FA Davis Chapter 17 Mental Health

Which treatment strategy would be most beneficial for the client with bipolar disorder who is experiencing severe symptoms of corticosteroid-induced psychosis?

Lithium carbonate

While communicating with a client, the nurse suspects bipolar mania. The nurse also finds a decreased neutrophil count in the laboratory reports of the client. Which medication would be most beneficial for this client?

Lithium carbonate

A client with multiple sclerosis who is on steroid therapy is admitted to the psychiatric ward. Which symptoms does the nurse observe in the client?

Mania

While caring for a client with psychotic disorder, the nurse infers that he is at risk of being violent with other individuals. Which symptom enabled the nurse to reach this conclusion?

Manic excitement

The nurse is caring for a client with impaired social interaction. The nurse sets limits on the manipulative behavior of the client. Which outcome in the client does the nurse expect from this intervention?

The client develops appropriate interaction skills

The nurse is caring for a client who is at high risk for violence. While caring, the nurse offers an empathetic response to the client's feelings. Which outcome does the nurse expect from this intervention?

The client develops trust

A client is admitted into the psychiatric unit with symptoms of hypomania. The client's history indicates that the client has never experienced a full manic episode. Which would the nurse infer from these findings?

The client has bipolar II disorder.

While interacting with a client, the nurse suspects that the client is having a manic episode of bipolar disorder. Which statement supports the nurse's suspicion?

The client has elevated or irritable mood

The mother of an adolescent client says, "My child keeps talking about calling the U.S. President to give him suggestions." The nurse also finds that the client has increased libido. Which does the nurse interpret from these findings?

The client is experiencing hypomania

While caring for a client with extreme hyperactivity associated with mania, the nurse engages the client in physical activities. Which outcome does the nurse expect from this intervention?

The client releases pent-up tension

Which does the nurse expect in a client who shows hypomanic episodes of bipolar disorder?

The client shows manic symptoms that last for at least 4 consecutive days.

After assessing a child, the nurse suspects the child has cyclothymic disorder. Which statement of the child's mother supports the nurse's assumption?

" My child has had periods of elevated moods from the age of 5 years. These episodes are more frequent since she turned 8 years old."

The registered nurse is teaching a group of student nurses about cognitive therapy. Which statement made by a student nurse requires correction?

"Cognitive therapy describes mania as a triad of negative distortions."

The primary health-care provider prescribes lithium carbonate therapy to a client with mania. Which instruction would the nurse provide to the client to prevent adverse effects associated with the medication?

"Drink 6 to 8 large glasses of water each day."

While communicating with a client, the nurse suspects that the client has a manic episode of bipolar disorder. Which statement of the client supports the nurse's suspicion?

"I communicate better than anyone else."

While educating a client diagnosed with bipolar disorder, the nurse teaches the client to avoid excessive exposure to very high or low temperatures. Which category of medications might be present on the medication list of the client?

Antipsychotic

Which statement made by the student nurse requires correction regarding promoting client safety?

"I will use the most restrictive method of promoting safety."

Which statement made by a client with bipolar mania indicates personalizing thought?

"My sister is this happy only when she's with me."

Which statement by the client indicates an automatic thought that occurs spontaneously in a client with bipolar mania?

"The mistakes I've made are not really important."

The nurse is caring for a client diagnosed with bipolar disorder. On interaction with the client, the nurse suspects that the client is in the delirious mania stage. Which statement of the client supports the nurse's conclusion? Select all that apply.

* "Go away! Leave me alone." * "I don't want to go into the bathroom because somebody is in there and is planning to kill me." * "I saw a demon standing in front of me."

A client with mania has shown progressive improvement with lithium therapy. After successful treatment, the client is discharged. Which suggestions would the nurse give to the client? Select all that apply.

* "Notify the primary health-care provider if pregnancy is planned or suspected." * "Contact the primary health-care provider if you have excessive vomiting."

