Deck 12: Bipolar Disorders

Question 1

You are working with the RN to plan short-term goals for a 28-year-old hospitalized manic patient. Which is the most important goal?
1)Protection from self-inflicted harm
2)Meals in excess of metabolic requirement
3)Strict participation in unit activities
4)Enforced medication compliance

Answer 1

1

Question 2

Marnie is a 16-year-old patient with bipolar disorder. She is manic right now and is in the hallway naked, making sexual requests of the staff and other patients. What is your best course of action?
1)Quietly approach her, escort her to her room, and assist her in getting dressed.
2)Quietly approach her, escort her to her room, and explain to her the inappropriateness of her actions.
3)Approach her, confront her behavior as it is happening, and escort her to her room.
4)Confront her behavior in the hall, apologize to the other patients, and escort her to her room.

Answer 2

1

Question 3

Lithium toxicity is most likely with which of the following patients?
1)An elderly man with diarrhea from food poisoning
2)A teenage girl on oral contraceptives
3)A 40-year-old man who smokes marijuana on the weekend
4)All of the above are at high risk

Answer 3

1

Question 4

Toni, diagnosed with bipolar disorder, is currently in the mania stage. The staff noted that Toni has placed her lipstick on in an exaggerated way. She is currently pacing the floor and is easily angered. The nurse approaches Toni in an attempt to ease some of her behaviors. The most therapeutic response by the nurse would be:
1)"Would you like to watch TV?"
2)"Would you like me to talk with you?"
3)"Let's walk and talk."
4)Avoid giving attention to the patient by not responding to her behavior.

Question 5

Your patient in the psychiatric unit is still up at midnight playing cards. You tell him, "It's time to get some sleep now." What is the purpose of this response?
1)Limit setting
2)Reality testing
3)Controlling patient so other patients will respond the same way
4)Enforcing rules

Question 6

Which of the following are signs of mania (select all that apply)?
1)Pessimistic feelings
2)Increased sexual drive
3)Denial that anything is wrong
4)Decreased energy
5)Decreased need for sleep

Question 7

A 30-year-old male patient is admitted to the psychiatric unit with a diagnosis of bipolar disorder. His family reports that for the past 2 months, he has been in constant motion, sleeping very little, spending lots of money, and has been "full of ideas." During the initial assessment with the patient, the nurse would expect him to exhibit which of the following?
1)Short, polite responses to interview questions
2)Introspection related to his present situation
3)Exaggerated self-importance
4)Feelings of helplessness and hopelessness

Question 8

Which of the following best describes bipolar I disorder?
1)Full manic cycles with possibility of depression
2)Disturbance in mood that is a direct result of physiological effects of substance abuse
3)Periods of mild mania followed by mild depression
4)Intense depression followed by normal mood

Question 9

Which diversional activity is most appropriate for a patient in a manic phase?
1)A card game
2)Exercise class
3)Cross-stitch
4)Computer game

Question 10

Lithium is most commonly used to treat which of the following disorders?
1)Dysthymia
2)Schizophrenia
3)Generalized anxiety disorder
4)Bipolar disorder

Question 11

Your new patient admitted to the psychiatric unit is pacing and agitated. Which of the following is the most appropriate intervention?
1)Introduce the patient to all the other patients.
2)Direct him to a group therapy session.
3)Place him in a quiet area away from other patients.
4)Review the unit rules with the patient to distract him.

Question 12

Which statement is most likely to be from a patient in a manic episode?
1)"I don't need to sleep."
2)"I am Jesus Christ."
3)"Leave me alone while I am reading this textbook."
4)"I am worthless."

Question 13

Which of the following would present the greatest risk of developing bipolar disorder?
1)Use of stimulant medications as a child
2)History of anxiety disorder as a teenager
3)First-degree relative with the bipolar disorder diagnosis
4)History of conduct disorder

Question 14

Your 28-year-old patient was admitted to the psychiatric unit with a diagnosis of bipolar disorder in major depression with symptoms of withdrawal and extreme sadness. After 2 weeks on the unit, the patient suddenly becomes more talkative, sleeps only 2 hours a night, and acts seductively with the male patients. What is the most likely explanation for this change?
1)The antidepressants are effective.
2)The patient was diagnosed incorrectly.
3)She is having a manic episode as part of her illness.
4)She is recovering from her depression.