Deck 26: Bipolar Disorders

Question 1

A patient diagnosed with bipolar I disorder says, "I will lead the next group about medications. I have studied all the effects and problems with drugs on the Internet, so I can solve patients' questions." How should the nurse document this finding?

A) Flight of ideas
B) Distractibility
C) Limit-testing
D) Grandiosity

Answer 1

Grandiosity

Question 2

A newly admitted patient is experiencing a manic episode. The patient is verbally and physically aggressive. The plan for care should include:

A) setting clear limits, providing a quiet environment, and limiting activities.
B) avoiding use of antipsychotic drugs for 24 hours and providing nourishment ad lib.
C) orienting to unit activities, encouraging gross motor activity, and watching television.
D) avoiding confrontations by not enforcing limits and encouraging physical exercise at bedtime.

Answer 2

setting clear limits, providing a quiet environment, and limiting activities.

Question 3

Which principle is most useful and effective when interacting with a patient experiencing a manic episode?

A) Encourage the patient to freely express feelings.
B) Use a calm, matter-of-fact approach.
C) Do not interrupt the patient.
D) Frequently use silence.

Answer 3

Use a calm, matter-of-fact approach.

Question 4

A medication teaching plan for a patient receiving lithium should include:

A) directions to eat one or two bananas daily.
B) dietary teaching to limit daily sodium intake.
C) the need to restrict daily fluid intake to 1000 ml.
D) the importance of laboratory testing to monitor the lithium level.

Question 5

Which indicator of disordered communication is the nurse most likely to assess in a patient having a manic episode?

A) Loose associations
B) Flight of ideas
C) Echolalia
D) Mutism

Question 6

During community lunch, a manic patient tells another patient, "Push yourself away from the table. You're too fat for your own good!" How should the nurse intervene?

A) Say to the patient, "You may remain at lunch only if you apologize."
B) Tell the patient, "You must leave lunch and go to your room now."
C) Calmly tell the patient that insulting others is not permitted.
D) Extinguish the behavior by ignoring it.

Question 7

A patient at the clinic describes periods of sadness and depression as well as episodes of elation over the past 3 years. The patient adds, "Fortunately, I have been able to keep my job despite these mood changes." These findings are most consistent with which disorder?

A) Bipolar I
B) Bipolar II
C) Cyclothymic
D) Seasonal affective

Question 8

The nurse prepares to take vital signs for a patient experiencing mania. What is the nurse's best intervention when the patient's talking interferes with the assessment?

A) Use a voice volume louder than the patient's to say, "Stop talking now."
B) Interrupt by saying, "It's time to take your vital signs now."
C) Delay taking the vital signs until the patient is quieter.
D) Wait tolerantly for the patient to finish talking.

Question 9

What are the best menu selections for lunch for a hyperactive patient during a manic episode? Select all that apply.

A) Cherry pie
B) Macaroni and cheese
C) Chocolate chip cookies
D) Tossed salad with ranch dressing
E) Roast beef sandwich on whole-grain bread

Question 10

A nurse presents a psychoeducational program to patients with bipolar disorder and their families. Information about signs of impending relapse of mania should include:

A) diarrhea, thirst, and gross tremor.
B) sleep disturbances and racing thoughts.
C) decreased libido, anhedonia, and hypersomnia.
D) delusional thinking, excessive guilt, and passivity.

Question 11

A patient diagnosed with bipolar disorder is laughing and giddy one minute and seconds later is angry and sarcastic. How should the nurse document the patient's mood?

A) Incongruent
B) Inappropriate
C) Blunted
D) Labile

Question 12

When a hyperactive, aggressive patient with bipolar disorder threatens to beat up another patient, the initial nursing intervention should be to:

A) provide firm verbal limits.
B) place the patient in seclusion.
C) ask the patient, "Why are you so angry?"
D) distract the patient with diversional activities.

Question 13

A nurse presents a psychoeducational program to patients with bipolar disorder and their families. Information about signs of impending relapse of depressive episode should include:

A) diarrhea, thirst, and gross tremor.
B) sleep disturbances and racing thoughts.
C) decreased libido, anhedonia, and inertia.
D) anorexia, excessive guilt, and aggression.

Question 14

The spouse of a patient diagnosed with bipolar I disorder says, "We want to have children, but I worry they could inherit this problem. There is also bipolar disorder on my side of the family." What is the nurse's most appropriate action?

A) Direct the couple to seek genetic counseling.
B) Encourage the couple to consider adopting children.
C) Encourage the spouse to discuss options with a spiritual advisor.
D) Educate the spouse about environmental determinants of bipolar disorder.

Question 15

Within a 15-minute period, a patient having a manic episode voices these complaints. "Dinner was cold. The bath towels are rough. The solarium is too hot. I have a sore throat. Another patient needs a shower. The medication nurse is too slow." The nurse should:

A) listen but ignore the patient's complaints.
B) tell the patient to use the suggestion box.
C) assess the patient's throat, and take vital signs.
D) invite the patient to share the concerns at the community meeting.

Question 16

A nurse assesses a new patient experiencing a manic episode. Which behavior is most likely to have occurred before hospitalization?

A) Watching others closely but avoiding interaction
B) Taking frequent rest periods during the day
C) Going rapidly from one activity to another
D) Remaining in the home for long periods

Question 17

A patient is hospitalized with new onset of manic behavior. It would be important for the nurse to inspect and report results of which laboratory tests? Select all that apply.

A) Calcium
B) Creatinine
C) Potassium
D) Drug screens
E) Thyroid function

Question 18

A nurse teaching about bipolar disorder should inform patients and their families of possible depressive symptoms. Which symptoms should the nurse include? Select all that apply.

A) Passivity
B) Aggression
C) Hyperactivity
D) Psychomotor retardation
E) Preoccupation with death