Question 1

A client was initially prescribed lithium for treatment of bipolar disorder.Recently the client has begun to cycle rapidly between mood states.Which therapy,if any,is indicated?&#10;A)No therapy is necessary.&#10;B)Change to an anticonvulsant such as carbamazepine.&#10;C)Discontinue all medications and allow the client a drug holiday.&#10;D)Change to an H2 blocker.

Accepted Answer

Rapid cycling can occur in bipolar disorder despite treatment with lithium, and switching to an anticonvulsant such as carbamazepine or valproic acid may be effective in stabilizing mood. Discontinuing all medications or switching to an H2 blocker is not indicated for this issue.

Question 2

The nurse manager of a psychiatric inpatient facility is orienting a newly hired nurse.Which instruction would the manager provide regarding clients with bipolar disorder?&#10;A)&#34;Continuously assess the clients for mood elevation.&#34;&#10;B)&#34;Make safety a priority.&#34;&#10;C)&#34;Offer fluids such as coffee or tea frequently through the day.&#34;&#10;D)&#34;Monitor the client's sleep cycles.&#34;&#10;E)&#34;Measure vital signs four times a day.&#34;

Accepted Answer

Clients with bipolar disorder are at risk for mood swings, including elevated mood which may lead to impulsivity and risk-taking behaviors. Therefore, it is important for nurses to continuously assess for mood elevation and prioritize safety measures. Additionally, monitoring sleep cycles is important as disruptions in sleep have been linked to the onset of both manic and depressive episodes. Offering coffee or tea frequently throughout the day and measuring vital signs four times a day are not specific instructions relevant to bipolar disorder management.

Question 3

A client expresses concern regarding a cousin's recent diagnosis with bipolar disorder and asks about genetic screening.How should the nurse respond?&#10;A)&#34;I will ask the physician to discuss this with you.&#34;&#10;B)&#34;We will have to check to see if your insurance will pay for it before scheduling.&#34;&#10;C)&#34;Reliable testing is not yet widely available.&#34;&#10;D)&#34;So many people want this done that scheduling is a problem.&#34;

Accepted Answer

There is no specific genetic test available for bipolar disorder. While there may be some genetic components to the disorder, it is not yet fully understood and reliable genetic testing is not yet widely available.

Question 4

A nurse who works in an inpatient psychiatric facility is caring for a client diagnosed with bipolar disorder.The nurse would look for which activity to indicate the client is about to change from the manic state to the depressed state?

A)The client talks more with others.
B)The client paces the facility halls.
C)The client begins to have sleep disturbances.
D)The client sits quietly in a chair,not moving for long periods of time.

Accepted Answer

Sleep disturbances, such as insomnia or hypersomnia, are common indicators of an impending change from a manic to a depressed state in clients with bipolar disorder. Option A, talking more, may be a sign of hypomania but does not necessarily indicate an impending switch to depression. Option B, pacing, is a behavior often seen during manic episodes, and Option D, sitting quietly for long periods of time, is a hallmark symptom of depression but may not indicate an imminent change from mania to depression.

Question 5

A female client has recently been diagnosed with bipolar disorder.Her husband asks if there is any possibility that the disease has been transmitted to their children.What is the best nursing response?

A)"Only if there is another person in your wife's ancestry who was diagnosed with this disorder."
B)"Does your wife have a twin with this disorder?"
C)"Your children's risk for developing this disorder is higher than that of the general population."
D)"We believe so,but there is no research to support our anecdotal observations."

Unlock Deck

Unlock for access to all 13 flashcards in this deck.

Unlock Deck

k this deck

Accepted Answer

Bipolar disorder has a genetic component, and research suggests that children of individuals with the disorder are at higher risk of developing it themselves. However, environmental factors also play a role in the development of bipolar disorder, and the exact cause of the disorder is not yet fully understood. It is important to provide the husband with accurate information and support, while also recognizing that the risk of transmission is only part of a complex picture.

Question 6

Based on current research,how should the nurse advise a client with bipolar disorder?&#10;A)&#34;Avoid illegal stimulants.&#34;&#10;B)&#34;Reduce your sun exposure.&#34;&#10;C)&#34;Increase your exercise time.&#34;&#10;D)&#34;Avoid secondhand exposure to tobacco smoke.&#34;

Accepted Answer

Current research suggests that individuals with bipolar disorder should avoid illegal stimulants as they can exacerbate symptoms and increase the risk of mood episodes. This includes substances such as cocaine, amphetamines, and MDMA (ecstasy).

