Question 1

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.What should be the nurse's initial intervention?

Accepted Answer

During a manic episode,the client experiences increased agitation and extreme hyperactivity that can lead to a risk for injury.Overstimulation can exacerbate these symptoms.Therefore,the nurse's initial action should focus on removing the client from the stimulating environment to a calmer location.

Question 2

Which client statement would the nurse recognize as indicating that the client understands dietary teaching related to lithium carbonate (Lithobid)treatment?

Accepted Answer

A client taking Lithobid should be taught not to skimp on dietary sodium intake.He or she should take Lithobid on a full stomach to avoid gastrointestinal upset and choose lower-calorie foods to prevent weight gain.

Question 3

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

Accepted Answer

Grandiosity is defined as a belief that personal abilities are better than anyone else's.This client is experiencing delusions of grandeur,which are commonly experienced in mania.

Question 4

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." What should be the priority nursing action?

Accepted Answer

When assessing a client diagnosed with bipolar disorder,the nurse should not lose sight of the fact that co-occurring physical problems could be masked by hyperactive,manic,or both behaviors.The client's statement of "I'm thirsty and I'm burning up" could be a symptom of either infection or dehydration and must be assessed.

Question 5

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

Accepted Answer

The nurse should instruct the client taking lithium to avoid excessive use of caffeine,maintain a consistent sodium intake,and consume at least 2,500 to 3,000 mL of fluid per day.The risk of developing lithium toxicity is high due to the narrow margin between therapeutic doses and toxic levels.

Question 6

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

Accepted Answer

It is difficult to diagnose a child or adolescent with bipolar disorder because bipolar symptoms are similar to attention deficit-hyperactivity disorder symptoms and because children are naturally active,energetic,and spontaneous.Symptoms may also be comorbid with other childhood disorders,such as conduct disorder.

Question 7

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

Accepted Answer

Family studies have shown that if one parent is diagnosed with bipolar disorder,the risk that a child will have the disorder is around 28%.If both parents are diagnosed with the disorder,the risk is two to three times as great.

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?

Accepted Answer

Clients experiencing mania are subject to frequent mood variations,easily changing from irritability and anger to sadness and crying.Therefore,it is necessary to maintain low levels of stimuli in the client's environment (low lighting,few people,simple décor,low noise levels).Anxiety levels rise in a stimulating environment.Neutral colors and pale accessories are most appropriate for a client experiencing mania.

Question 9

A newly admitted client is diagnosed with bipolar disorder: manic episode.Which symptom related to altered thought is the nurse most likely to assess?

Accepted Answer

Clients diagnosed with bipolar disorder: manic episode experience cognition and perception fragmentation often with psychosis during acute mania.Rapid thinking proceeds to racing and disjointed thinking (flight of ideas)and may be manifested by a continuous flow of accelerated,pressured speak with abrupt changes from topic to topic.

Question 10

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

Accepted Answer

Clients experiencing mania are subject to frequent mood variations,easily changing from irritability and anger to sadness and crying.Therefore,it is necessary to maintain a calm,unemotional approach during client interactions.

Quiz 26: Bipolar and Related Disorders