Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
Which of the following aspects of bipolar disorder predicts a favorable response to lithium treatment?
A. Rapid cycling
Rapid cycling is associated with a poorer response to lithium, often requiring alternative or adjunctive therapies.
B. Euthymic intervals
Clear euthymic intervals between episodes are associated with classic bipolar disorder, which predicts a favorable response to lithium treatment.
C. Psychotic symptoms
Psychotic symptoms do not reliably predict lithium response; these patients may require additional antipsychotic therapy.
D. Mixed episodes
Mixed episodes often respond less predictably to lithium alone and may need combination therapy.
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: Rapid cycling is associated with a poorer response to lithium, often requiring alternative or adjunctive therapies.
Choice B reason: Clear euthymic intervals between episodes are associated with classic bipolar disorder, which predicts a favorable response to lithium treatment.
Choice C reason: Psychotic symptoms do not reliably predict lithium response; these patients may require additional antipsychotic therapy.
Choice D reason: Mixed episodes often respond less predictably to lithium alone and may need combination therapy.
Similar Questions
A 2-year-old boy presents to the nurse practitioner with new onset seizures and a history of a port-wine stain at birth. Which of the following is not a clinical feature of Sturge-Weber syndrome (SWS)?
A. Sturge-Weber syndrome (SWS) is a rare disorder affecting the skin and nervous system
SWS is indeed a rare neurocutaneous disorder affecting the skin (port-wine stains) and central nervous system, making this a true clinical feature.
B. Symptoms of SWS may include seizures, muscle weakness, and developmental and intellectual disability
Neurologic manifestations, including seizures, hemiparesis, and intellectual disability, are characteristic features of SWS.
C. Treatment may include anti-seizure medications, medications and/or surgery for glaucoma, and low-dose aspirin to reduce the pressure in the eyes and brain
Management often involves anticonvulsants, glaucoma treatment, and sometimes low-dose aspirin to reduce vascular complications, confirming these are accurate features.
D. The prognosis for SWS is usually poor, with an average lifespan of 30 years
The prognosis of SWS varies widely; many patients live well into adulthood, making the statement of an average lifespan of 30 years inaccurate.
Full Explanation
Choice A reason: SWS is indeed a rare neurocutaneous disorder affecting the skin (port-wine stains) and central nervous system, making this a true clinical feature.
Choice B reason: Neurologic manifestations, including seizures, hemiparesis, and intellectual disability, are characteristic features of SWS.
Choice C reason: Management often involves anticonvulsants, glaucoma treatment, and sometimes low-dose aspirin to reduce vascular complications, confirming these are accurate features.
Choice D reason: The prognosis of SWS varies widely; many patients live well into adulthood, making the statement of an average lifespan of 30 years inaccurate.
A 54-year-old Latino man receives a phone call that his mother has had a stroke and is in ICU at his local hospital. Soon after, he begins trembling, then shouting and screaming. The impression is that he is completely out of control. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?
A. Khayal
Khayal is a South Asian culture-bound syndrome associated with anxiety and somatic complaints, not acute episodes of shouting and aggression.
B. Ataque de nervios
Ataque de nervios is a Latino culture-bound syndrome triggered by acute stress or trauma, characterized by shouting, trembling, and emotional outbursts, matching this patient’s presentation.
C. Amok
Amok is a Southeast Asian syndrome involving sudden aggressive outbursts, but it is culturally specific to Malaysia and the Philippines.
D. Dhat
Dhat is a South Asian culture-bound syndrome involving anxiety about semen loss, not acute aggressive episodes.
Full Explanation
Choice A reason: Khayal is a South Asian culture-bound syndrome associated with anxiety and somatic complaints, not acute episodes of shouting and aggression.
Choice B reason: Ataque de nervios is a Latino culture-bound syndrome triggered by acute stress or trauma, characterized by shouting, trembling, and emotional outbursts, matching this patient’s presentation.
Choice C reason: Amok is a Southeast Asian syndrome involving sudden aggressive outbursts, but it is culturally specific to Malaysia and the Philippines.
Choice D reason: Dhat is a South Asian culture-bound syndrome involving anxiety about semen loss, not acute aggressive episodes.
A 52-year-old woman is at her regular medication management appointment with her PMHNP. Her father was recently diagnosed with Alzheimer's disease, and she wants to know what herbal products she can use to prevent memory loss. She tells the PMHNP, "I have heard a lot about ginkgo biloba being good for the brain and memory. What's your opinion?"
A. "Nothing over the counter has ever been proven to work to prevent Alzheimer's disease."
While factually correct, this statement is dismissive and does not validate the patient’s autonomy or concerns.
B. "I understand your concern, and while there is no evidence that ginkgo biloba prevents Alzheimer's disease or dementia, it's certainly your choice to take this product."
This response is accurate and patient-centered, acknowledging the lack of proven benefit while respecting the patient’s choice to use ginkgo biloba.
C. "If it were me, I wouldn't waste my money."
This is a personal opinion rather than an evidence-based, professional response and may seem judgmental.
D. "Don't worry about it; there is a very small chance that you will develop dementia."
This statement minimizes the patient’s concern and may provide false reassurance.
Full Explanation
Choice A reason: While factually correct, this statement is dismissive and does not validate the patient’s autonomy or concerns.
Choice B reason: This response is accurate and patient-centered, acknowledging the lack of proven benefit while respecting the patient’s choice to use ginkgo biloba.
Choice C reason: This is a personal opinion rather than an evidence-based, professional response and may seem judgmental.
Choice D reason: This statement minimizes the patient’s concern and may provide false reassurance.