Question 1

A patient experiencing acute mania has disrobed in the hall three times in 2 hours. The nurse should:

Accepted Answer

A)  direct the patient to wear clothes at all times. 
B)  ask if the patient finds clothes bothersome. 
C)  tell the patient that others feel embarrassed. 
D)  arrange for one-on-one supervision. 
A)  direct the patient to wear clothes at all times. 
B)  ask if the patient finds clothes bothersome. 
C)  tell the patient that others feel embarrassed. 
D)  arrange for one-on-one supervision.

Question 2

A patient diagnosed with bipolar disorder is being treated as an outpatient during a hypomanic episode. Which suggestions should the nurse provide to the family? (Select all that apply.)

Accepted Answer

A)  Provide structure 
B)  Limit credit card access 
C)  Encourage group social interaction 
D)  Limit work to half days 
E)  Monitor the patient's sleep patterns 
A)  Provide structure 
B)  Limit credit card access 
C)  Encourage group social interaction 
D)  Limit work to half days 
E)  Monitor the patient's sleep patterns

Question 3

A patient experiencing acute mania has exhausted the staff members by noon. The patient has joked, manipulated, insulted, and fought all morning. Staff members are feeling defensive and fatigued. Which is the best action?

Accepted Answer

A)  Confer with the health care provider regarding use of seclusion for this patient. 
B)  Hold a staff meeting to discuss consistency and limit setting approaches. 
C)  Conduct a meeting with all patients to discuss the behavior. 
D)  Explain to the patient that the behavior is unacceptable. 
A)  Confer with the health care provider regarding use of seclusion for this patient. 
B)  Hold a staff meeting to discuss consistency and limit setting approaches. 
C)  Conduct a meeting with all patients to discuss the behavior. 
D)  Explain to the patient that the behavior is unacceptable.

Question 4

A patient diagnosed with bipolar disorder and who takes lithium telephones the nurse at the clinic to say, "I've had severe diarrhea 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" The nurse should advise the patient:

Accepted Answer

A)  "Restrict oral fluids for 24 hours and stay in bed." 
B)  "Have someone bring you to the clinic immediately." 
C)  "Drink a large glass of water with 1 teaspoon of salt added." 
D)  "Take an over-the-counter antidiarrheal medication hourly until the diarrhea subsides." 
A)  "Restrict oral fluids for 24 hours and stay in bed." 
B)  "Have someone bring you to the clinic immediately." 
C)  "Drink a large glass of water with 1 teaspoon of salt added." 
D)  "Take an over-the-counter antidiarrheal medication hourly until the diarrhea subsides."

Question 5

Which dinner menu is best suited for the patient diagnosed with bipolar disorder experiencing acute mania?

Accepted Answer

A)  Spaghetti and meatballs, salad, a banana 
B)  Beef and vegetable stew, a roll, chocolate pudding 
C)  Broiled chicken breast on a roll, an ear of corn, apple 
D)  Chicken casserole, green beans, flavored gelatin with whipped cream 
A)  Spaghetti and meatballs, salad, a banana 
B)  Beef and vegetable stew, a roll, chocolate pudding 
C)  Broiled chicken breast on a roll, an ear of corn, apple 
D)  Chicken casserole, green beans, flavored gelatin with whipped cream

Question 6

A nurse receives this laboratory result for a patient diagnosed with bipolar disorder: lithium level 1 mEq/L. This result is:

Accepted Answer

A)  within therapeutic limits. 
B)  below therapeutic limits. 
C)  above therapeutic limits. 
D)  likely to be inaccurate. 
A)  within therapeutic limits. 
B)  below therapeutic limits. 
C)  above therapeutic limits. 
D)  likely to be inaccurate.

Question 7

A patient diagnosed with bipolar disorder is in the maintenance phase of treatment. The patient asks, "Do I have to keep taking this lithium even though my mood is stable now?" Select the nurse's most appropriate response.

