1) Which of the following is true of the relationship between bipolar disorder and suicide? a) Clients need to be monitored only in the depressed phase because this is when suicides occur. b) As long as clients with bipolar disorder adhere to their medication regimen, there is little risk for suicide. c) Suicide is a serious risk those diagnosed with bipolar disorder commit suicide. d) Clients with bipolar disorder are not considered high risk for suicide. 2) A 31-year-old client admitted with acute mania tells the staff and the other clients that he is on a secret mission for the President of the United States. He states, “I am the only one he trusts, because I am the best!” What term will the nurse use when documenting this behavior? a) Flight of ideas b) Grandiosity c) Rapid cycling d) Unpredictability 3) A client hospitalized for a psychotic relapse is being discharged home to family. Which topic is important to address when teaching both the client and the family to recognize possible signs of impending mania? a) Decreased social interaction b) Increased appetite c) Increased attention to bodily functions d) Decreased sleep 4) Which of the following describe the symptoms of the manic phase of bipolar disorder? (Select all that apply.) a) Distractibility b) Low self-esteem c) Excessive energy d) Withdrawal from environment e) Racing thoughts f) Purposeless movement 5) A client diagnosed with bipolar disorder has a nursing care plan that includes several nursing diagnoses listed. Which diagnosis should the nurse address first? a) Self-care deficit, bathing, and hygiene b) Knowledge, deficient c) Nonadherence d) Risk for injury 6) An acute phase nursing intervention aimed at reducing hyperactivity is demonstrated by which intervention? a) Directing unit activities b) Orienting a new client to the unit c) Writing in a diary d) Exercising in the gym 7) What is the first-line drug used to treat mania? a) Carbamazepine b) Clonazepam c) Lithium carbonate d) Lamotrigine 8) Which behavior would be characteristic of a client during a manic episode? a) Going rapidly from one activity to another b) Being unwilling to leave home to see other people c) Taking frequent rest periods and naps during the day d) Watching others intently and talking little 9) The nurse can expect a client demonstrating typical manic behavior to be attired in clothing that includes with characteristics? a) Ill-fitted and ragged b) Dark colored and modest c) Colorful and inappropriate d) Compulsively neat and clean 10) When a client experiences four or more mood episodes in a 12-month period, which term is used to describe this behavior? a) Incongruent b) Cyclothymic c) Dyssynchronous d) Rapid cycling 11) When a client reports that lithium causes an upset stomach, the nurse should make which suggestion associated with taking the medication? a) 2 hours after meals b) With an antacid c) 30 minutes before meals d) With meals 12) When the partner of a manic client asks about genetic transmission of bipolar disorder, the nurse’s answer should be predicated on which information? a) Much depends on the socioeconomic class of the individuals. b) Highly creative people tend toward development of the disorder. c) No research exists to suggest genetic transmission. d) The rate of bipolar disorder is higher in relatives of people with bipolar disorder. 13) What term is used to identify the condition demonstrated by a person who has numerous hypomanic and dysthymic episodes over a two-year period? a) Cyclothymia. b) Bipolar II disorder. c) Bipolar I disorder. d) Seasonal affective disorder. 14) Which side effects of lithium can be expected at therapeutic levels? a) Coarse hand tremor and gastrointestinal upset b) Nausea and thirst c) Ataxia and hypotension d) Fine hand tremor and polyuria 15) What is the priority nursing diagnosis for a hyperactive manic client during the acute phase of treatment? a) Impaired verbal communication b) Risk for injury/suicide c) Ineffective role performance d) Risk for other-directed violence 16) A manic client tells a nurse “Bud. Crud. Dud. I’m a real stud! You’d like what I have to offer. Let’s go to my room.” What is the best initial approach to managing this behavior? a) Enforcing consequences by responding, “Let’s walk down to the seclusion room.” b) Reprimand the client by stating, “What an offensive thing to suggest!” c) Clarifying the nurse–client relationship by stating, “I don’t have sex with clients.” d) Distracting the client by suggesting, “It’s time to work on your art project.” 17) What is a desired outcome for the maintenance phase of treatment for a manic client? a) Adhere to follow-up medical appointments. b) Take medication more than 50% of the time. c) Use alcohol to moderate occasional mood “highs.” d) Exhibit optimistic, energetic, playful behavior. 18) What action should the nurse take on learning that a manic client’s serum lithium level is 1.8 mEq/L? a) Advise the client to curtail salt intake for 24 hours. b) Continue to administer medication as ordered. c) Advise the client to limit fluids for 12 hours. d) Withhold medication and notify the physician. 19) A bipolar client tells the nurse, “I have the finest tenor voice in the world. The three tenors who do all those TV concerts are going to retire because they can’t compete with me.” What term should the nurse use to identify this behavior? a) Limit testing b) Flight of ideas c) Grandiosity d) Distractibility 20) When a hyperactive manic client expresses the intent to strike another client, what is the initial nursing intervention? a) question the client’s motive. b) initiate physical confrontation. c) prepare the client for seclusion. d) set verbal limits.

MH: Bipolar Practice questions

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