Chapter 26 -- Bipolar disorders Prep-U Questions

A client has been diagnosed with bipolar disorder. After teaching the client about the different medication classifications used to help stabilize mood, the nurse determines that the teaching was successful when the client identifies which class of medications? a. Anticonvulsants b. Antianxiety c. Antibiotics d. Anticoagulants

a

A client taking lithium therapy has a serum therapeutic level of 0.8 mEq/L. What priority dietary instruction should the nurse include in the teaching plan? a. Maintain daily sodium intake b. Limit fluid intake to 6-8 oz (180-340 mL) glasses a day c. Monitor weight pattern d. Switch to a DASH diet

a

A client with mania is in the dining room at lunchtime and is observed taking food from other clients' trays. Which is the priority action by the nurse? a. Set and maintain limitations on behavior to avoid threat to others' rights. b. Take the client out of the dining room and avoid lunch until the client calms down. c. Allow the client to take the food and replace the other clients' trays. d. Inform the client that they will lose the privilege of eating in the dining room.

a

Both valproate and carbamazepine may be lethal if high doses are ingested. Toxic symptoms appear in 1 to 3 hours and include what? a. Neuromuscular disturbances b. Bradycardia c. Tinnitus d. Urinary frequency

a

The nurse is preparing to administer a dose of lithium carbonate & assesses a lithium level of 1.8 mEq/L (1.8 mmol/L). The client is having N/V and diarrhea. Which is the priority action by the nurse? a. Withhold the lithium and notify the healthcare provider b. Administer an antiemetic and then proceed with the administration of lithium c. Augment the excretion of lithium with the administration of mannitol IV d. Prepare the client for hemodialysis to remove the toxic amount of lithium

a

The nurse is reviewing the hx of a client diagnosed w/ bipolar I disorder. The hx reveals that the client, in between manic episodes, consistently uses self-negating statements when describing the self, expresses feelings of being ashamed, & describes self as being unable to deal w/ events. The client also demonstrates little eye contact during interactions. The nurse interprets this info as reflecting a problem in which area? a. Self-esteem b. Denial c. Anxiety d. Coping

a

Which lab value is within the range of safety for maintenance or treatment with lithium? a. 1.2 mEq/L b. 1.6 mEq/L c. 2.4 mEq/L d. 2.0 mEq/L

a

A nurse is assessing a client who is brought to the emergency department. The nurse suspects that the client is experiencing mania. Which finding would support the nurse's suspicion? SATA a. Statements of self-importance b. Easily distractible c. Flight of ideas d. Slowness of speech e. Sleepiness

a, b, c

A bipolar client presents to the clinic with reports of headaches and feeling more irritable than usual. What is the best nursing response? a. "Continue to take your medication because the symptoms are minor." b. "Can you tell me more about these symptoms?" c. "Have you been taking your medication correctly?" d. "Let's get some bloodwork done."

b

A client experiencing acute mania from bipolar disorder refuses hospitalization. Which type of treatment would the nurse anticipate being prescribed for this client? a. Community clinic b. Intensive outpatient program c. Virtual health care d. Primary care visits

b

A client taking lithium for bipolar disorder is having mild diarrhea. The nurse informs the client that this is an example of what? a. Toxic effect b. Side effect c. Desired effect d. Therapeutic effect

b

A client w/ bipolar disorder states to the nurse that they've been experiencing mania & depression every day for 2 weeks & cannot work or take care of their children. Which is the best response by the nurse? a. "Are you sure you're taking your meds for bipolar disorder as prescribed?" b. "You're rapid-cycling & we may need to make an adjustment w/ your meds" c. "We will have to keep you in the hospital involuntarily since you could be a danger to yourself" d. "That is typical in bipolar disor

b

A client who is experiencing mania states, "What time is it? I have to see the doctor. Is breakfast here yet? I've got to see the doctor first. Can I get my cereal out of the kitchen?" Which response by the nurse would be most appropriate? a. "Are you hungry?" b. "Please speak slowly. I'm not sure what you need first" c. "You will have to be quiet and have breakfast after the doctor comes" d. "Why are your thoughts racing this morning?"

b

A client with mania is in the dining room at lunchtime and is observed taking food from other clients' trays. The nurse's intervention should be based on which rationale? a. As soon as lunch is over, the client will calm down. b. Other clients need to be protected from the intrusive behavior. c. The client's behavior is not an imminent threat to anyone's physical safety. d. The client needs food and fluids in any way possible.