Accepted Answer

A)  "You will be able to stop the medication in approximately 1 month." 
B)  "Taking the medication every day helps prevent relapses and recurrences." 
C)  "Usually patients take this medication for approximately 6 months after discharge." 
D)  "It's unusual that the health care provider has not already stopped your medication." 
A)  "You will be able to stop the medication in approximately 1 month." 
B)  "Taking the medication every day helps prevent relapses and recurrences." 
C)  "Usually patients take this medication for approximately 6 months after discharge." 
D)  "It's unusual that the health care provider has not already stopped your medication."

Question 8

After hospital discharge, what is the priority intervention for a patient diagnosed with bipolar disorder who is taking antimanic medication, as well as for the patient's family?

Accepted Answer

A)  Decreasing physical activity 
B)  Increasing food and fluids 
C)  Meeting self-care needs 
D)  Psychoeducation 
A)  Decreasing physical activity 
B)  Increasing food and fluids 
C)  Meeting self-care needs 
D)  Psychoeducation

Question 9

Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), and gabapentin (Neurontin). Which drug also belongs to this group?

Accepted Answer

A)  Clonazepam (Klonopin) 
B)  Risperidone (Risperdal) 
C)  Lamotrigine (Lamictal) 
D)  Aripiprazole (Abilify) 
A)  Clonazepam (Klonopin) 
B)  Risperidone (Risperdal) 
C)  Lamotrigine (Lamictal) 
D)  Aripiprazole (Abilify)

Question 10

Outcome identification for the treatment plan of a patient with grandiose thinking associated with acute mania focuses on:

Accepted Answer

A)  maintaining an interest in the environment. 
B)  developing an optimistic outlook. 
C)  self-control of distorted thinking. 
D)  stabilizing the sleep pattern. 
A)  maintaining an interest in the environment. 
B)  developing an optimistic outlook. 
C)  self-control of distorted thinking. 
D)  stabilizing the sleep pattern.

Question 11

A patient experiencing acute mania waves a newspaper and says, "I must have my credit card and use the computer right now. A store is having a big sale and I need to order 10 dresses and four pairs of shoes." Select the nurse's most appropriate intervention.

Accepted Answer

A)  Suggest to the patient to ask a friend do the shopping and bring purchases to the unit. 
B)  Invite the patient to sit with the nurse and look at new fashion magazines. 
C)  Tell the patient that computer use is not allowed until self-control improves. 
D)  Ask whether the patient has enough money to pay for the purchases. 
A)  Suggest to the patient to ask a friend do the shopping and bring purchases to the unit. 
B)  Invite the patient to sit with the nurse and look at new fashion magazines. 
C)  Tell the patient that computer use is not allowed until self-control improves. 
D)  Ask whether the patient has enough money to pay for the purchases.

Question 12

When a hyperactive patient experiencing acute mania is hospitalized, what initial nursing intervention is a priority?

Accepted Answer

A)  Allow the patient to act out his or her feelings. 
B)  Set limits on the patient's behavior as necessary. 
C)  Provide verbal instructions to the patient to remain calm. 
D)  Restrain the patient to reduce hyperactivity and aggression. 
A)  Allow the patient to act out his or her feelings. 
B)  Set limits on the patient's behavior as necessary. 
C)  Provide verbal instructions to the patient to remain calm. 
D)  Restrain the patient to reduce hyperactivity and aggression.

Question 13

The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. Select the nurse's best response.

Accepted Answer

A)  "A high proportion of patients diagnosed with bipolar disorders are found among creative writers." 
B)  "A higher rate of relatives diagnosed with bipolar disorder is found among patients with bipolar disorder." 
C)  "Patients diagnosed with bipolar disorder have higher rates of relatives who respond in an exaggerated way to daily stresses." 
D)  "More individuals diagnosed with bipolar disorder come from high socioeconomic and educational backgrounds." 
A)  "A high proportion of patients diagnosed with bipolar disorders are found among creative writers." 
B)  "A higher rate of relatives diagnosed with bipolar disorder is found among patients with bipolar disorder." 
C)  "Patients diagnosed with bipolar disorder have higher rates of relatives who respond in an exaggerated way to daily stresses." 
D)  "More individuals diagnosed with bipolar disorder come from high socioeconomic and educational backgrounds."