A client with mania reports an inability to sleep. Which appropriate actions does the nurse take to help the client sleep better? Select all that apply.

* Administer sedative agents as prescribed * Reduce lighting in the room * Help perform relaxation exercises before sleep

Which side effect in the client who is on lithium carbonate therapy prompts the primary health-care provider to decrease the dose of the medication? Select all that apply.

* Arrhythmia * Fine hand tremors

Which signs and symptoms indicate that the client has disturbed sensory perception? Select all that apply.

* Disorientation * Auditory hallucinations

Which interventions would the nurse implement while caring for a client with mania who is on lithium carbonate therapy? Select all that apply.

* Draw blood samples 12 hours after the last dose. * Notify the primary health-care provider if the serum lithium levels reach 1.5 mEq/L

Which conditions can be effectively treated using topiramate? Select all that apply.

* Epilepsy * Migraine

A client with bipolar disorder is at high risk of self-harm. The nurse finds that the client perceives actions of others as threatening. What does the nurse do to ensure the safety of this client? Select all that apply.

* Places the client on 1-1 precautions * Maintains low level of stimuli in the client environment

Which are the characteristic cognitive symptoms observed in a client with delirious mania? Select all that apply.

* Stupor * Confusion * Disorientation

Which category of drugs has the potential to initiate a manic episode? Select all that apply.

* Sulfonamides * Antiulcer agents * Antihypertensive agents

A client is admitted to the psychiatric ward with a history of two manic episodes. On interaction, the nurse learns that the client has acute symptoms of mania. Which interventions would the nurse include in the acute phase treatment plan for this client? Select all that apply.

* Take measures to alleviate insomnia in the client * Provide adequate quantities of foods and fluids. * Assist the client in performing personal hygiene and grooming. * Remove dangerous objects from the client's environment

The nurse is caring for a client who is diagnosed with hypomania. Which behavior does the nurse find in the client? Select all that apply.

* The client is cheerful and expansive with an underlying irritability * The client talks and laughs very loudly while communicating with the nurse

A client with bipolar disorder is diagnosed with glaucoma. Which medication is contraindicated in this client for the treatment of bipolar disorder?

Clonazepam

Which is the normal therapeutic serum concentration in a client with acute mania receiving lithium therapy?

1.0 mEq/L

A nurse caring for a manic client observes that the client has persistent gastrointestinal upset and blurred vision. After reviewing the laboratory reports, the nurse finds that the client has signs of lithium toxicity. Which concentration of lithium does the nurse find in the client's blood serum?

1.8 eMq/L

Which is the daily dose range of lithium carbonate for a client with acute mania?

1800 to 2400 mg

The nurse is preparing to administer topiramate 50 mg by mouth twice daily. Available are 25 mg tablets. How many total tablets will the nurse administer per day? Enter the numeral only.

4 tablets

Which stage of mania is associated with the behavior of manipulating others to fulfill the client's wishes?

Acute mania

Which condition can be effectively treated using a combination of olanzapine and fluoxetine?

Bipolar disorder with depressive episodes

Which side effect is suspected in the client who is on verapamil therapy?

Bradycardia

Which medication indicated for attention deficit-hyperactivity disorder (ADHD) induces mania?

Bupropion

The nurse is caring for a client with depression who reports burning and stabbing muscle pains due to nerve damage. The medical reports indicate that the client has herpes zoster infection. Which medication would be most beneficial for the client?

Carbamazepine

The nurse is caring for a client with symptoms of alcohol withdrawal. Which medication would the nurse prepare to administer?

Carbamazepine

Which should the nurse do before administering lithium carbonate to a client for the first time?

Check for a history of seizures

A client with bipolar disorder is diagnosed with migraine. Which medication is effective when the primary health-care provider prefers a single medication for the treatment of both the conditions?

Chlorpromazine

After reviewing the medication list of a client with bipolar mania, the nurse advises the client to use extra sunscreen, wear protective clothing, and limit time spent outdoors to 30 minutes. Which medication is the nurse likely to find among the client's prescriptions?

