M28.B Bipolar Disorders
5) Which client observation indicates that interventions provided to a client in the manic phase of bipolar disorder have improved self-care activities? A) Completed morning bath and changed clothes B) Washes hands after using the toilet when reminded C) Cleaned liquid spilled on floor but did not change clothes D) Brushes own teeth every time when reminded
A
A woman with bipolar disorder wishes to become pregnant and asks the nurse if she should stop the medications. Which would be the nurse's best response? A. "Speak with your healthcare provider about tapering and changing some of your medications." B. "Stop all of your medications except your lithium." C. "Do not stop your medications or you will have a manic episode." D. "Stop your medications immediately."
A
An older client is beginning lithium therapy for newly diagnosed bipolar disorder. For which medical condition should the nurse review the chart before administering the prescribed medication? A. Kidney insufficiency B. Liver failure C. Anemia D. Infection
A
The nurse should understand that cognitive-behavioral therapy focuses on which activity? (Select all that apply.) A. Reflection B. Hypnosis C. Cognitive modification D. Role playing E. Mindfulness
A, C, D, E
The nurse is caring for a client with bipolar disorder who is admitted to the hospital after an accidental overdose of sleeping medication. Which is an appropriate nursing diagnosis for this client? (Select all that apply.) A. Coping, Ineffective B. Self-care, Readiness for Enhanced C. Knowledge, Deficient D. Relationship, Ineffective E. Violence: Self-Directed, Risk for
A, B, C, E
The nurse is caring for an adolescent experiencing a manic period of bipolar disorder. Which technique reinforces behavior limits? (Select all that apply.) A. Speaking in a calm but matter-of-fact tone B. Building trust with the adolescent C. Curbing manipulative behavior D. Overstepping personal boundaries to help the adolescent E. Modeling behavior for the adolescent to follow
A, B, C, E
The nurse is working with the activities director in a group home for clients with bipolar disorder. Which activity should the nurse include? (Select all that apply.) A. Dance B. Floor aerobics C. Flag football D. Soccer E. Walking
A, B, E
8) A student nurse is assisting in the care of a client with bipolar disorder. The student nurse researches the disorder further, focusing on the pathophysiology and etiology of the disorder. Which are true regarding the pathophysiology and etiology of bipolar disorder? Select all that apply. A) No definitive cause or specific pathophysiology has been identified for bipolar spectrum disorders. B) Bipolar disorders, anxiety disorders, and personality disorders share biological susceptibility and inheritance patterns. C) Immunologic abnormalities may contribute to the pathophysiology of mania and bipolar disorder. D) Children of parents with bipolar disorder have an increased risk of developing the disorder. E) Stressful life events and an emotionally overinvolved, hostile, and critical communication pattern are factors associated with heritability of the disorder.
A, C, D, E
The behavioral health nurse is collaborating with the dietitian to create a diet plan for a client with bipolar disorder who is living independently. Which intervention should the nurse include? (Select all that apply.) A. Reviewing the use of nutritious meal-replacement drinks B. Planning three large meals per day C. Identifying easily prepared meals D. Planning foods that are portable E. Making a list of client food preferences
A, C, D, E
The healthcare provider has prescribed lithium carbonate for a client diagnosed with bipolar disorder. Which information should the nurse include in the client teaching? (Select all that apply.) A. "Lab work will be needed to monitor the therapeutic level of this medication." B. "Monitor for constipation, as this could indicate lithium toxicity." C. "This medication needs to be closely monitored by a healthcare provider if you suspect that you may be pregnant." D. "This medication may be used with an anticonvulsant used as a mood stabilizer." E. "Monitor for nausea and vomiting, as this could indicate lithium toxicity."
A, C, D, E
The nurse is providing discharge instructions for a client with bipolar disorder who presented to the hospital in a manic state. Which instruction should the nurse include? (Select all that apply.) A. Recognize medication side effects. B. Recognize the importance of adhering to therapy schedules. C. Seek help when needed. D. Learn methods to prevent the disorder. E. Learn effective self-administration of medications.
A, D, C, E
1) The nurse is providing care to a client diagnosed with bipolar disorder. The client's family asks the nurse what this is. Which response by the nurse is appropriate? A) "Bipolar disorder is a type of depression that includes attention deficit disorder symptoms." B) "Bipolar disorder means there are cycles of depression as well as extreme elevations in mood, or mania." C) "Bipolar disorder just means that the mood alternates with the seasons, and it becomes worse in the winter." D) "Bipolar disorder is just another type of depression, except depression occurs in cycles."
B
6) A client in the manic phase of bipolar disorder is prescribed lithium and has a current lithium blood level of 0.4 mEq/L. Which clinical manifestation does the nurse anticipate when assessing this client? A) A decrease in manic behavior B) Hyperactivity and pressured speech C) A return to baseline behavior, calm and rational D) Signs and symptoms of depression
B
The behavioral health nurse is assessing a client with bipolar disorder. Which finding indicates that the client is in a state of hypomania? A. The client is experiencing hallucinations. B. The client expresses euphoric feelings of being on top of the world. C. The client feels powerless and is coping with the use of alcohol. D. The client demonstrates flight of ideas.