Question 14

A patient diagnosed with bipolar disorder is hyperactive and manic after discontinuing lithium. The patient threatens to hit another patient. Which comment by the nurse is appropriate?

Accepted Answer

A)  "Stop that! No one did anything to provoke an attack by you." 
B)  "If you do that one more time, you will be secluded immediately." 
C)  "Do not hit anyone. If you are unable to control yourself, we will help you." 
D)  "You know we will not let you hit anyone. Why do you continue this behavior?" 
A)  "Stop that! No one did anything to provoke an attack by you." 
B)  "If you do that one more time, you will be secluded immediately." 
C)  "Do not hit anyone. If you are unable to control yourself, we will help you." 
D)  "You know we will not let you hit anyone. Why do you continue this behavior?"

Question 15

A patient diagnosed with bipolar disorder has rapid cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed?

Accepted Answer

A)  Phenytoin (Dilantin) 
B)  Clonidine (Catapres) 
C)  Carbamazepine (Tegretol) 
D)  Chlorpromazine (Thorazine) 
A)  Phenytoin (Dilantin) 
B)  Clonidine (Catapres) 
C)  Carbamazepine (Tegretol) 
D)  Chlorpromazine (Thorazine)

Exam 16: Bipolar Spectrum Disorders

A patient experiencing acute mania has disrobed in the hall three times in 2 hours. The nurse should:

A patient diagnosed with bipolar disorder is being treated as an outpatient during a hypomanic episode. Which suggestions should the nurse provide to the family? (Select all that apply.)

A patient experiencing acute mania has exhausted the staff members by noon. The patient has joked, manipulated, insulted, and fought all morning. Staff members are feeling defensive and fatigued. Which is the best action?

A patient diagnosed with bipolar disorder and who takes lithium telephones the nurse at the clinic to say, "I've had severe diarrhea 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" The nurse should advise the patient:

Which dinner menu is best suited for the patient diagnosed with bipolar disorder experiencing acute mania?

A nurse receives this laboratory result for a patient diagnosed with bipolar disorder: lithium level 1 mEq/L. This result is:

A patient diagnosed with bipolar disorder is in the maintenance phase of treatment. The patient asks, "Do I have to keep taking this lithium even though my mood is stable now?" Select the nurse's most appropriate response.

After hospital discharge, what is the priority intervention for a patient diagnosed with bipolar disorder who is taking antimanic medication, as well as for the patient's family?

Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), and gabapentin (Neurontin). Which drug also belongs to this group?

Outcome identification for the treatment plan of a patient with grandiose thinking associated with acute mania focuses on:

A patient experiencing acute mania waves a newspaper and says, "I must have my credit card and use the computer right now. A store is having a big sale and I need to order 10 dresses and four pairs of shoes." Select the nurse's most appropriate intervention.

When a hyperactive patient experiencing acute mania is hospitalized, what initial nursing intervention is a priority?

The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. Select the nurse's best response.

A patient diagnosed with bipolar disorder is hyperactive and manic after discontinuing lithium. The patient threatens to hit another patient. Which comment by the nurse is appropriate?

A patient diagnosed with bipolar disorder has rapid cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed?

Practicing the Science and Art of Psychiatric Nursing

Mental Health and Mental Illness

Theories and Therapies

Biological Basis for Understanding Psychopharmacology

Settings for Psychiatric Care

Legal and Ethical Basis for Practice

Nursing Process and QSEN: The Foundation for Safe and Effective Care

Communication Skills: Medium for All Nursing Practice

Therapeutic Relationships and the Clinical Interview

Trauma and Stress-Related Disorders

Anxiety, Anxiety Disorders, and Obsessive-Compulsive and Related Disorders

Somatic Symptom Disorders and Dissociative Disorders

Personality Disorders

Eating Disorders

Mood Disorders: Depression

Schizophrenia Spectrum Disorders and Other Psychotic Disorders

Neurocognitive Disorders

Substance-Related and Addictive Disorders

Crisis and Mass Disaster

Child, Partner, and Elder Violence

Sexual Violence

Suicidal Thoughts and Behavior

Anger, Aggression, and Violence

Care for the Dying and Those Who Grieve

Children and Adolescents

Adults

Older Adults

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