b

A visitor comes to see a client who is suicidal. Upon entering the unit, the nurse notices that the visitor has brought the client a can of the client's favorite soda. Which action should the nurse take at his time? a. Confiscate the soda can as a restricted item. b. Pour the soda into a plastic cup. c. Ask the visitor not to bring outside items on the unit in the future. d. Ask the visitor to place the soda can at the nurse's desk until he or she leaves.

b

After educating a client with bipolar disorder on his prescribed lithium therapy, the nurse determines that additional education is needed when the client states which of the following? a. "I can use sugarless candies to help with any metallic taste" b. "I need to cut back on my salt intake when it's really hot outside" c. "I need to avoid drinking any alcohol" d. "I need to report any problems with severe diarrhea or slurred speech"

b

The client's spouse calls the health clinic stating that the client is having a manic episode. What information should alert the nurse to recommend that the client should go to the emergency room for treatment? a. Client has stayed up most of the night watching television. b. Client is avoiding eye contact and visibly shaking. c. Client has experienced work-related stress. d. Client is pacing around the bedroom.

b

A client with a diagnosis of bipolar disorder is described by a family member as "flip-flopping between being happy and loving to irritable and hostile." Which characteristic symptoms of this disorder is the family member referring to? a. Manic episode b. Grandiosity c. Emotional lability d. Euthymic mood

c

A client with mania attempts to hit the nurse during a conversation. Which is the best response by the nurse? a. "If you do that one more time, you will be put in seclusion immediately" b. "Why do you continue that kind of behavior? You know I won't let you do it" c. "Do not swing at me again. If you cannot control yourself, we will help you" d. "Stop that. I didn't do anything to provoke an attack"

c

During report, the nurse learns that a client with mania has not slept since admission 2 days ago. On entering the day room, the nurse finds this client dancing to loud music. Which is the most appropriate statement by the nurse? a. "Do you think you could sit still for a few minutes so we can talk?" b. "Turn the radio down so we can hear ourselves talk." c. "Let's go to the conference room and talk for a while." d. "How are you ever going to get any rest if you keep that music on?"

c

Police officers bring a client to the MH unit for admission. The client had been directing traffic on a busy city street, shouting rhymes like "to work, you jerk, for perks" & making obscene gestures at cars that came close to the client. When the spouse is contacted at work, the spouse reports that the client stopped taking lithium 3 weeks ago & hasn't slept or eaten for 3 days. Which two features characteristic of the manic phase of bipolar disorder can the nurse identify? a. Vegetative

c

A client with bipolar I disorder has been prescribed lithium. On a follow-up visit, the client reports a metallic taste in the mouth. Which intervention would the nurse most likely suggest? Select all that apply. a. "Watch how much sodium you eat" b. "Watch how much fluid you are drinking" c. "Make sure to brush your teeth frequently" d. "Try using sugarless candies periodically" e. "Take the medicine with meals"

c, d

A 35 y/o client w/ bipolar disorder has a hx of discontinuing meds when feeling well & becoming manic again. During their last episode of mania, the client lost thousands of dollars in investments. Which intervention will be most helpful in achieving med adherence? a. Point out that each time the client stops taking meds, the client becomes manic again b. Ensure that a family member takes responsibility for administering meds c. Remind the client that they owe it to the their spouse & children

d

A client recovering from the manic phase of bipolar disorder is distraught to realize all savings account money was spent during the episode. Which action would the nurse make a priority for this client? a. Discuss medication side effects b. Explain consequences of behavior c. Consult social services d. Assess for risk of suicide

d

A client who has liver damage is receiving lithium for treatment of bipolar disorder. The nurse understands that which of the following may occur when the client is receiving lithium? a. No alteration in plasma levels b. Decreased plasma concentration c. Monitoring of plasma levels is not needed d. Increased plasma concentration

d

The nurse provides medication teaching to a client with bipolar disorder. Which statement indicates that teaching about divalproex sodium was effective? a. "I will stop taking if side effects occur." b. "I can drink a cocktail with dinner." c. "I can take this with my herbal supplements." d. "I can take this with a meal."

d

Which behavior is the priority concern as the nurse begins a care plan for a client in the manic phase of bipolar disorder? a. Bizarre, colorful, inappropriate dress b. Grandiose thinking and poor concentration c. Insulting, provocative behavior directed at staff d. Hyperactivity, dismissing meals, and sleep disturbance

d

Which psychotropic medication is administered based on an individualized dosage according to blood levels of the drug? a. Clozapine b. Thioridazine c. Alprazolam d. Lithium carbonate

d