B
Which aspect should the nurse address in the psychosocial history assessment of a client with bipolar disorder? A. Neurologic assessment B. Observation of client affect C. Vital signs D. Presence of physical complaints
B
Which collaborative process of initial monitoring should the nurse implement for a client who has been prescribed lithium? A. Arranging for therapy sessions every 1-3 days B. Testing lithium serum levels every 1-3 days C. Testing sodium levels every 1-3 days D. Arranging for blood urea nitrogen (BUN) and creatinine levels every 1-3 days
B
The nurse is evaluating the effectiveness of the nursing interventions for a client with bipolar disorder. Which evaluation of outcomes is appropriate for this client? (Select all that apply.) A. The client was able to sleep at least 4 hours at night. B. The client was able to avoid unsafe or socially inappropriate behavior in a variety of situations. C. The client remained in a safe environment and free from injury. D. The client was able to demonstrate reality-based thinking by making an effective decision. E. The client did not commit violent or harmful acts against self or others.
B, C, D, E
2) The nurse is providing care to a client who is exhibiting manifestations of a mood disorder. Which assessment findings indicate that the client may be at an increased risk for bipolar disorder? Select all that apply. A) Blood pressure 120/80 mmHg B) Recent major life-altering event C) Works out at the gym every week D) Currently employed E) Mother diagnosed with bipolar disorder
B, E
7) A client in the manic phase of bipolar disorder will not sit down to eat. Which can the nurse do to ensure adequate nutrition and improved self-care of this client? Select all that apply. A) Provide a sedative before meals. B) Discuss finger-food options with the dietitian. C) Use a jacket restraint at meal times. D) Ask the healthcare provider if intravenous feedings would be applicable. E) Provide nutritious liquids.
B, E
10) Which statement about bipolar disorder is true? A) The client will exhibit functional impairment at work during remission periods. B) Episodes associated with bipolar disorder tend to decrease in frequency with age. C) Some clients with bipolar disorder do not experience remission periods. D) Bipolar disorders typically appear between the ages of 25 and 50.
C
11) A woman with bipolar disorder is taking lithium. She continues to take lithium until she realizes she is pregnant, which is 6 weeks into the pregnancy. Which potential adverse effect might the nurse tell the client about when she asks about lithium and pregnancy? A) Craniofacial defects B) Neural tube defects C) Heart defects D) Gastrointestinal defects
C
3) The nurse is caring for a client with bipolar disorder who has expressed the desire to harm self. What is the priority nursing diagnosis for this client? A) Powerlessness B) Impaired Social Interaction C) Risk for Suicide D) Social Isolation
C
A client with bipolar disorder has only been prescribed an antidepressive medication. Which risk factor should the nurse consider to be the highest? A. No change B. Compulsive behaviors C. Manic episode D. Increased anxiety
C
The nurse is caring for a client with bipolar disorder experiencing a depressive episode. The client tells the nurse, "I don't know why I even try anymore. I always fail at everything in my life. I should just give up." Which aspect of the psychosocial history during the nursing exam is most important? A. Self-esteem assessment B. Hallucination assessment C. Suicide assessment D. Interpersonal relationship assessment
C
The parents of a child with bipolar disorder ask the nurse what treatments will help control the child's violent outbursts and temper tantrums. Which would be the nurse's best response? A. "Punishing the child will help change behavior." B. "There is no cure for bipolar disorder and no hope for the child's behavior to improve." C. "Psychotherapy will help the child learn coping and appropriate actions to build relationships." D. "Maximum doses of prescribed medication should be administered to control behavior."
C
Which intervention is a priority to include in the plan of care for the client with bipolar disorder to prevent suicide? A. Developing a daily schedule for consistency B. Engaging the client in conversation of current events C. Access to contact information for help in times of crisis D. Joining a local sports league for social interaction
C
9) The nurse understands that bipolar disorders affect clients differently across the lifespan. Which is true regarding bipolar disorder and lifespan considerations? A) Children with bipolar disorders present with mood changes only. B) Children with bipolar disorders rarely exhibit violent tempers. C) Suicide risk does not increase in adolescents and teenagers who are diagnosed with bipolar disorders. D) Lifetime prevalence of bipolar disorders in adolescents is 0-3%.
D
The nurse is leading a group therapy session for clients with bipolar disorder. During the session, a client with bipolar I disorder becomes increasingly restless and starts constantly interrupting and criticizing other members of the group. The client ignores the nurse's repeated requests to stop the disruptive behavior. Which type of bipolar episode is the client likely experiencing? A. Depressive B. Disruptive C. Cyclothymic D. Manic
D
The nurse is teaching colleagues about cyclothymic disorder. Which statement should the nurse include? A. "It is a mood disorder similar to major depression but of mild to moderate severity." B. "It is a form of depression that occurs in the fall and winter." C. "It involves a single manic episode." D. "It involves a mood range from moderate depression to hypomania."
D
Which medication should the nurse expect to administer to the client with bipolar disorder for immediate treatment of the clinical manifestations of mania? A. Anticholinergic medication, diphenhydramine B. An antidepressant medication, paroxetine C. Antimanic medication, lithium carbonate D. An antipsychotic mood stabilizer, olanzapine
D
4) A client in the manic phase of bipolar disorder is unable to sleep during the night. Which interventions could be helpful to this client? Select all that apply. A) Engage in conversation. B) Extend daytime naps. C) Encourage the client to watch television. D) Assist the client with a warm bath and provide a light snack. E) Encourage the client to listen to soothing music.
D, E