A patient with rapid cycling bipolar disorder is not responding well to lithium. The patient tells the nurse, 'It feels as though I’ll never get well. I get better, and then I get worse.' The reply that is based on knowledge of current therapy would be:

Correct Answer: C

Rationale: Rationale: Choice C is correct as valproic acid is a commonly used alternative for rapid cycling bipolar disorder resistant to lithium. It is effective in stabilizing mood swings. - Choice A is incorrect as it only acknowledges the patient's feelings without addressing treatment options. - Choice B is incorrect as it minimizes the seriousness of the patient's condition and potential risks of mania. - Choice D is incorrect as it disregards the need for alternative treatment options and assumes lithium will eventually work, which may not be the case for rapid cycling bipolar disorder.

Correct Answer: A

Rationale: Desmond Manderson argues that the portrayal of drugs as having almost demonic powers is prevalent not only in cultural representations of illicit drugs but also in drug legislation. This is because drug laws often criminalize drug use, perpetuating the idea of drugs as inherently evil. Hippie communes focus more on drug use as a means of spiritual exploration rather than demonizing drugs. Kantian philosophy emphasizes rationality and autonomy, not drug portrayal. Catholic theology may view drug use as a sin, but does not necessarily attribute demonic powers to drugs.

Correct Answer: B

Rationale: Step-by-step rationale for answer B: 1. Clozapine can cause agranulocytosis, a serious side effect characterized by a low white blood cell count. 2. The patient's symptoms of sore throat, fever, and tiredness may indicate a potential infection or agranulocytosis. 3. Blood work is necessary to monitor the patient's white blood cell count to rule out agranulocytosis. 4. Keeping the appointment and arranging for blood work allows for timely assessment and appropriate management. Summary of other choices: A: Incorrect. Advising the patient to drink juices and water and rest without further assessment may delay necessary medical intervention. C: Incorrect. Merely acknowledging flu season without taking proactive steps to assess the patient's condition is inadequate. D: Incorrect. Jumping to conclusions about the seriousness of the symptoms without proper evaluation through blood work is premature and may cause unnecessary alarm.

Correct Answer: A

Rationale: The correct answer is A: depression. Hypothyroidism and Parkinson's disease can both lead to symptoms of depression due to their impact on neurotransmitters and hormones. Hypothyroidism can cause fatigue, weight gain, and mood changes, while Parkinson's disease can lead to decreased dopamine levels, affecting mood. Bipolar disorder (B) is not directly associated with these conditions. Schizophrenia (C) is a separate mental health disorder with different symptoms. Posttraumatic stress disorder (D) is more related to experiencing a traumatic event, not specifically linked to hypothyroidism or Parkinson's disease.

Correct Answer: C

Rationale: The correct answer is C: Decreased weight. Orlistat works by inhibiting the absorption of dietary fats in the intestines, leading to reduced calorie intake and ultimately weight loss. This is the intended therapeutic effect of orlistat. A: Increased wakefulness - Orlistat does not affect wakefulness. B: Increased appetite - Orlistat actually helps reduce appetite by promoting a feeling of fullness. D: Decreased hyperactivity - Orlistat does not have any direct impact on hyperactivity.