Question: A patient diagnosed with bipolar disorder is being treated on an outpatient basis with lithium carbonate 300 mg three times daily and has now reported being nauseated. To reduce the nausea, what will the nurse suggest the lithium be taken with?
Answer Choices: a. Food b. An antacid c. A large glass of juice
Answer: a. Food
Question: A health teaching plan for a patient taking lithium should include which instructions?
Answer Choices: a. Maintain normal salt and fluids in the diet. b. Drink twice the usual daily amount of fluids. c. Double the lithium dose if diarrhea or vomiting occurs. d. Avoid eating aged cheese, processed meats, and red wine.
Answer: a. Maintain normal salt and fluids in the diet.
Question: Which nursing diagnosis would most likely apply to both a patient diagnosed with major depressive disorder (MDD) as well as one experiencing acute mania?
Answer Choices: a. Deficient diversional activity b. Disturbed sleep pattern c. Fluid volume excess d. Defensive coping
Answer: b. Disturbed sleep pattern
Question: Which dinner menu is best suited for the patient diagnosed with bipolar disorder experiencing acute mania?
Answer Choices: 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
Answer: c. Broiled chicken breast on a roll, an ear of corn, apple
Question: What is the focus of outcome identification for the treatment plan of a patient presenting with grandiose thinking associated with acute mania?
Answer Choices: a. Maintaining an interest in the environment b. Developing an optimistic outlook c. Self-control of distorted thinking d. Stabilizing the sleep pattern
Answer: c. Self-control of distorted thinking
Question: Which documentation indicates that the treatment plan for a patient experiencing acute mania has been effective?
Answer Choices: a. “Converses without interrupting; 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.”
Answer: a. “Converses without interrupting; clothing matches; participates in activities.”
Question: A patient experiencing mania dances around the unit, seldom sits, monopolizes conversations, interrupts, and intrudes. Which nursing intervention will best assist the patient with energy conservation?
Answer Choices: a. Monitor physiological functioning. b. Provide a subdued environment. c. Supervise personal hygiene. d. Observe for mood changes.
Answer: b. Provide a subdued environment.
Question: A patient diagnosed with bipolar disorder has been hospitalized for 7 days and has taken lithium 600 mg three times daily. Staff members observe increased agitation, pressured speech, poor personal hygiene, hyperactivity, and bizarre clothing. What is the nurse’s best intervention?
Answer Choices: a. Educate the patient about the proper ways to perform personal hygiene and coordinate clothing. b. Continue to monitor and document the patient’s speech patterns and motor activity. c. Ask the health care provider to prescribe an increased dose and frequency of lithium. d. Consider the need to check the lithium level. The patient may not be swallowing medications.
Answer: d. Consider the need to check the lithium level. The patient may not be swallowing medications.
Question: A patient experiencing acute mania has disrobed in the hall three times in 2 hours. What intervention should the nurse implement?
Answer Choices: a. Place the patient in the seclusion room. b. Ask if the patient finds clothes bothersome. c. Tell the patient that others feel embarrassed. d. Arrange for one-on-one supervision.
Answer: d. Arrange for one-on-one supervision.
Question: A patient experiencing acute mania is dancing atop the pool table in the recreation room. The patient waves a pool cue in one hand and says, “I’ll protect myself if anyone comes near me.” What is the nurse’s first intervention?
Answer Choices: a. Telling the patient, “You need to be secluded.” b. Demanding the patient, “get down from the table.” c. Clearing the room of all other patients. d. Assembling staff for a show of force.
Answer: c. Clearing the room of all other patients.
Question: After hospital discharge, what is the priority intervention for a patient diagnosed with bipolar disorder who is taking antimanic medication?
Answer Choices: a. Decreasing physical activity b. Increasing food and fluids c. Meeting self-care needs d. Psychoeducation
Answer: d. Psychoeducation
Question: A patient receiving lithium should be assessed for which evidence of early toxicity?
Answer Choices: a. Pharyngitis, mydriasis, and dystonia b. Alopecia, purpura, and drowsiness c. Diarrhea, thirst, and vomiting d. Ascites, dyspnea, and edema
Answer: c. Diarrhea, thirst, and vomiting
Question: 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.
Answer Choices: 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.”
Answer: b. “Taking the medication every day helps prevent relapses and recurrences.”
Question: A patient prescribed lithium telephones the nurse at the clinic to say, “I’ve had severe diarrhea for 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?” What instructions should the nurse provide?
Answer Choices: 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.
Answer: b. Have someone bring you to the clinic immediately.
Question: Lithium is prescribed for a new patient. Which information from the patient’s history indicates that monitoring serum concentrations of the drug will be especially challenging and critical?
Answer Choices: a. Arthritis b. Epilepsy c. Exercise-induced asthma d. Congestive heart failure
Answer: d. Congestive heart failure
Question: 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 to assist in managing these behaviors? (Select all that apply.)
Answer Choices: 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.
Answer: a. Provide structure. b. Limit credit card access. e. Monitor the patient’s sleep patterns.
Question: A nurse prepares the plan of care for a patient experiencing a manic episode. Which nursing diagnoses are most appropriate? (Select all that apply.)
Answer Choices: a. Imbalanced nutrition: more than body requirements b. Disturbed thought processes c. Sleep deprivation d. Chronic confusion e. Social isolation
Answer: b. Disturbed thought processes c. Sleep deprivation
Question: A patient tells the nurse, “I am so ashamed of being bipolar. When I’m manic, my behavior embarrasses my family. Even if I take my medication, there’s no guarantee I won’t have a relapse. I am such a burden to my family.” These statements support which nursing diagnoses? (Select all that apply.)
Answer Choices: a. Powerlessness b. Defensive coping c. Chronic low self-esteem d. Impaired social interaction e. Risk-prone health behavior
Answer: a. Powerlessness c. Chronic low self-esteem
Question: A person diagnosed with schizophrenia has had difficulty keeping a job because of severe paranoia. Today the person shouts, “They’re all plotting to destroy me.” Select the nurse’s most therapeutic response.
Answer Choices: a. “Everyone here is trying to help you. No one wants to harm you.” b. “Feeling that people want to destroy you must be very frightening.” c. “That is not true. People here are trying to help if you will let them.” d. “Staff members are health care professionals who are qualified to help you.”
Answer: b. “Feeling that people want to destroy you must be very frightening.”
Question: A newly admitted patient diagnosed with schizophrenia is hypervigilant and constantly scans the environment. The patient states, “I saw two doctors talking in the hall. They were plotting to kill me.” The nurse may correctly assess this as what classic behavior?
Answer Choices: a. Echolalia b. An idea of reference c. A delusion of infidelity d. An auditory hallucination
Answer: b. An idea of reference