A patient is admitted with bipolar affective disorder. The nurse acknowledges which medication as one used to treat this disorder for some patients in place of lithium?

Correct Answer: D

Rationale: The correct answer is D: Divalproex. Divalproex, also known as valproic acid, is commonly used to treat bipolar affective disorder as a mood stabilizer. It helps control manic episodes and prevent future episodes. Thiopental (A) is a short-acting barbiturate used for anesthesia, not bipolar disorder. Ginkgo biloba (B) is an herbal supplement with no proven efficacy in treating bipolar disorder. Fluvoxamine (C) is an antidepressant used for treating depression, not specifically for bipolar disorder. In summary, divalproex is the correct choice due to its established effectiveness in managing bipolar symptoms, while the other options lack evidence or are not indicated for this condition.

Correct Answer: A

Rationale: The correct answer is A: Paroxetine. Paroxetine is a selective serotonin reuptake inhibitor (SSRI) that works by increasing serotonin levels in the brain. It is commonly used to treat depression, anxiety disorders, and other conditions. Amitriptyline (B) is a tricyclic antidepressant, not an SSRI. Divalproex sodium (C) is an anticonvulsant used for epilepsy and bipolar disorder, not an SSRI. Bupropion hydrochloride (D) is an atypical antidepressant that works on dopamine and norepinephrine, not serotonin. Therefore, the correct choice is A as it is the only SSRI in the options provided.

Correct Answer: B

Rationale: The correct answer is B: Instruct the patient to avoid beer and cheddar cheese. Tranylcypromine sulfate is a monoamine oxidase inhibitor (MAOI), and consuming foods high in tyramine, such as beer and cheddar cheese, can lead to a hypertensive crisis due to the interaction with MAOIs. It is crucial for the nurse to advise the patient to avoid these foods to prevent serious complications. Incorrect choices: A: Warn the patient about severe hypotension - This is incorrect because MAOIs are known to cause hypertensive crises, not hypotension. C: Encourage the patient to take ginseng and ephedra - This is incorrect because ginseng and ephedra can interact with MAOIs and lead to an increased risk of hypertensive crisis. D: Encourage the patient to eat fruit such as bananas - This is incorrect because while a healthy diet is important, there is no specific indication for bananas

Correct Answer: D

Rationale: The correct answer is D because concurrent use of NSAIDs can increase lithium levels by reducing its renal clearance. This is due to NSAIDs inhibiting the renal excretion of lithium, leading to potential lithium toxicity. Option A is incorrect as the maximum dose of lithium is typically around 2.4 g/day. Option B is also incorrect as the therapeutic range for lithium is usually between 0.6 to 1.2 mEq/L for acute mania and 0.6 to 1.0 mEq/L for maintenance therapy. Option C is incorrect because lithium is known to inhibit the release of neurotransmitters, including gamma-aminobutyric acid, rather than increasing receptor sensitivity.

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Antidepressants can initially worsen suicidal thoughts in some patients. 2. Monitoring for suicidal tendencies allows early intervention. 3. Suicide risk assessment is essential during antidepressant therapy. 4. Prompt identification of suicidal ideation can prevent self-harm. Summary: - B: Orthostatic hypotension is a common side effect but not directly related to monitoring antidepressant therapy. - C: Taking the drug with food is for gastrointestinal distress, not specific to antidepressant monitoring. - D: Information about drug effectiveness does not address the critical need to monitor for suicidal tendencies.