Assessment of a client reveals severe and sudden mood swings from mania to depression. Which diagnosis should the nurse suspect?

Major depressive disorder

Dysthymic disorder

Personality disorder

Bipolar disorder

Answer and Explanation

The Correct Answer is D

D. Bipolar disorder is characterized by episodes of mania or hypomania (elevated, expansive, or irritable mood, increased energy, racing thoughts) alternating with episodes of depression (sadness, loss of interest, low energy). The mood swings can be severe, and the transition between mood states can occur suddenly.

A. Major depressive disorder is characterized by persistent feelings of sadness and loss of interest or pleasure in activities. It does not involve manic or hypomanic episodes, which are essential for diagnosing bipolar disorder.

B. Dysthymic disorder involves chronic, low-grade depression that lasts for at least two years. It does not typically present with episodes of mania or hypomania.

C. Personality disorders involve enduring patterns of behavior, cognition, and inner experience that deviate markedly from the expectations of the individual's culture. While some personality disorders can present with mood instability, the description of severe and sudden mood swings from mania to depression is not characteristic of personality disorders in general.

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Correct Answer is A

Explanation

A. This response acknowledges the client's feelings of helplessness, which can validate her experience and promote further discussion about her emotions and challenges related to her eating disorder. It shows empathy and encourages the client to explore her feelings.

B. While this question is open-ended and invites the client to explore the underlying reasons for her behavior, it might inadvertently suggest that the client should have insights or control over her behavior that she may not currently possess. It could potentially make the client feel blamed or misunderstood if she cannot provide a clear answer.

C. This response is directive and judgmental, which can lead to the client feeling criticized or defensive. It does not acknowledge the complexity of the client's experience and may not be effective in building rapport or promoting trust between the nurse and client.

D This response acknowledges the client's self-awareness and validates her recognition of the problem, which can be empowering and supportive. It reinforces the positive step the client has taken in acknowledging the issue without placing blame or judgment.

A. Give the client two aspirin tablets and monitor his headache and heart rate B. Notify the physician immediately C. Notify the physician when convenient D. Reassure the client that these are common side effects of his medication

Correct Answer is B

Explanation

B. This is the correct priority action. Serotonin syndrome can be life-threatening if not promptly recognized and treated. The physician needs to be notified immediately so that appropriate actions can be taken to manage the client's symptoms and potentially adjust the medication regimen.

A. Aspirin is not appropriate for treating serotonin syndrome. Monitoring the client's symptoms is important, but this action does not address the potential seriousness of the symptoms described.

C. Delaying notification could lead to worsening of symptoms and potential complications. Given the potential seriousness of serotonin syndrome, waiting until it's convenient is not appropriate.

D. While headache, palpitations, and stiffness could potentially be side effects of antidepressant medication, the combination of these symptoms raises concern for serotonin syndrome, which requires immediate medical attention rather than reassurance alone.

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Assessment of a client reveals severe and sudden mood swings from mania to depression. Which diagnosis should the nurse suspect?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a 20-year-old college student who has a 2-year history of bulimia nervosa. She tells the nurse, "I know my eating binges and vomiting are not normal, but I cannot do anything about them." Which of the following is a therapeutic response by the nurse?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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