A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate because he complains that it makes him feel sick. Which of the following medications might be alternatively prescribed for mood stabilization in bipolar disorders?

Correct Answer: B

Rationale: The correct answer is B: Valproic acid (Depakote). Valproic acid is commonly used as a mood stabilizer in bipolar disorder. It helps to control manic episodes and stabilize mood swings. It is effective in treating bipolar disorder and is well tolerated by many patients. It is an appropriate alternative to lithium carbonate for mood stabilization. Explanation for why the other choices are incorrect: A: Sertraline (Zoloft) is an antidepressant and not typically used as a primary treatment for bipolar disorder. C: Trazodone (Desyrel) is primarily used as an antidepressant and not as a mood stabilizer for bipolar disorder. D: Paroxetine (Paxil) is an antidepressant and is not indicated for mood stabilization in bipolar disorder. In summary, Valproic acid (Depakote) is the most appropriate alternative medication for mood stabilization in bipolar disorder compared to the other choices provided.

Correct Answer: B

Rationale: The correct answer is B because abruptly stopping a beta blocker can lead to rebound hypertension, angina, or arrhythmias due to sudden withdrawal of the medication. Tapering down the dose gradually allows the body to adjust and reduces the risk of adverse effects. Choice A is incorrect because abruptly stopping a beta blocker can be harmful. Choice C is incorrect as it suggests maintaining the dose while taking another antianginal medication, which may not be necessary. Choice D is incorrect as halving the dose without proper guidance can lead to inadequate therapeutic effect or withdrawal symptoms.

Correct Answer: A

Rationale: The correct answer is A: Reduced anxiety. GABA is an inhibitory neurotransmitter in the brain that helps reduce neuronal excitability. By potentiating its action, the medication would enhance its calming effect, resulting in reduced anxiety. Choice B (Enhanced memory) is incorrect as GABA primarily affects anxiety and not memory. Choice C (Disorganized thinking) is incorrect as GABA's role is not related to cognitive processes. Choice D (Sensory perceptual alterations) is incorrect as GABA modulation does not typically lead to changes in sensory perception.

Correct Answer: A

Rationale: The correct answer is A because it provides the patient with appropriate education on how to manage the dizziness related to orthostatic hypotension, a common side effect of antidepressants. Changing positions slowly and dangling feet can prevent sudden drops in blood pressure upon standing. Choice B is incorrect as stopping driving may not be necessary, and napping may not directly address the dizziness. Choice C is incorrect as it dismisses the patient's symptoms and does not provide practical advice on managing the dizziness. Choice D is incorrect as abruptly stopping the medication without consulting the doctor can be dangerous and does not address the underlying issue of orthostatic hypotension.

Correct Answer: D

Rationale: The correct answer is D: Nonopioid analgesic, such as indomethacin (Indocin). Given the ankle injury, nonopioid analgesics like indomethacin are appropriate for managing pain as they target inflammation and reduce pain without the risk of opioid-related side effects. Synthetic opioids (A) and opium alkaloids (B) are not typically indicated for mild to moderate pain like an ankle twist. Opioid antagonists (C) like naloxone are used to reverse opioid overdose, not for pain relief. In this case, the nonopioid analgesic is the most suitable choice for managing the player's pain effectively.