A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer™s disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first?

Correct Answer: B

Rationale: The correct answer is B: CT scan. In this scenario, a CT scan is the most appropriate initial diagnostic procedure to differentiate between Alzheimer's disease and multiple infarcts. A CT scan can quickly detect any acute infarcts or hemorrhages in the brain, which are common in multiple infarcts but not in Alzheimer's disease. It can also identify signs of atrophy or structural changes associated with Alzheimer's disease. Skull x-rays (A) are not helpful for diagnosing brain conditions. PET (C) and SPECT (D) scans are more advanced imaging techniques that may be used later in the diagnostic process but are not typically the first-line tests for this situation.

Correct Answer: B

Rationale: The correct answer is B: Dopamine-blocking effects. Restlessness and uncontrollable need to be in motion are symptoms of extrapyramidal side effects caused by dopamine blockade in the brain. Dopamine is a neurotransmitter involved in movement control, and blocking its effects can lead to motor disturbances. Anticholinergic effects (choice A) typically cause dry mouth, blurred vision, and constipation. Endocrine-stimulating effects (choice C) would not directly cause restlessness or the need to be in motion. Ability to stimulate spinal nerves (choice D) is not a common side effect of psychiatric medications and would not explain the symptoms described.

Correct Answer: B

Rationale: The correct answer is B: Mood stabilizers. In bipolar disorder, characterized by manic and depressive episodes, mood stabilizers like lithium or anticonvulsants are essential to manage symptoms like aggressiveness and irritability. Psychostimulants (A) can exacerbate mania, anticholinergics (C) are not indicated for bipolar disorder, and antidepressants (D) can trigger manic episodes. Mood stabilizers help maintain emotional balance and prevent mood swings, making them the most appropriate choice in this scenario.

Correct Answer: C

Rationale: The correct answer is C: imipramine. Imipramine is a tricyclic antidepressant with strong anticholinergic properties, leading to side effects such as dry mouth, constipation, blurred vision, and urinary retention. These side effects are common with medications that block the action of acetylcholine in the body. Lithium (A) is used for mood stabilization in bipolar disorder and does not typically cause anticholinergic side effects. Buspirone (B) is an anxiolytic medication that does not have significant anticholinergic effects. Risperidone (D) is an atypical antipsychotic that may cause some anticholinergic side effects but is not as strongly associated with these effects as imipramine.

Correct Answer: B

Rationale: The correct answer is B. The nurse should develop outcome criteria related to improvement in depression because SSRIs are primarily used to treat depression by increasing the levels of serotonin in the brain. Monitoring improvement in depression is crucial to assess the effectiveness of the medication. Choice A (coherent thought processes) is not specific to SSRIs and may not directly correlate with the medication's therapeutic effects. Choice C (reduced levels of motor activity) is not a common side effect of SSRIs and is not typically monitored as an outcome criterion. Choice D (decreased extrapyramidal symptoms) is irrelevant as SSRIs do not target extrapyramidal symptoms, which are associated with antipsychotic medications.