A client with rapid cycling bipolar disorder is not responding well to lithium. The client tells the nurse, "It feels as though I'll never get well. I get better, then I get worse." The reply that is based on knowledge of current therapy would be:
1. "You're feeling very discouraged aren't you?"
2. "It's not all bad, is it? Sometimes you like being high."
3. "Another drug, valproic acid, is proving effective for rapid cycling."
4. "If your kidneys hold out, the lithium will eventually control the symptoms."
ANS: 3
Valproic acid is a first line agent for the treatment of bipolar disorder. It is particularly effective with rapid cycling. The other options are not responsive to the question stem, which asks for knowledge of current therapy.
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