The nurse is caring for a patient diagnosed with Bipolar I who tells the nurse that frequent admissions for severe mania have adversely impacted their children and family. The nurse feels consumed with worry, concern, and has intrusive thoughts about the patient's family and their situation. The nurse recognizes that she is experiencing:

Choice A reason: Bupropion is an atypical antidepressant, inhibiting dopamine and norepinephrine reuptake, enhancing prefrontal cortex and reward system activity. Unlike SSRIs or MAOIs, it minimally affects serotonin, targeting catecholamines to improve mood and energy, aligning with its unique mechanism in treating depression.

Choice B reason: Tricyclic antidepressants block serotonin and norepinephrine reuptake and have anticholinergic effects, unlike bupropion, which targets dopamine and norepinephrine without significant anticholinergic activity. This distinct pharmacological profile excludes bupropion from the tricyclic class, making this choice incorrect.

Choice C reason: Selective serotonin reuptake inhibitors like fluoxetine target serotonin exclusively, increasing 5-HT levels. Bupropion primarily inhibits dopamine and norepinephrine reuptake, with minimal serotonin effects, making it an atypical antidepressant, not an SSRI, due to its distinct neurochemical action.

Choice D reason: Monoamine oxidase inhibitors like phenelzine prevent monoamine breakdown, increasing serotonin, dopamine, and norepinephrine. Bupropion’s selective reuptake inhibition of dopamine and norepinephrine, without MAO inhibition, distinguishes it as an atypical antidepressant, not an MAOI, due to its specific mechanism.

Choice A reason: Marriage counseling addresses situational crises like divorce, not maturational crises, which involve developmental transitions. It targets interpersonal conflict, not the normative stress of life stages, missing the neuroadaptive challenges of maturational growth like childbirth.

Choice B reason: Recognizing relapse symptoms is relevant for chronic mental illness, not maturational crises. Relapse involves dopamine or serotonin dysregulation, not the normative developmental stress of life transitions, making this intervention unrelated to maturational coping needs.

Choice C reason: Selecting a group home addresses a situational crisis for a troubled teen, not a maturational one. Maturational crises involve normative developmental stages, like childbirth, requiring anticipatory guidance, not reactive interventions for behavioral issues.

Choice D reason: Childbirth classes prepare couples for the maturational crisis of parenthood, a normative life transition. They reduce stress by enhancing prefrontal cortex-mediated coping skills and serotonin-driven emotional regulation, supporting adaptation to developmental changes, making this the best intervention.