Question 1

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

Accepted Answer

Using a calm and unemotional approach during interactions with a client in a manic episode is most therapeutic because it helps to decrease the client's level of agitation and promotes a sense of safety and trust in the nurse-client relationship. Enforcing limits and limiting interactions may be necessary in certain situations, but they should be done in a calm and respectful manner. Encouraging the client to establish social relationships with peers may not be appropriate during a manic episode as the client may not have the ability to engage in appropriate social interactions.

Question 2

A client and nurse therapist are developing a treatment plan that includes strategies to manage bipolar disorder.Which should be included? Select all that apply.
A)Maintain a consistent sleep schedule.
B)Become an expert on mental health.
C)Create a daily medication schedule.
D)Set a time frame to achieve remission.
E)Develop an emergency plan.

Accepted Answer

The answer of A client and nurse therapist are developing...

Question 3

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

Accepted Answer

Lithium therapy requires patients to avoid excessive caffeine as it can affect lithium levels, maintain consistent sodium intake to prevent lithium toxicity or ineffectiveness, and ensure adequate hydration (2500 to 3000 mL of fluid per day) to prevent lithium concentration fluctuations.

Question 4

Which of the following explanations should the nurse include when teaching parents why it is difficult to diagnose a child or adolescent exhibiting symptoms of bipolar disorder? Select all that apply.
A)Symptoms of bipolar disorder are similar to those of attention deficit-hyperactivity disorder.
B)Children are naturally active,energetic,and spontaneous.
C)Neurotransmitter levels vary considerably in accordance with age.
D)The diagnosis of Bipolar Disorder cannot be assigned prior to the age of 18.
E)Genetic predisposition is not a reliable diagnostic determinant.

Accepted Answer

Symptoms of bipolar disorder can overlap with those of ADHD, making it challenging to distinguish between the two. Additionally, children naturally exhibit behaviors that can mimic symptoms of bipolar disorder, such as high energy and spontaneity, complicating diagnosis.

Question 5

A client on an inpatient unit is diagnosed with Bipolar Disorder: Manic Episode.During a discussion in the dayroom about weekend activities,the client raises his voice,becomes irritable,and insists that plans change.Which should be the nurse's initial intervention?
A)Ask the group to take a vote on alternative weekend events.
B)Remind the client to quiet down or leave the dayroom.
C)Assist the client to move to a calmer location.
D)Discuss with the client impulse control problems.

Accepted Answer

The client's behavior suggests increasing agitation and irritability, which can be a sign of escalating manic symptoms. Moving the client to a calmer location can help reduce stimulation and prevent further escalation of symptoms. A and B do not address the underlying symptoms and may even increase agitation. D may be appropriate at a later time, but the immediate concern is to prevent the client from becoming more agitated.

Question 6

Which client statement indicates to the nurse that the client understands dietary teaching related to lithium carbonate (Lithobid)treatment?
A)"I will limit my intake of fluids daily."
B)"I will maintain normal salt intake."
C)"I will take Lithobid on an empty stomach."
D)"I will increase my caloric intake to prevent weight loss."

Accepted Answer

Lithium carbonate can cause sodium depletion, so it is important to maintain a normal salt intake to prevent this. A is incorrect because lithium can cause dehydration, so fluids should not be limited. C is incorrect because lithium carbonate should be taken with food to minimize gastric upset. D is incorrect because lithium carbonate can cause weight gain, not weight loss.

Question 7

Which carries a warning label stating that the use of the medication increases risk for suicidal thoughts and behaviors?
A)Antipsychotics
B)Antiepileptics
C)Mood stabilizers
D)Anxiolytics

Accepted Answer

The answer of Which carries a warning label stating that...

Question 8

The inpatient psychiatric unit is being redecorated.At a unit meeting,staff discusses bedroom décor for clients experiencing mania.The nurse manager evaluates which suggestion as most appropriate?
A)Rooms should contain extra-large windows with views of the street.
B)Rooms should contain brightly colored walls with printed drapes.
C)Rooms should be painted deep colors and located close to the nurse's station.
D)Rooms should be painted with neutral colors and contain pale-colored accessories.

