Question 1

A patient with 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 demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action will the staff take initially?

Accepted Answer

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

Question 3

The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. Which response should the nurse provide?

Accepted Answer

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

Question 4

A patient diagnosed with acute mania has distributed pamphlets about a new business venture on a street corner for 2 days. Which nursing diagnosis has priority?

Accepted Answer

A)  Risk for injury 
B)  Ineffective coping 
C)  Impaired social interaction 
D)  Ineffective therapeutic regimen management 
A)  Risk for injury 
B)  Ineffective coping 
C)  Impaired social interaction 
D)  Ineffective therapeutic regimen management

Question 5

A patient tells the nurse, "I'm ashamed of being bipolar. When I'm manic, my behavior embarrasses everyone. Even if I take my medication, there are no guarantees. I'm a burden to my family." These statements support which nursing diagnoses? (Select all that apply.)

Accepted Answer

A)  Powerlessness 
B)  Defensive coping 
C)  Chronic low self-esteem 
D)  Impaired social interaction 
E)  Risk-prone health behavior 
A)  Powerlessness 
B)  Defensive coping 
C)  Chronic low self-esteem 
D)  Impaired social interaction 
E)  Risk-prone health behavior

Question 6

When a hyperactive patient diagnosed with acute mania is hospitalized, what is the initial nursing intervention?

Accepted Answer

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

Question 7

This nursing diagnosis applies to a patient experiencing acute mania: Imbalanced nutrition: less than body requirements related to insufficient caloric intake and hyperactivity as evidenced by 5-pound weight loss in 4 days. Select an appropriate outcome. The patient will

Accepted Answer

A)  ask staff for assistance with feeding within 4 days. 
B)  drink six servings of a high-calorie, high-protein drink each day. 
C)  consistently sit with others for at least 30 minutes at meal time within 1 week. 
D)  consistently wear appropriate attire for age and sex within 1 week while on the psychiatric unit. 
A)  ask staff for assistance with feeding within 4 days. 
B)  drink six servings of a high-calorie, high-protein drink each day. 
C)  consistently sit with others for at least 30 minutes at meal time within 1 week. 
D)  consistently wear appropriate attire for age and sex within 1 week while on the psychiatric unit.

Question 8

A newly diagnosed patient is prescribed lithium. Which information from the patient's history indicates that monitoring of serum concentrations of the drug will be challenging and critical?

Accepted Answer

A)  Arthritis 
B)  Epilepsy 
C)  Psoriasis 
D)  Heart failure 
A)  Arthritis 
B)  Epilepsy 
C)  Psoriasis 
D)  Heart failure

Question 9

A health teaching plan for a patient taking lithium should include instructions to

Accepted Answer

A)  maintain normal salt and fluids in the diet. 
B)  drink twice the usual daily amount of fluid. 
C)  double the lithium dose if diarrhea or vomiting occurs. 
D)  avoid eating aged cheese, processed meats, and red wine. 
A)  maintain normal salt and fluids in the diet. 
B)  drink twice the usual daily amount of fluid. 
C)  double the lithium dose if diarrhea or vomiting occurs. 
D)  avoid eating aged cheese, processed meats, and red wine.

Question 10

Which nursing diagnosis would most likely apply to a patient diagnosed with major depressive disorder as well as one experiencing acute mania?

Accepted Answer

A)  Deficient diversional activity 
B)  Disturbed sleep pattern 
C)  Fluid volume excess 
D)  Defensive coping 
A)  Deficient diversional activity 
B)  Disturbed sleep pattern 
C)  Fluid volume excess 
D)  Defensive coping

Question 11

A patient 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 appropriate intervention. The nurse

Accepted Answer

A)  suggests the patient have a friend do the shopping and bring purchases to the unit. 
B)  invites the patient to sit together and look at new fashion magazines. 
C)  tells the patient computer use is not allowed until self-control improves. 
D)  asks whether the patient has enough money to pay for the purchases. 
A)  suggests the patient have a friend do the shopping and bring purchases to the unit. 
B)  invites the patient to sit together and look at new fashion magazines. 
C)  tells the patient computer use is not allowed until self-control improves. 
D)  asks whether the patient has enough money to pay for the purchases.

Question 12

A nurse assesses a patient who takes lithium. Which findings demonstrate evidence of complications?

Accepted Answer

A)  Pharyngitis, mydriasis, and dystonia 
B)  Alopecia, purpura, and drowsiness 
C)  Diaphoresis, weakness, and nausea 
D)  Ascites, dyspnea, and edema 
A)  Pharyngitis, mydriasis, and dystonia 
B)  Alopecia, purpura, and drowsiness 
C)  Diaphoresis, weakness, and nausea 
D)  Ascites, dyspnea, and edema

Question 13

A patient diagnosed with bipolar disorder is dressed in a red leotard and bright scarves. The patient twirls and shadow boxes. The patient says gaily, "Do you like my scarves? Here they are my gift to you." How should the nurse document the patient's mood?

Accepted Answer

A)  Euphoric 
B)  Irritable 
C)  Suspicious 
D)  Confident 
A)  Euphoric 
B)  Irritable 
C)  Suspicious 
D)  Confident

Question 14

Outcome identification for the treatment plan of a patient experiencing grandiose thinking associated with acute mania will focus on

Accepted Answer

A)  developing an optimistic outlook. 
B)  distorted thought self-control. 
C)  interest in the environment. 
D)  sleep pattern stabilization. 
A)  developing an optimistic outlook. 
B)  distorted thought self-control. 
C)  interest in the environment. 
D)  sleep pattern stabilization.

