A nurse is reviewing newly written prescriptions for a client admitted with acute mania due to bipolar I disorder. Which of the following medications should the nurse identify as appropriate for stabilizing the client’s mood during the manic phase?
Valproic acid
Bupropion
Fluoxetine
Alprazolam
The Correct Answer is A
Choice A reason: Valproic acid is a mood stabilizer and anticonvulsant that is highly effective in controlling acute manic episodes in bipolar I disorder. It works by increasing gamma-aminobutyric acid (GABA) activity, which stabilizes neuronal firing and reduces manic symptoms such as hyperactivity, pressured speech, and impulsivity. It is considered a first-line agent for acute mania.
Choice B reason: Bupropion is an antidepressant that primarily affects norepinephrine and dopamine. It is not appropriate for acute mania because antidepressants can exacerbate manic symptoms and destabilize mood in bipolar disorder. Its use is more appropriate in depressive episodes, not manic phases.
Choice C reason: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant. Like bupropion, it can worsen mania if given during the manic phase. Antidepressants are generally avoided in acute mania unless combined with a mood stabilizer, and even then, they are used cautiously.
Choice D reason: Alprazolam is a benzodiazepine used for anxiety disorders. While it may provide short-term sedation, it does not stabilize mood or treat the underlying pathophysiology of mania. It is not considered an appropriate treatment for bipolar mania.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: ECT is not the first-line treatment for depression. Antidepressant medications and psychotherapy are typically tried first.
Choice B reason: ECT is not a permanent cure for depression. It is highly effective but relapse can occur, requiring maintenance therapy.
Choice C reason: ECT is not primarily used for anxiety disorders. It is reserved for severe depression, catatonia, or treatment-resistant cases.
Choice D reason: ECT is particularly effective for patients with treatment-resistant depression, especially when symptoms are severe and life-threatening, such as suicidal ideation and significant weight loss. This makes it the most appropriate reason for choosing ECT in this case.
Correct Answer is ["2"]
Explanation
Step 1 is: Ordered dose = 50 mg.
Step 2 is: Available dose = 25 mg per tablet.
Step 3 is: Required tablets = (50 mg ÷ 25 mg) = 2.
Step 4 is: Result = 2 tablets per dose.
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