A 23-year-old pregnant woman has been referred to the PMHNP by her OB/GYN for management of bipolar disorder. Lithium should be avoided in the first trimester due to which potential teratogenic risk?
Neural tube defects
Ebstein's anomaly
Cleft palate
Floppy baby syndrome
The Correct Answer is B
Choice A reason: Neural tube defects are commonly associated with folate deficiency and medications like valproic acid or carbamazepine, not lithium.
Choice B reason: Ebstein's anomaly is a congenital heart defect involving the tricuspid valve and is the most well-documented teratogenic risk associated with lithium exposure during the first trimester. It is rare but serious, making this the correct answer.
Choice C reason: Cleft palate is associated with various teratogens, including phenytoin and alcohol, but not typically with lithium.
Choice D reason: Floppy baby syndrome refers to hypotonia in infants and is most commonly linked to maternal benzodiazepine use, not lithium.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Person-centered therapy emphasizes unconditional positive regard and self-actualization. While it is supportive and growth-oriented, it does not specifically focus on identifying solutions or future improvements.
Choice B reason: Psychoanalysis explores unconscious conflicts and past experiences. It often involves deep exploration of negative emotions and unresolved issues, rather than a forward-looking, solution-oriented approach.
Choice C reason: Existential therapy addresses philosophical concerns such as meaning, freedom, and isolation. It encourages personal responsibility but does not primarily focus on practical solutions or life improvement strategies.
Choice D reason: Solution-focused therapy emphasizes identifying strengths, resources, and exceptions to problems. It is future-oriented and helps clients envision and work toward a better life, making it the best fit for this question.
Correct Answer is A
Explanation
Choice A reason: The client exhibits traits of both avoidant and dependent personality disorders. Avoidant personality disorder is marked by social inhibition, feelings of inadequacy, and hypersensitivity to criticism. Dependent personality disorder involves excessive reliance on others for decision-making and daily tasks. Her avoidance of social interaction, fear of rejection, and dependence on her husband and mother support this dual diagnosis.
Choice B reason: Borderline personality disorder involves emotional instability, impulsivity, and intense interpersonal relationships. The client does not display mood lability, self-harm, or unstable relationships typical of borderline personality disorder.
Choice C reason: Social anxiety disorder involves intense fear of social situations due to concerns about being judged or embarrassed. While the client has social avoidance, her pervasive dependence and submissiveness suggest a personality disorder rather than an anxiety disorder alone.
Choice D reason: Agoraphobia is the fear of being in situations where escape might be difficult or help unavailable. It typically involves avoidance of public places, not reliance on others for social tasks or submissiveness in relationships.
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