Answer Options:
a. Minimize the side effects of lithium.
b. Bring hyperactivity under rapid control.
c. Enhance the antimanic actions of lithium.
d. Provide long-term control of hyperactivity.
Answer: B. Bring hyperactivity under rapid control.
Question: A health teaching plan for a patient taking lithium should include which instructions?
Answer Options:
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 documentation indicates that the treatment plan for a patient experiencing acute mania has been effective?
Answer Options:
a. “Conversation without interrupting; clothing matches; participates in planned activities.”
b. “Irritable, suggestible, distractible; napped for 10 minutes in a quiet setting.”
c. “Attentive; shook staff hand; cautious; notes intrusions in conversation.”
d. “Heavy makeup; seductive toward staff; pressured speech.”
Answer: A. “Conversation without interrupting; clothing matches; participates in planned activities.”
Question: Which dinner menu is best suited for the patient diagnosed with bipolar disorder experiencing acute mania?
Answer Options:
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: 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 Options:
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: Which belief by a nurse supports the highest degree of patient advocacy during a multidisciplinary patient care planning session?
Answer Options:
a. All mental illnesses are culturally determined.
b. Schizophrenia and bipolar disorder are cross-cultural disorders.
c. Symptoms of mental disorders are constant from culture to culture.
d. Some symptoms of mental disorders may reflect a person’s cultural patterns.
Answer: d. Some symptoms of mental disorders may reflect a person’s cultural patterns.
Question: A new psychiatric nurse is providing care to a parent diagnosed with bipolar disorder. This nurse angrily recalls embarrassing events concerning the parent’s behavior in the community. Select the best ways for this nurse to cope with these feelings. (Select all that apply.)
Answer Options:
a. Seeking ways to use the understanding gained from childhood to help patients cope with their own illnesses
b. Recognizing that these feelings are unhealthy and try to suppress them when working with patients
c. Recognizing that psychiatric nursing is not an appropriate career choice and explore other nursing specialties
d. Beginning new patient relationships by saying, “My own parent had mental illness, so I accept it without stigma”
e. Recognizing that the feelings may add sensitivity to the nurse’s practice, but supervision is important
Answer: A. Seeking ways to use the understanding gained from childhood to help patients cope with their own illnesses
E. Recognizing that the feelings may add sensitivity to the nurse’s practice, but supervision is important
Question: A nurse can anticipate anticholinergic side effects are likely to occur when a patient is prescribed what medication?
Answer Options:
a. Lithium
b. Buspirone
c. Risperidone
d. Fluphenazine
Answer: d. Fluphenazine
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 Options:
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: An adult patient tells the case manager, “I don’t have bipolar disorder anymore, so I don’t need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now I’m bored and don’t have any friends.” Which resources should the nurse suggest for the patient? (Select all that apply.)
Answer: a. Psychoeducation classes
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 Options:
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: 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 Options:
a. Deficient diversional activity
b. Disturbed sleep pattern
c. Fluid volume excess
d. Defensive coping
Answer: B. Disturbed sleep pattern
Question: A nurse prepares for an initial interview with a patient with suspected adult attention-deficit/hyperactivity disorder (ADHD). Questions should be focused to elicit information about which problem?
Answer Options:
a. Headaches
b. Inattention
c. Sexual impulses
d. Trichotillomania
Answer: b. Inattention
Question: After hospital discharge, what is the priority intervention for a patient diagnosed with bipolar disorder who is taking antimanic medication?
Answer Options:
a. Decreasing physical activity
b. Increasing food and fluids
c. Meeting self-care needs
d. Psychoeducation
Answer: D. Psychoeducation
Question: The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. What response supported by research should the nurse provide?
Answer Options:
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.”
Answer: B. “A higher rate of relatives diagnosed with bipolar disorder is found among patients with bipolar disorder.”