Answer: C
 Exercise has been found to have a positive impact on mood and can be helpful for those with bipolar disorder. It can help reduce symptoms of depression and anxiety and improve overall well-being.

Therefore, the best choices are A and C.

Question 7

The family history of a client recently diagnosed with bipolar disorder reveals several ancestors with the same diagnosis.What additional information should the nurse look for in this pedigree?&#10;A)How many of the affected ancestors were also alcoholics?&#10;B)Were there unaffected relatives who had elevated mood levels?&#10;C)How many of the affected relatives had children?&#10;D)Did any unaffected relatives have other psychosocial dysfunction?&#10;E)How many of the unaffected female relatives held jobs outside the home?

Accepted Answer

Unaffected relatives with elevated mood levels or other psychosocial dysfunction may be at risk for developing bipolar disorder.

Question 8

The prescriber is hesitant to order valproic acid for a 20-year-old with bipolar disorder.What is the primary rationale for this concern?&#10;A)Valproic acid is not as effective in younger clients.&#10;B)The client had a previous adverse reaction to lithium.&#10;C)This drug can disrupt reproductive hormones.&#10;D)This drug causes hirsutism.

Accepted Answer

Valproic acid has been shown to disrupt reproductive hormones, leading to polycystic ovary syndrome (PCOS) in some female clients. This is a particular concern for young women who may want to have children in the future. The prescriber may be hesitant to order valproic acid for this reason.

Question 9

A client diagnosed with bipolar disorder says,&#34;I don't understand why I go back and forth between being manic and being sad and depressed.&#34; Which explanations should the nurse offer?&#10;A)&#34;When you are getting too many chemicals in your brain,you have manic spells.&#34;&#10;B)&#34;When you don't take your drug,you get sick.&#34;&#10;C)&#34;The chemicals in your brain get all mixed up.&#34;&#10;D)&#34;When you do not get enough of certain chemicals in your brain,you feel depressed.&#34;&#10;E)&#34;When you can't control your mania,you use up so much energy that you crash and become depressed.&#34;

Accepted Answer

The answer of A client diagnosed with bipolar disorder says,&#34;I...

Question 10

Which nursing diagnosis is common to clients diagnosed with bipolar disease?&#10;A)Imbalanced Nutrition: More than Body Requirements&#10;B)Risk for Self-Harm&#10;C)Ineffective Airway Clearance&#10;D)Activity Intolerance

Accepted Answer

Risk for self-harm is a common nursing diagnosis for individuals with bipolar disorder as they are at an increased risk for suicide and self-mutilation. The other options, imbalanced nutrition, ineffective airway clearance, and activity intolerance may also be present, but are not as commonly associated with bipolar disorder.

Question 11

A client has been prescribed carbamazepine.What education should the nurse provide?&#10;A)&#34;This medication will stabilize your thyroid's influence on your bipolar disorder.&#34;&#10;B)&#34;This drug is in the class of antimania drugs.&#34;&#10;C)&#34;This medication is given to stabilize serotonin and dopamine.&#34;&#10;D)&#34;This medication will cure your bipolar disorder.&#34;

Accepted Answer

The answer of A client has been prescribed carbamazepine.What education...

Question 12

Which interventions would the nurse plan to support the stabilization of a client's circadian rhythm?&#10;A)Give medications on time.&#10;B)Use environmental clues for awakening.&#10;C)Support calming bedtime routines.&#10;D)Assure quiet on the unit at night.&#10;E)Offer warm milk or hot cocoa at night.

Accepted Answer

The answer of Which interventions would the nurse plan to...

Question 13

A client's identical twin has been diagnosed with bipolar disorder.The client says,"I know this problem runs in families.What are the chances I will also develop it?" What is the nurse's best response?

A)"Your chance is the same as that of your nontwin siblings."
B)"Concordance figures put your risk at between 40% and 45%."
C)"Your risk is likely lower than that of your nontwin siblings."
D)"Genetics is not the only determining factor for the development of bipolar disorder."

Unlock Deck

Unlock for access to all 13 flashcards in this deck.

Unlock Deck

k this deck

Accepted Answer

The answer of A client's identical twin has been diagnosed...

Deck 19: Bipolar Disease and Genetic Linkages