Question 15

The nurse receives a laboratory report indicating a patient's serum level is 1 mEq/L. The patient's last dose of lithium was 8 hours ago. This result is

Accepted Answer

A)  within therapeutic limits. 
B)  below therapeutic limits. 
C)  above therapeutic limits. 
D)  invalid because of the time lapse since the last dose. 
A)  within therapeutic limits. 
B)  below therapeutic limits. 
C)  above therapeutic limits. 
D)  invalid because of the time lapse since the last dose.

Question 16

Which documentation indicates that the treatment plan for a patient diagnosed with acute mania has been effective?

Accepted Answer

A)  "Converses with few interruptions; clothing matches; participates in activities." 
B)  "Irritable, suggestible, distractible; napped for 10 minutes in afternoon." 
C)  "Attention span short; writing copious notes; intrudes in conversations." 
D)  "Heavy makeup; seductive toward staff; pressured speech." 
A)  "Converses with few interruptions; clothing matches; participates in activities." 
B)  "Irritable, suggestible, distractible; napped for 10 minutes in afternoon." 
C)  "Attention span short; writing copious notes; intrudes in conversations." 
D)  "Heavy makeup; seductive toward staff; pressured speech."

Question 17

A patient diagnosed with bipolar disorder has rapidly changing mood 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 
B)  clonidine 
C)  risperidone 
D)  carbamazepine 
A)  phenytoin 
B)  clonidine 
C)  risperidone 
D)  carbamazepine

Question 18

Which suggestions are appropriate for the family of a patient diagnosed with bipolar disorder who is being treated as an outpatient during a hypomanic episode? (Select all that apply.)

Accepted Answer

A)  Limit credit card access. 
B)  Provide a structured environment. 
C)  Encourage group social interaction. 
D)  Supervise medication administration. 
E)  Monitor the patient's sleep patterns. 
A)  Limit credit card access. 
B)  Provide a structured environment. 
C)  Encourage group social interaction. 
D)  Supervise medication administration. 
E)  Monitor the patient's sleep patterns.

Exam 13: Bipolar and Related Disorders

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

A patient demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action will the staff take initially?

The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. Which response should the nurse provide?

A patient diagnosed with acute mania has distributed pamphlets about a new business venture on a street corner for 2 days. Which nursing diagnosis has priority?

A patient tells the nurse, "I'm ashamed of being bipolar. When I'm manic, my behavior embarrasses everyone. Even if I take my medication, there are no guarantees. I'm a burden to my family." These statements support which nursing diagnoses? (Select all that apply.)

When a hyperactive patient diagnosed with acute mania is hospitalized, what is the initial nursing intervention?

This nursing diagnosis applies to a patient experiencing acute mania: Imbalanced nutrition: less than body requirements related to insufficient caloric intake and hyperactivity as evidenced by 5-pound weight loss in 4 days. Select an appropriate outcome. The patient will

A newly diagnosed patient is prescribed lithium. Which information from the patient's history indicates that monitoring of serum concentrations of the drug will be challenging and critical?

A health teaching plan for a patient taking lithium should include instructions to

Which nursing diagnosis would most likely apply to a patient diagnosed with major depressive disorder as well as one experiencing acute mania?

A patient 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 appropriate intervention. The nurse

A nurse assesses a patient who takes lithium. Which findings demonstrate evidence of complications?

A patient diagnosed with bipolar disorder is dressed in a red leotard and bright scarves. The patient twirls and shadow boxes. The patient says gaily, "Do you like my scarves? Here they are my gift to you." How should the nurse document the patient's mood?

Outcome identification for the treatment plan of a patient experiencing grandiose thinking associated with acute mania will focus on

The nurse receives a laboratory report indicating a patient's serum level is 1 mEq/L. The patient's last dose of lithium was 8 hours ago. This result is

Which documentation indicates that the treatment plan for a patient diagnosed with acute mania has been effective?

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

Which suggestions are appropriate for the family of a patient diagnosed with bipolar disorder who is being treated as an outpatient during a hypomanic episode? (Select all that apply.)

Mental Health and Mental Illness

Theories and Therapies

Psychobiology and Psychopharmacology

Treatment Settings

Cultural Implications

Legal and Ethical Considerations

The Nursing Process and Standards of Care

Therapeutic Relationships

Therapeutic Communication

Stress Responses and Stress Management

Childhood and Neurodevelopmental Disorders

Schizophrenia Spectrum Disorders

Depressive Disorders

Anxiety and Obsessive-Compulsive Disorders

Trauma, Stressor-Related, and Dissociative Disorders

Somatic Symptom Disorders

Eating and Feeding Disorders

Sleep–Wake Disorders

Sexual Dysfunctions, Gender Dysphoria, and Paraphilias

Impulse Control Disorders

Substance-Related and Addictive Disorders

Neurocognitive Disorders

Personality Disorders

Suicide and Nonsuicidal Self-Injury

Crisis and Disaster

Anger, Aggression, and Violence

Child, Older Adult, and Intimate Partner Violence

Sexual Assault

Dying, Death, and Grieving

Older Adults

Serious Mental Illness

Forensic Nursing

Therapeutic Groups

Family Interventions

Integrative Care

Filters