Answer Options:
a. “Stop that! No one did anything to provoke an attack by you.”
b. “If you do that one more time, you will be secluded immediately.”
c. “Do not hit anyone. If you are unable to control yourself, we will help you.”
d. “You know we will not let you hit anyone. Why do you continue this behavior?”
Answer: C. “Do not hit anyone. If you are unable to control yourself, we will help you.”
Question: A patient receiving lithium should be assessed for which evidence of early toxicity?
Answer Options:
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 commands other patients, “Get me a book. Take this stuff out of here,” and other similar demands. What is the best initial approach by the nurse to interrupt this behavior without entering into a power struggle?
Answer Options:
a. Distraction: “Let’s go to the dining room for a snack.”
b. Humor: “How much are you paying servants these days?”
c. Limit setting: “You must stop ordering other patients around.”
d. Honest feedback: “Your controlling behavior is annoying others.”
Answer: A. Distraction: “Let’s go to the dining room for a snack.”
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 Options:
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 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 Options:
a. Food
b. An antacid
c. A large glass of juice
d. An antiemetic medication
Answer: A. Food
Question: A patient experiencing acute mania waves a newspaper and says, “I must have 10 credit cards for use for shoes.” What is the nurse’s most appropriate intervention?
Answer Options:
a. Sitting set next to the patient to assist in ordering the shoes online.
b. Asking staff to accompany the patient to a shopping mall.
c. Consistently sitting with others for at least 30 minutes at mealtime within 1 week while in the unit
d. Telling the patient to sit with the unit and look at new fashion magazines
Answer: B. Asking staff to accompany the patient to a shopping mall.
Question: What is the focus of outcome identification for the treatment plan of a patient presenting with grandiose thinking associated with acute mania?
Answer Options:
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: A patient prescribed lithium telephones the nurse at the clinic to say, “I’ve had severe diarrhea 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 Options:
a. “Have someone bring you to the clinic immediately.”
b. “Restrict oral fluids for 24 hours and stay in bed.”
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: A. “Have someone bring you to the clinic immediately.”
Question: When a hyperactive patient experiencing acute mania is hospitalized, what initial nursing intervention is a priority?
Answer Options:
a. Allowing the patient to act out his or her feelings
b. Setting limits on the patient’s behavior as necessary
c. Providing verbal instructions to the patient to remain calm
d. Restraining the patient to reduce hyperactivity and aggression
Answer: B. Setting limits on the patient’s behavior as necessary
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 Options:
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: 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 Options:
a. Arthritis
b. Epilepsy
c. Exercise-induced asthma
d. Congestive heart failure
Answer: D
Multiple Response Question 973
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 Options
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.
A, B, E
Question: A patient experiencing acute mania undresses in the group room and dances. What should be the nurse’s first intervention?
Answer Options:
a. Quietly ask the patient, “Why don’t you put on your clothes?”
b. Firmly tell the patient, “Stop dancing, and put on your clothing.”
c. Put a blanket around the patient and walk with the patient to a quiet room.
d. Allow the patient stay in the group room while moving the other patients to a different area.
Answer: C. Put a blanket around the patient and walk with the patient to a quiet room.