause.
A 51-year-old woman is diagnosed with primary osteoarthritis (OA) of the knee. The NP will educate the woman that which of the following could have contributed to or might worsen her OA?
A. Diabetes mellitus, a congenital abnormality, obesity
Diabetes mellitus is a metabolic disorder and is not a primary contributor to OA; congenital abnormalities alone are less commonly a major factor.
B. Overuse of joints, obesity, diabetes mellitus
While overuse and obesity contribute to OA, diabetes mellitus is not considered a key causal factor.
C. Overuse of joints, obesity, aging
OA risk increases with mechanical stress on joints, cumulative overuse, obesity that increases joint load, and aging-related degeneration of cartilage, making this the most accurate combination of contributing factors.
D. Overuse of joints, obesity, a congenital abnormality
Congenital abnormalities can predispose to OA in some cases, but aging is a far more common contributing factor overall.
Full Explanation
Choice A reason: Diabetes mellitus is a metabolic disorder and is not a primary contributor to OA; congenital abnormalities alone are less commonly a major factor.
Choice B reason: While overuse and obesity contribute to OA, diabetes mellitus is not considered a key causal factor.
Choice C reason: OA risk increases with mechanical stress on joints, cumulative overuse, obesity that increases joint load, and aging-related degeneration of cartilage, making this the most accurate combination of contributing factors.
Choice D reason: Congenital abnormalities can predispose to OA in some cases, but aging is a far more common contributing factor overall.