Question 1

A client who has been diagnosed with Bipolar I Disorder states,"God has taught me how to decode the Bible." The nurse should anticipate which combination of medications would be ordered to address this client's symptoms?

Accepted Answer

A) Lithium carbonate (Lithobid)and risperidone (Risperdal) 
B) Lithium carbonate (Lithobid)and carbamazepine (Tegretol) 
C) Valproic acid (Depakote)and sertraline (Zoloft) 
D) Valproic acid (Depakote)and lamotrigine (Lamictal)

Question 2

The nurse is planning care for a client diagnosed with Bipolar Disorder: Manic Episode.Which should be the first priority of the listed client outcomes?

Accepted Answer

A) Maintains nutritional status 
B) Interacts appropriately with peers 
C) Remains free from injury 
D) Sleeps 6 to 8 hours a night

Question 3

The mental health nurse is providing discharge teaching for a client diagnosed with Bipolar Disorder.Which statement indicates that the nurse's teaching is effective?

Accepted Answer

A) "I shouldn't take my lithium when I have the flu." 
B) "I am looking forward to having real coffee in the morning." 
C) "I can get off medication in 5 years if I am stable." 
D) "I'll be the designated driver since I shouldn't have alcohol with lamotrigine."

Question 4

A client has been taking lithium for several years with good symptom control.The client presents in the emergency department with blurred vision,tinnitus,and severe diarrhea.Which lithium level should the nurse correlate with these symptoms?

Accepted Answer

A) 1.3 mEq/L 
B) 1.7 mEq/L 
C) 2.3 mEq/L 
D) 3.7 mEq/L

Question 5

A client diagnosed with Bipolar Disorder,who has taken lithium carbonate (Lithane)for 1 year,presents in an emergency department with severe diarrhea,blurred vision,and tinnitus.The nurse should interpret these symptoms to be indicative of which of the following?

Accepted Answer

A) Consumption of foods high in tyramine 
B) Lithium carbonate discontinuation syndrome 
C) Development of lithium carbonate tolerance 
D) Lithium carbonate toxicity

Question 6

A client's spouse asks,"What evidence supports the possibility of genetic transmission of bipolar disorder?" Which is the best nursing reply?

Accepted Answer

A) "Clients diagnosed with Bipolar Disorders have alterations in neurochemicals that affect behaviors." 
B) "Higher rates of relatives diagnosed with Bipolar Disorder are found in families of clients diagnosed with this disorder." 
C) "Higher rates of relatives of clients diagnosed with Bipolar Disorder respond in an exaggerated way to daily stress." 
D) "More individuals diagnosed with Bipolar Disorder come from higher socioeconomic and educational backgrounds."

Question 7

As clients are leaving the dayroom following a group therapy session,the nurse notices a client admitted for acute mania is clenching and unclenching both fists,swearing,and glaring at a staff member.Which action should the nurse take first?

Accepted Answer

A) Calmly ask the client to go to the "quiet room." 
B) Instruct clients to return to the dayroom. 
C) Prepare to administer a sedative medication. 
D) Ask a staff member to call hospital security.

Question 8

A client is diagnosed with Bipolar Disorder and admitted to an inpatient psychiatric unit.Which is the priority outcome for this client?

Accepted Answer

A) The client will accomplish activities of daily living independently by discharge. 
B) The client will verbalize feelings during group sessions by discharge. 
C) The client will remain safe throughout hospitalization. 
D) The client will use problem-solving to cope adequately after discharge.

Question 9

A client diagnosed with Bipolar Disorder: Depressive Episode intentionally overdoses on sertraline (Zoloft).Family reports that the client has experienced anorexia,insomnia,and recent job loss.Which should be the priority nursing diagnosis for this client?

Accepted Answer

A) Risk for suicide R/T hopelessness 
B) Anxiety: severe R/T hyperactivity 
C) Imbalanced nutrition: less than body requirements R/T refusal to eat 
D) Dysfunctional grieving R/T loss of employment

Question 10

Which carries a warning label stating that the use of the medication increases risk for suicidal thoughts and behaviors?

Accepted Answer

A) Antipsychotics 
B) Antiepileptics 
C) Mood stabilizers 
D) Anxiolytics

Question 11

The clinic nurse is reviewing the medication list of a client diagnosed with Medication-Induced Bipolar Disorder.The nurse recognizes which may have precipitated the client's mood disturbance? Select all that apply.

Accepted Answer

A) Oral contraceptives 
B) Antihypertensives 
C) Dopamine agonist 
D) Corticosteroids 
E) Alpha-adrenergics

Question 12

A client is admitted in a manic episode of bipolar I disorder.Which nursing intervention is most therapeutic for this client?

Accepted Answer

A) Use a calm,unemotional approach during client interactions. 
B) Focus primarily on enforcing limits. 
C) Limit interactions to decrease external stimuli. 
D) Encourage the client to establish social relationships with peers.

Question 13

A client diagnosed with Bipolar I Disorder: Manic Episode refuses to take lithium carbonate because he complains that it makes him feel sick.Which of the following medications might be alternatively prescribed for mood stabilization in bipolar disorders?

Accepted Answer

A) Sertraline (Zoloft) 
B) Valproic acid (Depakote) 
C) Trazodone (Desyrel) 
D) Paroxetine (Paxil)

Question 14

A newly admitted client is diagnosed with Bipolar Disorder: Manic Episode.Which symptom related to altered thought is the nurse most likely to assess?

Accepted Answer

A) Pacing 
B) Flight of ideas 
C) Lability of mood 
D) Irritability

Question 15

Which of the following instructions regarding lithium therapy should be included in the nurse's discharge teaching? Select all that apply.

Accepted Answer

A) Avoid excessive use of beverages containing caffeine. 
B) Maintain a consistent sodium intake. 
C) Consume at least 2500 to 3000 mL of fluid per day. 
D) Restrict sodium content. 
E) Restrict fluids to 1500 mL per day.

Exam 26: Bipolar and Related Disorders