Accepted Answer

Clients experiencing mania may be sensitive to sensory stimulation, such as bright colors, patterns, or excessive stimulation from outdoor views. Therefore, neutral colors and pale-colored accessories would create a calm and soothing environment. Additionally, being close to the nurse's station may provide reassurance and support for the client during times of agitation or restlessness.

Question 9

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

Accepted Answer

The strongest evidence supporting the possibility of genetic transmission of bipolar disorder is the higher rates of relatives diagnosed with bipolar disorder that are found in families of clients diagnosed with this disorder. This suggests there is a genetic link that increases the risk of developing bipolar disorder.

Question 10

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?
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."

Accepted Answer

This statement reflects an understanding that alcohol should not be consumed while taking lamotrigine, a medication commonly used to treat bipolar disorder. It also demonstrates an awareness of the importance of safety and responsibility while taking medication. The other statements are incorrect and show a lack of understanding or potential noncompliance with important aspects of managing bipolar disorder.

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

Accepted Answer

The answer of The clinic nurse is reviewing the medication...

Question 12

The nurse learns at report that a newly admitted client experiencing mania is demonstrating grandiose delusions.The nurse should recognize that which client statement provides supportive evidence of this symptom?
A)"I can't stop my sexual urges.They have led me to numerous affairs."
B)"I'm the world's most perceptive attorney."
C)"My wife is distraught about my overspending."
D)"The FBI is out to get me."

Accepted Answer

Grandiose delusions involve an exaggerated sense of one's importance, power, knowledge, or identity. The statement "I'm the world's most perceptive attorney" is an example of a grandiose delusion, indicating an unrealistic belief in one's abilities or status.

Question 13

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?
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.

Accepted Answer

The answer of As clients are leaving the dayroom following...

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

Accepted Answer

Flight of ideas is a symptom of bipolar disorder during a manic episode, in which the client experiences rapid, often unconnected thoughts and ideas, making it difficult to concentrate or follow a conversation. This symptom is related to altered thought processes seen in bipolar disorder.

Question 15

A client diagnosed with Bipolar Disorder states,"I hate oatmeal.Let's get everybody together to do exercises.I'm thirsty and I'm burning up.Get out of my way;I have to see that guy." Which is the priority nursing action?
A)Assess the client's vital signs.
B)Offer to have the dietitian discuss food preferences.
C)Encourage the client to lead the exercise program in the community meeting.
D)Acknowledge the client briefly and then walk away.

Accepted Answer

The priority nursing action in this scenario is to assess the client's vital signs. The client is exhibiting signs of mania and may be experiencing hyperthermia, which could be a medical emergency. The nurse should assess the client's temperature, heart rate, and blood pressure to determine if any additional interventions or medical treatment are necessary.

Quiz 26: Bipolar and Related Disorders

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

A client and nurse therapist are developing a treatment plan that includes strategies to manage bipolar disorder.Which should be included? Select all that apply.

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

Which of the following explanations should the nurse include when teaching parents why it is difficult to diagnose a child or adolescent exhibiting symptoms of bipolar disorder? Select all that apply.

A client on an inpatient unit is diagnosed with Bipolar Disorder: Manic Episode.During a discussion in the dayroom about weekend activities,the client raises his voice,becomes irritable,and insists that plans change.Which should be the nurse's initial intervention?

Which client statement indicates to the nurse that the client understands dietary teaching related to lithium carbonate (Lithobid) treatment?

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

The inpatient psychiatric unit is being redecorated.At a unit meeting,staff discusses bedroom décor for clients experiencing mania.The nurse manager evaluates which suggestion as most appropriate?

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

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?

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.

The nurse learns at report that a newly admitted client experiencing mania is demonstrating grandiose delusions.The nurse should recognize that which client statement provides supportive evidence of this symptom?

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?

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

A client diagnosed with Bipolar Disorder states,"I hate oatmeal.Let's get everybody together to do exercises.I'm thirsty and I'm burning up.Get out of my way;I have to see that guy." Which is the priority nursing action?