A 37-year-old man presents to the PMHNP based on a referral from his primary care physician, who suspects rapid cycling bipolar I disorder. Which of the following should be ordered to rule out an underlying medical etiology?
Dexamethasone suppression test
Liver function test
CSF 5-HIAA level
Thyroid function tests
The Correct Answer is D
Choice A reason: The dexamethasone suppression test is used primarily to assess for hypercortisolism or Cushing's syndrome, which is less commonly linked to mood cycling.
Choice B reason: Liver function tests are important for monitoring medication metabolism but are not typically used to identify the etiology of rapid cycling bipolar disorder.
Choice C reason: CSF 5-HIAA levels can reflect serotonin metabolism but are not standard for evaluating rapid cycling bipolar disorder and are rarely used in clinical practice.
Choice D reason: Thyroid dysfunction, including hyperthyroidism or hypothyroidism, can present with mood disturbances and contribute to rapid cycling in bipolar disorder; therefore, thyroid function tests are critical to rule out an underlying medical cause.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The frontal lobe primarily governs voluntary motor activity, executive functions, and speech production rather than sensory integration for taste or reading.
Choice B reason: The parietal lobe processes sensory input, integrates information for reading and writing, and contributes to gustatory sensation. The postcentral gyrus of the parietal lobe contains the primary somatosensory cortex critical for these functions.
Choice C reason: The occipital lobe is responsible for visual processing and is not involved in taste or language-related sensory functions.
Choice D reason: The temporal lobe is involved in auditory processing, memory, and language comprehension but does not directly process primary sensory input for taste or writing.
Correct Answer is B
Explanation
Choice A reason: GABA deregulation refers to disruptions in inhibitory neurotransmission, which may contribute to bipolar symptoms but does not specifically explain the progressive sensitization seen with repeated episodes.
Choice B reason: Kindling describes the process by which repeated subthreshold stimulation of neurons eventually leads to spontaneous, autonomous activity. In bipolar disorder, initial episodes are triggered by stressors, but later episodes may occur with decreasing external provocation, reflecting the kindling phenomenon.
Choice C reason: Genetic loading refers to inherited susceptibility to bipolar disorder but does not account for the progressive, self-propagating nature of episodes.
Choice D reason: Voltage-gated channel abnormalities may play a role in neuronal excitability but do not specifically describe the phenomenon of progressive autonomy in episode recurrence seen in bipolar disorder.
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