Question 1

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

Accepted Answer

Research has shown that there is a higher incidence of bipolar disorder in first-degree relatives (such as parents, siblings, and children) of individuals who have been diagnosed with the disorder. This suggests a genetic component to the disorder, although environmental factors may also play a role.

Question 2

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 3

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

Accepted Answer

Clients experiencing mania may be more sensitive to stimuli and overly stimulated by bright colors or busy patterns. Neutral colors and pale accessories may be more soothing and calming. Additionally, clients experiencing mania may benefit from being located closer to the nurse's station for closer observation and monitoring. Extra-large windows could potentially be a safety concern for clients at risk for elopement or suicidal ideation.

Question 4

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

Accepted Answer

Maintaining normal salt intake is essential when taking lithium carbonate as it can affect sodium levels in the body. Limiting fluid intake, taking on an empty stomach, and increasing caloric intake are not recommended or necessary when taking lithium carbonate.

Question 5

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

Option B, "I'm the world's most perceptive attorney," is an example of grandiose delusion, which is a symptom of mania. The person experiencing mania may perceive themselves as possessing special abilities or having an inflated sense of self-importance. Option A is an example of hypersexuality, option C is an example of overspending, and option D is an example of paranoia, which are all common symptoms of mania but not specific to grandiose delusions.

Question 6

A client is admitted in the manic phase of bipolar affective disorder. Which nursing intervention should be most therapeutic for this client?

Accepted Answer

Using a calm, unemotional approach during client interactions is most therapeutic for a client in the manic phase of bipolar affective disorder as it helps to decrease the client's agitation and may help to prevent escalation of manic behaviors. Focusing primarily on enforcing limits or limiting interactions may be important, but should not be the primary intervention. Encouraging the client to establish social relationships with peers may not be appropriate during the manic phase as the client's behavior may be unpredictable or potentially harmful to others.

Question 7

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 8

A client on an inpatient unit is diagnosed with bipolar disorder: manic phase. During a discussion in the dayroom about weekend activities, the client raises voice, becomes irritable, and insists that plans change. What should be the nurse's initial intervention?

Accepted Answer

The client's behavior suggests symptoms of a manic episode, which can be exacerbated by overstimulation and agitation. The nurse should first move the client to a calmer location to help reduce the stimuli and provide a safer environment for both the client and other patients. Providing a quiet and secure space can help reduce anxiety, agitation, and impulsivity associated with manic episodes. The other options, such as asking the group to take a vote or discussing impulse control, may not be effective in managing a client in a manic phase. Additionally, asking the client to quiet down or leave the dayroom may escalate the situation, leading to further agitation and aggression.

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

Flight of ideas is a common symptom of manic episodes in bipolar disorder, characterized by rapid and continuous flow of ideas, often with abrupt changes of topic without completing a thought.

Question 10

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

The client's statements suggest possible symptoms of mania, which can include increased physical activity, elevated temperature, and dehydration. Assessing the client's vital signs can help identify any potential health risks or complications.

Quiz 28: Mood Disorders: Bipolar Disorder