A patient with bipolar disorder has taken lamotrigine (Lamictal) for 3 months with an excellent response. Which complaint from the patient necessitates the nurse’s priority attention?

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) “I have a rash on my chest and abdomen.” This complaint requires the nurse's priority attention because it could indicate a severe adverse reaction known as Stevens-Johnson syndrome, a potentially life-threatening condition associated with lamotrigine use. Option B) “I experience occasional nausea” is not the priority because nausea is a common side effect of many medications and is not typically life-threatening. Option C) “I have a little hand tremor” may be a side effect of lamotrigine, but it is not as urgent as a potential severe skin reaction like Stevens-Johnson syndrome. Option D) “My nose is stuffy” is likely unrelated to lamotrigine use and does not indicate a serious adverse reaction requiring immediate attention. In an educational context, this question highlights the importance of recognizing and prioritizing potential adverse drug reactions, especially those that can be life-threatening. Nurses and healthcare professionals need to be vigilant in monitoring patients for signs of serious side effects and taking prompt action to ensure patient safety.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Benzodiazepines. Benzodiazepines are a class of drugs that act as central nervous system depressants and are commonly used to treat acute anxiety and panic disorders due to their fast-acting anxiolytic properties. In the case of a patient experiencing acute anxiety following an automobile accident, a benzodiazepine like lorazepam or diazepam can help alleviate their symptoms quickly and effectively. Option A) Tricyclic antidepressants are not the best choice in this situation as they are not typically used for acute anxiety due to their slower onset of action compared to benzodiazepines. Option B) Antipsychotic drugs are primarily used to treat conditions like schizophrenia and bipolar disorder, and they are not the first-line treatment for acute anxiety. Option C) Antimanic drugs are used to stabilize mood in conditions like bipolar disorder and are not indicated for acute anxiety management. In an educational context, it is important for healthcare providers to understand the pharmacological properties of different drug classes to make informed decisions regarding patient care. Teaching patients about the appropriate use of medications, such as benzodiazepines for acute anxiety, is crucial to ensure optimal treatment outcomes and patient safety.

Correct Answer: A

Rationale: In 2003 the National Organization of Nurse Practitioner Faculties (NONPF) published a comprehensive set of competencies defining the scope and practice of psychiatric mental health nurse practitioners (PMHNPs). An example of a competency specific to medication prescribing for PMHNPs states that the PMHNP “prescribes psychotropic and related medications based on clinical indicators of a patient’s status, including results of diagnostic and lab tests as appropriate, to treat symptoms of psychiatric disorders and improve functional health status.” Knowledge of pharmacology algorithms or of monotherapeutic symptoms is not applicable since they are not required needs. A knowledge of the doses of all “atypical” psychotropic drugs is too specific to one class of psychotropic medications. Nurses need to know information about all psychotropic medications.

Correct Answer: B

Rationale: In the context of pharmacology, understanding the uses of herbal therapies is crucial for healthcare professionals. Feverfew is commonly used for migraine headaches due to its anti-inflammatory and vasodilatory properties. This herb has been studied for its effectiveness in reducing the frequency and severity of migraines. Option A, muscle aches, is incorrect because feverfew is not specifically indicated for this condition. Option C, leg cramps, is also incorrect as feverfew is not commonly used for this purpose. Option D, incision pain after surgery, is incorrect because feverfew is not typically recommended for postoperative pain management. Educationally, this question highlights the importance of knowing the specific uses of herbal remedies, especially in the context of managing common health conditions. Understanding the evidence-based uses of herbs like feverfew can help nurses and other healthcare providers make informed decisions when discussing complementary therapies with patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Stimulants. The patient's symptoms align with the effects of stimulant drugs like amphetamines or cocaine. These substances typically cause restlessness, hyperactivity, talkativeness, confusion, euphoria, tachycardia, and fever due to their stimulant properties on the central nervous system. Option A) Opioids are unlikely as opioids typically present with symptoms like respiratory depression, pinpoint pupils, sedation, and constipation, which are not consistent with the patient's symptoms. Option B) Alcohol intoxication would manifest with symptoms such as slurred speech, impaired coordination, sedation, and potentially respiratory depression, which do not match the patient's presentation. Option D) Depressants like benzodiazepines or barbiturates would result in symptoms such as sedation, decreased heart rate, respiratory depression, and impaired coordination, which are contradictory to the patient's hyperactive state. Educationally, understanding the distinct effects of different drug classes is crucial for healthcare professionals to accurately assess and manage patients presenting with substance-related symptoms. Recognizing the signs of stimulant intoxication, as in this case, enables appropriate interventions and ensures patient safety.