Which of the following symptoms experienced over 1 month would be ...

[ss2343]

Which of the following symptoms experienced over 1 month would be most helpful to diagnose bipolar disorder?
 
  1. Difficulty sleeping, obsession with death, hallucinations
  2. Delusions, unkempt appearance, fatigue
  3. Abnormal eating patterns, feelings of despair, flight of ideas
  4. Increased goal-directed behavior and talkativeness, distractibility

Question 2

The 10-year-old patient is receiving methylphenidate (Ritalin). The patient's mother tells the nurse he just won't sleep while on his medication. What is the best response by the nurse?
 
  1. You can give him a 25 mg diphenhydramine (Benadryl) tablet at bedtime.
  2. Do not give the medication after 4:00 p.m.
  3. Do not give the medication after 6:00 p.m.
  4. This is serious; you should ask the doctor about atomoxetine (Strattera).

[asware1]

Answer to Question 1

Correct Answer: 3
Rationale: Bipolar disorder involves periods of mania and depression. Abnormal eating patterns and feelings of despair are symptoms of depression, whereas flight of ideas is a symptom of mania. Increased goal-directed behavior, talkativeness, and distractibility are symptoms of mania. Difficulty sleeping, obsession with death, hallucinations, delusions, unkempt appearance, and fatigue are symptoms of depression.

Answer to Question 2

Correct Answer: 2
Rationale: Stimulant medications like methylphenidate (Ritalin) will interfere with sleep. To avoid insomnia, it is best to give the last dose prior to 4:00 p.m. Diphenhydramine (Benadryl) is not necessary. The effects of methylphenidate (Ritalin) will wear off by bedtime if it is given prior to 4:00 p.m. 6:00 p.m. is too late for the last dose of methylphenidate (Ritalin). A medication change is premature without first trying to give the medication earlier in the day.

[ss2343]

Excellent

[bassamabas]

TYSM