Course Point Psych Chapter 20 Practice Questions

A patient with bipolar disorder is prescribed divalproex. Before initiating this therapy, which laboratory test would be most important for the nurse to obtain?

Liver function tests

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?

Other clients need to be protected from the intrusive behavior.

At 1 a.m., the client with mania rushes to the nurses' station and demands that the psychiatrist come to the unit now to write an order for a pass to go home. Which response by the nurse would be the most therapeutic?

"I can't call the psychiatrist now, but you and I can talk about your request for a pass."

A 52-year-old client with bipolar disorder tells the nurse, "I read that there are chemicals in my brain that can cause my symptoms." Knowing that the client is referring to neurotransmitters, which would be the best response by the nurse?

"Low levels of the neurotransmitter serotonin are associated with mania."

A client whose mania is related to a medical condition asks why the physician has prescribed carbamazepine instead of lithium. Which is the nurse's best response?

"This drug is best for clients who do not respond to lithium or whose mania is related to a medical condition, as is yours."

A client is prescribed carbamazepine as part of the treatment plan for bipolar disorder. The nurse obtains a complete blood count and differential before initiating therapy. The nurse would instruct the client to return to the outpatient facility for repeat blood testing at which time?

1 month

An inappropriately dressed client has not slept for 3 days and has been making excessive long-distance phone calls. When the client can be heard singing loudly in the examining room, the nurse makes initial plans to focus on what?

Assessing needs for food, liquids, and rest

Which is a food that might be incorporated into the plan of care for a client diagnosed in the manic phase of bipolar disorder?

Bananas

A client with bipolar disorder has been ordered a medication that is classified as an anticonvulsant. Which drug does the nurse know falls within this class of medications?

Carbamazepine

A client with bipolar disorder is admitted to the psychiatric unit. The client is talking loudly, walking back and forth rapidly, and exhibiting a short attention span. Which of the following would the nurse do first?

Decrease the client's environmental stimuli

A 35-year-old client with bipolar disorder has a history of discontinuing medication when feeling well and then becoming manic again. During the client's last episode of mania, the client lost several thousand dollars in risky investments. Which intervention will be most helpful in achieving medication adherence?

During stabilization, discuss the client's individual signs, symptoms, and consequences of relapse.

A nursing student learning about mood disorders correctly identifies which of the following to mean exaggerated feelings of well-being?

Euphoria

A client has been on lithium for 3 weeks now. The client approaches the nurse, saying, "I feel like I'm going to throw up, and I can't even hold this cup of coffee straight. Why can't I do the crossword puzzle? I usually can do them in about 5 minutes." What is the appropriate nursing intervention at this time?

Further assess the client's symptoms, call the physician, hold the client's next dose of lithium, and have a blood level drawn because the client is showing symptoms of toxicity.

The police bring a client to the hospital. They found the client in a hospital gown, swimming in a local creek. The client states that the client was "being baptized by Mother Nature, who loves and worships me." How would the nurse describe the client's current alterations in mental status?

Grandiose delusions

Which meal would the nurse provide to best meet the nutritional needs of a client who is manic?

Ham sandwich, cheese slices, milk

Which behavior is the priority concern as the nurse begins a care plan for a client in the manic phase of bipolar disorder?

Hyperactivity, dismissing meals, and sleep disturbance

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?

Increased plasma concentration

Which of the following is the treatment setting of choice for persons who are severely psychotic?

Inpatient admission

A client with bipolar disorder I is experiencing a depressive episode. Which of the following would the nurse expect to be prescribed?

Lamotrigine

A psychiatric-mental health nurse is preparing a review class for a group of nurses at the community mental health center. The topic is mood-stabilizing drugs. After teaching the class about the different drugs that may be prescribed, the nurse determines that the teaching was successful when the group identifies which drug as being prescribed most often?

Lithium

Which psychotropic medication is administered based on an individualized dosage according to blood levels of the drug?

Lithium carbonate

A client with bipolar disorder takes lithium 300 mg 3 times daily. The nurse is educating the client on its use, side effects, and need for compliance. The nurse evaluates that the dose is appropriate when the client reports what?

Minimal mood swings.

A client in an acute manic phase is pacing the halls and talking in a loud voice with pressured speech. The client is overly involved with coclients and frequently threatens and disrupts others on the unit. After administering lithium treatment for the client, the nurse can expect the plan of care to include which additional intervention?

Monitoring blood levels of the medication.

A client is exhibiting rapid shifts in mood. The nurse documents this as which of the following?

Mood lability

Which medication classification is considered first-line drug therapy for bipolar disorder?

Mood stabilizers

Police officers bring a client to the mental health unit for admission. The client had been directing traffic on a busy city street, shouting rhymes such as "to work, you jerk, for perks" and making obscene gestures at cars that came close to the client. When the client's spouse is contacted at work, the spouse reports that the client stopped taking lithium 3 weeks ago and has not slept or eaten for 3 days. With which two features characteristic of the manic phase of bipolar disorder can the nurse identify?

Poor judgment and hyperactivity

A client was admitted to the psychiatric unit after being picked up by police officers who found the client frantically running back and forth across the freeway. The client's spouse reports that the client stayed up all night, ate very little, and talked incessantly. Additional assessment findings that indicate a manic episode include what?

Pressured speech, combative behavior, and impaired judgment

A client with bipolar disorder is currently experiencing mania. The nurse identifies a nursing diagnosis of sleep deprivation related to the effects of the mania. Which would be most appropriate for the nurse to include in the client's plan of care?

Reducing environmental stimuli

A client is receiving lithium carbonate for the treatment of mania. The nurse would reinforce which teaching component regarding lithium treatment?

Schedule bloodwork for lithium levels.

A client taking lithium for bipolar disorder is having mild diarrhea. The nurse informs the client that this is an example of what?

Side effect

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? Select all that apply.

Statements of self-importance Flight of ideas Easily distractible

To confirm that a client is experiencing a manic episode, the nurse must eliminate the possibility that the client's symptoms are related to which problem?

Substance use

A concerned family member tells the nurse, "I am concerned about my sibling. My sibling has been acting very different lately." Knowing the family has a history of bipolar disorder, the nurse inquires further about this. Which behavior during the past week might indicate that the sibling has bipolar disorder?

Taking unnecessary risks

A client who has just been prescribed lithium for bipolar disorder is being given education from the nurse about this medication. Which is important for the nurse to include in teaching?

The higher the sodium level, the lower the lithium level will be.

The spouse of a client with bipolar disorder calls the nurse expressing distress about recent spending patterns of the client. The nurse suggests the spouse implement the limit-setting skills the spouse has learned in family therapy. In this instance, the nurse's action would be considered ...

appropriate; the spouse needs support in setting boundaries.