Question 1

The nursing instructor is teaching about bipolar disorders. Which symptom should the instructor include that is present during a manic episode but is absent in hypomania?

Accepted Answer

A)   Inflated self-esteem or grandiosity
B)   Decreased need for sleep
C)   Psychosis
D)   Flight of ideas or racing thoughts C

Question 2

A client has been diagnosed with major depressive episode. After treatment with an antidepressant, the client exhibits pressured speech and flight of ideas. Based on this symptom change, which information should the nurse share with the health-care provider?

Accepted Answer

A)   Ask to increase the dosage of the antidepressant.
B)   Ask that the client be reevaluated.
C)   Ask to order benztropine (Cogentin)  for the extrapyramidal symptoms.
D)   Ask that another class of antidepressants be used. B

Question 3

The nurse is assessing a teenaged client diagnosed with cyclothymic disorder. Which DSM-5 diagnostic criteria would the nurse expect this client to meet? (Select all that apply.)

Accepted Answer

A)   Symptoms lasting for a minimum of two years
B)   Numerous periods with manic symptoms
C)   Possible comorbid diagnosis of a delusional disorder
D)   Symptoms cause clinically significant impairment in important areas of functioning
E)   Depressive symptoms that do not meet the criteria for major depressive episode D,E

Question 4

The client diagnosed with bipolar disorder intentionally overdoses on antidepressants. Family members report that the client has experienced a relationship break-up, anorexia, and a recent job loss. Which nursing diagnosis is the priority based upon the client's signs and symptoms?

Accepted Answer

A)   Risk for self-directed violence R/T multiple losses
B)   Anxiety: severe R/T hyperactivity
C)   Imbalanced nutrition: less than body requirements R/T refusal to eat
D)   Dysfunctional grieving R/T hopelessness

Question 5

Which premise is basic to the recovery model used to treat clients diagnosed with bipolar disorder?

Accepted Answer

A)   Medication compliance
B)   Independent management
C)   Total absence of symptoms
D)   Improved psychosocial relationships

Question 6

The nurse presents a staff development session about the various challenges in the treatment of clients diagnosed with bipolar disorder. Which factor should the nurse include that is an essential component of relapse prevention?

Accepted Answer

A)   Methods to treat insomnia
B)   Inability to control irritability
C)   Lack of insight
D)   Medication adherence

Question 7

The health-care provider prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa) for a client with severe manic episodes. The client's spouse asks the nurse how Zyprexa works. Which response would the nurse make?

Accepted Answer

A)   "Zyprexa in combination with Eskalith cures bipolar disorder symptoms."
B)   "Zyprexa prevents extrapyramidal side effects."
C)   "Zyprexa increases the effectiveness of the immune system."
D)   "Zyprexa calms the agitation associated with mania."

Question 8

Which information would the nurse include in a teaching session about predisposing factors in the development of bipolar disorder, mania episode? (Select all that apply.)

Accepted Answer

A)   There are excessive levels of glutamate.
B)   Mania has greater right-side reduction in brain activity.
C)   Steroids are the most common medication to trigger a manic response.
D)   Expression of gene ANK3 is decreased in manic episodes.
E)   Dopamine levels are decreased in mania.

Question 9

The client with bipolar disorder refuses to take lithium carbonate (Lithobid) because of excessive weight gain. In order to increase adherence, which anticonvulsant medication should the nurse be prepared to administer?

Accepted Answer

A)   Sertraline (Zoloft) 
B)   Valproic acid (Depakote) 
C)   Verapamil (Calan) 
D)   Lurasidone (Latuda)

Question 10

A highly agitated client paces the unit and states, "I could buy and sell this place." The client's mood fluctuates from fits of laughter to outbursts of anger. Which chart entry would the nurse document for this client's behavior?

Accepted Answer

A)   "Rates mood 8/10. Exhibiting looseness of association. Euphoric."
B)   "Mood irritability. Exhibiting magical thinking. Nervousness."
C)   "Blunted affect. Exhibiting delusions of reference. Hyperactive."
D)   "Agitated and pacing. Exhibiting grandiosity. Mood labile."

Question 11

Which statement by the client indicates successful teaching about taking lithium carbonate (Lithobid) for the treatment of bipolar disorder?

Accepted Answer

A)   "I should decrease my intake of sodium."
B)   "Drinking ten large glasses of water a day is good for me."
C)   "Weight gain is a common, but troubling, side effect."
D)   "Diarrhea should be expected while using this drug."

Question 12

Which information should the nurse include when teaching parents who have children or adolescents with symptoms of bipolar disorder? (Select all that apply.)

Accepted Answer

A)   First-line treatment is a second-generation antipsychotic.
B)   In children and adolescents with bipolar disorder there is a high risk of relapse.
C)   There is a direct link between development of bipolar disorder and attention deficit/hyperactivity disorder.
D)   The diagnosis of bipolar disorder cannot be assigned prior to the age of 18.
E)   Genetic predisposition is not a reliable diagnostic determinant.

Question 13

____________________ is an alteration in mood that is expressed by feelings of elation, inflated self-esteem, grandiosity, hyperactivity, agitation, racing thoughts, and accelerated speech.

Accepted Answer

The answer of ____________________ is an alteration in mood that...

Question 14

The client diagnosed with bipolar disorder: manic episode has a goal of gaining 2 lbs. ( 0.91 kg.) by the end of the week. Which action would the nurse take to achieve this outcome?

Accepted Answer

A)   Provide client with high-calorie finger foods throughout the day.
B)   Accompany client to cafeteria to encourage adequate dietary consumption.
C)   Initiate total parenteral nutrition to meet dietary needs.
D)   Teach the importance of a varied diet to meet nutritional needs.

Question 15

The client taking lithium carbonate (Lithobid) presents to an emergency department with a temperature of 101°F (38°C), severe diarrhea, blurred vision, and tinnitus. Which interpretation should the nurse make regarding these symptoms?

Accepted Answer

A)   Symptoms indicate spending too much time outdoors without sunblock.
B)   Symptoms indicate antipsychotic withdrawal syndrome.
C)   Symptoms indicate the development of neutropenia.
D)   Symptoms indicate lithium carbonate toxicity.

Exam 17: Bipolar and Related Disorders