Chlorpromazine

Which would the nurse advise to prevent persistent vomiting and diarrhea for a client with bipolar disorder who is on lithium carbonate therapy?

Consume a diet with adequate sodium

The nurse is caring for a client with mania who is on lithium carbonate therapy. The nurse monitors the client's skin turgor daily. Which sign or symptom observed in the client supports this nursing intervention?

Dehydration

The primary health-care provider prescribes olanzapine to a client who is experiencing acute mania. Which condition in the health history of the client indicates the risk for complications?

Diabetes mellitus

Which symptom displayed by the client may indicate hypomanic episodes of bipolar disorder?

Distractibility

Which therapy might be helpful to a client with bipolar II disorder who is not responding to lithium therapy?

Electroconvulsive therapy

A client with mania refuses to cooperate with peers during group activity. The nurse observes that the client has inaccurate interpretation of the environment. Which intervention would the nurse include after effective treatment?

Evaluate the client's communication skills

Which behavior of a client made the nurse implement keeping juices and snacks on the unit at all times?

Hyperactivity

A research nurse finds that a client participating in a clinical trial is experiencing an episode of euphoria, elevated energy, irritable mood, and distractibility. Which would the nurse suspect is occurring with the client?

Imbalance between biogenic amines and acetylcholine

Which findings may be present in a client with a depressive episode of bipolar disorder?

Increased levels of acetylcholine

Which behavioral characteristics does the nurse observe in a client with hypomania?

Increased perception of environment

Which intervention would the nurse perform to prevent drowsiness and dizziness in a client who is on verapamil therapy?

Instruct the client not to operate heavy machinery

A client gave birth to a stillborn baby and is diagnosed with psychosis. Which treatment would be most beneficial for this client?

Lithium carbonate

A client with bipolar disorder has been in an accident and has severe traumatic brain injury. Which medication is contraindicated in this client for the treatment of bipolar disorder?

Lithium carbonate

Which medication binds to the ANK3 (ankyrin G) protein to prevent manic episodes of bipolar disorder?

Lithium carbonate

Which symptoms does the nurse expect to appear in the client whose serum concentration of lithium is 1.8 mEq/L?

Persistent vomiting

A client is diagnosed with bipolar II disorder with delirious symptoms of mania. Which interventions would the nurse include in the client's care plan?

Provider information about support groups

The nurse is caring for a client who is experiencing very frequent manic episodes. Which intervention by the nurse may help the client reduce the manic episodes of bipolar disorder?

Providing a private room in a quiet unit

Which actions by the nurse will help a hyperactive client achieve much-needed rest?

Providing a structured schedule of activities for the client.

Which action of the nurse is said to be effective while using mechanical restraints on a child with a manic episode of bipolar disorder?

Providing assistance while positioning the child

A client who is experiencing frequent manic episodes has a delusional thought process and low self-esteem. The nurse finds that the client is trying to manipulate others for self-gratification. Which interventions included in the client's care plan would the nurse expect to improve the client's self-esteem?

Reinforcing acceptable behaviors in the client

A client with mania who is extremely hyperactive and intensely agitated is admitted into the psychiatric ward. During client care, the nurse instructs the client to perform slow exercises. Which risks does the nurse intend to prevent in the client?

Risk of physical injury

Which medication would be beneficial to a client with autism?

Risperidone

A client diagnosed with bipolar I disorder is on divalproex therapy. During the follow-up visit, the nurse finds elevated mood swings in the client. Which intervention of the primary health-care provider is beneficial in this situation?

Switching the client to olanzapine therapy

A client who has undergone surgery for left ventricular dysfunction is receiving treatment for bipolar mania. Which medication may increase the risk of cardiac complications in the client?

Verapamil

Which medication regulates the influx and outflow of calcium from the cells through the expression of CACNA1C protein?

Verapamil