A client with bipolar disorder, having experienced a depressive episode, is prescribed lamotrigine (Lamictal). After educating the client on this medication, the nurse determines that the education was successful when the client makes which statement?

I need to have my blood tested about once a month.

This drug can affect my liver function.

I need to notify my provider if I develop a skin rash.

I have to watch how much salt I use every day.

Answer and Explanation

The Correct Answer is C

Choice A reason: Lamotrigine does not require monthly blood tests, as it has minimal hematologic or hepatic toxicity. It stabilizes mood via sodium channel inhibition, with skin rash (e.g., Stevens-Johnson syndrome) being the primary concern, not routine blood monitoring.

Choice B reason: Lamotrigine rarely affects liver function, unlike valproic acid. Its primary risk is cutaneous reactions due to immune-mediated hypersensitivity, not hepatotoxicity. Monitoring focuses on skin, not liver enzymes, as it modulates neuronal excitability without significant hepatic metabolism.

Choice C reason: Lamotrigine carries a risk of serious skin rashes, like Stevens-Johnson syndrome, due to immune-mediated hypersensitivity affecting epidermal cells. Notifying the provider about rashes is critical, as this reflects understanding of the drug’s most significant adverse effect, ensuring timely intervention.

Choice D reason: Salt intake is relevant for lithium, not lamotrigine, which stabilizes mood via sodium channel inhibition without affecting renal sodium handling. Dietary salt monitoring is unnecessary, as lamotrigine’s primary risk is dermatologic, not electrolyte-related, making this statement incorrect.

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Correct Answer is C

Explanation

Choice A reason: Claims by others are not a diagnostic criterion for major depressive disorder. Diagnosis relies on objective symptoms like anhedonia or appetite changes, driven by serotonin and dopamine dysregulation in the amygdala and prefrontal cortex, not subjective external observations.

Choice B reason: Unwise decisions are not a specific symptom of major depressive disorder. Impaired decision-making may occur due to prefrontal cortex dysfunction, but diagnostic criteria focus on mood, appetite, or sleep changes, reflecting serotonin and norepinephrine imbalances.

Choice C reason: A significant decrease in appetite is a core diagnostic symptom of major depressive disorder, linked to serotonin dysregulation affecting hypothalamic appetite regulation and amygdala-driven emotional distress, contributing to reduced food intake and weight loss in affected individuals.

Choice D reason: Sadness after a break-up is a normal emotional response, not a diagnostic criterion for major depressive disorder. Diagnosis requires pervasive symptoms like appetite loss or anhedonia, driven by sustained serotonin and dopamine imbalances, not situational sadness.

A. Cerebral atrophy of brain tissue. B. Organic functional changes in the brain. C. An inadequate amount of dopamine. D. Increased amount of dopamine.

Correct Answer is D

Explanation

Choice A reason: Cerebral atrophy is associated with neurodegenerative diseases, not schizophrenia’s positive symptoms. Hallucinations and delusions stem from dopamine hyperactivity in the mesolimbic pathway, not structural brain loss, making atrophy irrelevant to the acute psychotic symptoms described.

Choice B reason: Organic functional changes are vague and not specific to schizophrenia’s positive symptoms. Dopamine excess in the mesolimbic pathway drives hallucinations and delusions, not unspecified functional changes, making this choice too broad and inaccurate for the mechanism.

Choice C reason: Inadequate dopamine is linked to negative symptoms like apathy, due to prefrontal cortex hypofunction. Positive symptoms like hallucinations result from excessive dopamine in the mesolimbic pathway, making low dopamine an incorrect mechanism for these symptoms.

Choice D reason: Positive symptoms like hallucinations and delusions in schizophrenia result from increased dopamine in the mesolimbic pathway, causing hyperactive neural signaling. This dopamine excess overstimulates D2 receptors, leading to psychotic perceptions and beliefs, accurately explaining the neurological dysfunction.

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A client with bipolar disorder, having experienced a depressive episode, is prescribed lamotrigine (Lamictal). After educating the client on this medication, the nurse determines that the education was successful when the client makes which statement?

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Naxlex Comprehensive Predictor Exams

A client has been diagnosed with major depressive disorder. One clinical symptom of this diagnosis is what?

Correct Answer is C

Explanation

Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?

Correct Answer is D

Explanation

A client with schizophrenia is being treated with olanzapine (Zyprexa) 10 mg daily. The client asks the nurse how this medicine minimizes hallucinations. The nurse explains that the mechanism by which olanzapine controls the client's psychotic symptoms is believed to be what?

Which finding indicates the successful completion of an individual’s grieving process?

A client with bipolar disorder is prescribed valproic acid (Depakote) as part of the treatment plan. Before administering the medication, which test should be done?

As part of the stress response, the HPA axis is stimulated. Which structures make up this system?

A troubled adolescent pulled out a gun in a school cafeteria, fatally shot three people, and injured many others. Hundreds of parents come to the school after hearing news reports. After police arrest the shooter, which action should occur next?

A victim of intimate partner violence comes to the crisis center seeking help. The nurse uses crisis intervention strategies that focus on what?

The nurse preparing to teach a patient diagnosed with post-traumatic stress disorder (PTSD) about recommended psychotherapy and psychopharmacology will discuss:

The experience of trauma causes neurochemical changes in the brain that play a role in encoding fear memories that are implicated in Post Traumatic Stress Disorder. The nurse identifies the involvement of which neurotransmitters?