A 27-year-old woman with bipolar I disorder presents to the PMHNP for her regular medication management appointment. She announces that she is 12 weeks pregnant with her first child. This pregnancy was unplanned, and the patient is worried about her medications causing harm to her unborn fetus. Which statement is true about bipolar disorder and pregnancy?
Divalproex (Depakote) is a safe alternative to lithium (Eskalith).
Lithium (Eskalith) is safe during the first and third trimester.
Carbamazepine (Tegretol) is a safe alternative to lithium (Eskalith).
Clonazepam (Klonopin) does not carry an increased risk of major fetal malformations.
The Correct Answer is D
Choice A reason: Divalproex is associated with a high risk of neural tube defects and other congenital malformations when used during pregnancy, especially in the first trimester. It is not considered a safe alternative.
Choice B reason: Lithium carries a risk of cardiac malformations, particularly Ebstein’s anomaly, when used during the first trimester. Its safety profile is complex and requires careful monitoring, especially during early pregnancy.
Choice C reason: Carbamazepine is also teratogenic and associated with neural tube defects. It is not considered a safe alternative during pregnancy.
Choice D reason: Clonazepam, a benzodiazepine, has not been strongly linked to major fetal malformations. While caution is still advised due to risks of neonatal withdrawal and
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Sublimation is a mature defense mechanism where socially unacceptable impulses are transformed into socially acceptable actions. Jason’s shift from drug use to extreme sports channels his need for stimulation into a constructive outlet, making this a textbook example of sublimation.
Choice B reason: Suppression involves consciously choosing to delay or avoid dealing with distressing thoughts or feelings. Jason is not avoiding his impulses; he is redirecting them, which is more consistent with sublimation.
Choice C reason: Projection involves attributing one’s own unacceptable thoughts or feelings to someone else. Jason is not externalizing blame or emotions onto others, so this does not apply.
Choice D reason: Transference refers to redirecting feelings about significant others onto the therapist. Jason’s statement is about his own coping strategy, not about the therapeutic relationship.
Correct Answer is D
Explanation
Choice A reason: Cognitive behavioral therapy (CBT) focuses on identifying and changing negative thought patterns and behaviors. It is not classified as humanistic and was not developed by Carl Rogers.
Choice B reason: Dialectical behavioral therapy (DBT) is a form of CBT developed by Marsha Linehan, primarily for borderline personality disorder. It incorporates mindfulness and emotion regulation but is not humanistic.
Choice C reason: Rational emotive behavioral therapy (REBT) was developed by Albert Ellis and focuses on challenging irrational beliefs. It is cognitive-behavioral in nature, not humanistic.
Choice D reason: Person-centered therapy, developed by Carl Rogers, is a humanistic approach that emphasizes unconditional positive regard, empathy, and the client's capacity for self-healing. It is the correct answer.
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