(Psych) Bipolar and related disorders,
Exam Questions and Answers 100%
Pass
Margaret, a 68-year-old widow, is brought to the emergency department by her sister-in-
law. Margaret has a history of bipolar disorder and has been maintained on medication
for many years. Her sister- in-law reports that Margaret quit taking her medication a few
months ago, thinking she didn't need it anymore. Margaret is agitated, pacing,
demanding, and speaking very loudly. Her sister-in-law reports that Margaret eats very
little, is losing weight, and almost never sleeps. "I'm afraid she's going to just col- lapse!"
Margaret is admitted to the psychiatric unit. What is the priority nursing diagnosis for
Margaret?
a. Imbalanced nutrition: less than body requirements related to not eating
b. Risk for injury related to hyperactivity
c. Disturbed sleep pattern related to agitation
d. Ineffective coping related to denial of depression - Answer-b. Risk for injury related
to hyperactivity
Margaret, age 68, is diagnosed with Bipolar I Disorder, current episode manic. She is
extremely hyperactive and has lost weight. What is one way to promote adequate
nutritional intake for Margaret?
a. Sit with her during meals to ensure that she eats everything on her tray.
b. Have her sister-in-law bringall her food from home because she knows Margaret's
likes and dislikes.
c. Provide high-calorie, nutritious finger foods and snacks that Margaret can eat "on the
run."
d. Tell Margaret that she will be on room restriction until she starts gaining weight. -
Answer-c. Provide high-calorie, nutritious finger foods and snacks that Margaret can eat
"on the run."
The physician orders lithium carbonate 600 mg tid for a client newly diagnosed with
Bipolar I Dis- order. There is a narrow margin between the therapeutic and toxic levels
of lithium. What is the therapeutic range for acute mania?
a. 1.0 to 1.5 mEq/L
b. 10 to 15 mEq/L
c. 0.5 to 1.0 mEq/L
d. 5 to 10 mEq/L - Answer-a. 1.0 to 1.5 mEq/L
Although historically lithium has been the medication of choice for mania, several others
have been used with good results. Which of the following are used in the treatment of
bipolar disorder? Select all that apply.
,a. Olanzepine (Zyprexa)
b. Oxycodone (Oxycontin)
c. Carbamazepine (Tegretol)
d. Gabapentin (Neurontin)
e. Tranylcypromine (Parnate) - Answer-a. Olanzepine (Zyprexa)
c. Carbamazepine (Tegretol)
d. Gabapentin (Neurontin)
Margaret, a 68 year old widow experiencing a manic episode, is admitted to the
psychiatric unit after being brought to the emergency department by her sister in law.
Margaret yells, "My sister in law is just jealous of me! She's trying to make it look like I'm
insane!" This behavior is an example of?
a) delusion of grandeur
b) delusion of persecution
c) delusion of reference
d) delusion of control or influence - Answer-b. A delusion of persecution
Which of the following is the most common comorbid condition in children with bipolar
disorder?
a. Schizophrenia
b. Substance disorders
c. Oppositional defiant disorder
d. Attention deficit/hyperactivity disorder - Answer-d. Attention deficit/hyperactivity
disorder
A nurse is educating a client about his lithium therapy. She is explaining signs and
symptoms of lithium toxicity. Which of the following would she instruct the client to be on
the alert for?
a. Fever, sore throat, malaise
b. Tinnitus, severe diarrhea, ataxia
c. Occipital headache, palpitations, chest pain d. Skin rash, marked rise in blood
pressure, bradycardia - Answer-b. Tinnitus, severe diarrhea, ataxia
A client experiencing a manic episode enters the milieu area dressed in a provocative
and physically revealing outfit. Which of the following is the most appropriate
intervention by the nurse?
a. Tell the client she cannot wear this outfit while she is in the hospital.
b. Do nothing, and allow her to learn from the responses of her peers.
c. Quietly walk with her back to her room and help her change into something more
appropriate.
d. Explain to her that if she wears this outfit, she must remain in her room. - Answer-c.
Quietly walk with her back to her room and help her change into something more
appropriate.
, The nurse is prioritizing nursing diagnoses in the plan of care for a client experiencing a
manic episode. Number the diagnoses in order of the appropriate priority.
a. Disturbed sleep pattern evidenced by sleeping only 4 to 5 hours per night
b. Risk for injury related to manic hyperactivity
c. Impaired social interaction evidenced by manipulation of others
d. Imbalanced nutrition: Less than body requirements evidenced by loss of weight and
poor skin turgor - Answer-b. Risk for injury related to manic hyperactivity
d. Imbalanced nutrition: Less than body requirements evidenced by loss of weight and
poor skin turgor
a. Disturbed sleep pattern evidenced by sleeping only 4 to 5 hours per night
c. Impaired social interaction evidenced by manipulation of others
A child with bipolar disorder also has attention deficit/hyperactivity disorder (ADHD).
How would these comorbid conditions most likely be treated?
a. No medication would be given for either condition.
b. Medication would be given for both conditions simultaneously.
c. The bipolar condition would be stabilized first before medication for the ADHD would
be given.
d. The ADHD would be treated before consideration of the bipolar disorder. - Answer-c.
The bipolar condition would be stabilized first before medication for the ADHD would be
given.
D. Agitated and pacing. Exhibiting grandiosity. Mood labile.
The nurse should document that this clients behavior is Agitated and pacing. Exhibiting
grandiosity. Mood labile. The client is exhibiting signs of irritation accompanied by
aggressive behavior. Grandiosity refers to an exaggerated sense of power, importance,
knowledge, or identity. - Answer-1. A highly agitated client paces the unit and states, I
could buy and sell this place. The clients mood fluctuates from fits of laughter to
outbursts of anger. Which is the most accurate documentation of this clients behavior?
A. Rates mood 8/10. Exhibiting looseness of association. Euphoric.
B. Mood euthymic. Exhibiting magical thinking. Restless.
C. Mood labile. Exhibiting delusions of reference. Hyperactive.
D. Agitated and pacing. Exhibiting grandiosity. Mood labile.
B. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss
The nurse should identify that the priority nursing diagnosis for this client is altered
nutrition: less than body requirements R/T hyperactivity AEB weight loss. Due to the
Exam Questions and Answers 100%
Pass
Margaret, a 68-year-old widow, is brought to the emergency department by her sister-in-
law. Margaret has a history of bipolar disorder and has been maintained on medication
for many years. Her sister- in-law reports that Margaret quit taking her medication a few
months ago, thinking she didn't need it anymore. Margaret is agitated, pacing,
demanding, and speaking very loudly. Her sister-in-law reports that Margaret eats very
little, is losing weight, and almost never sleeps. "I'm afraid she's going to just col- lapse!"
Margaret is admitted to the psychiatric unit. What is the priority nursing diagnosis for
Margaret?
a. Imbalanced nutrition: less than body requirements related to not eating
b. Risk for injury related to hyperactivity
c. Disturbed sleep pattern related to agitation
d. Ineffective coping related to denial of depression - Answer-b. Risk for injury related
to hyperactivity
Margaret, age 68, is diagnosed with Bipolar I Disorder, current episode manic. She is
extremely hyperactive and has lost weight. What is one way to promote adequate
nutritional intake for Margaret?
a. Sit with her during meals to ensure that she eats everything on her tray.
b. Have her sister-in-law bringall her food from home because she knows Margaret's
likes and dislikes.
c. Provide high-calorie, nutritious finger foods and snacks that Margaret can eat "on the
run."
d. Tell Margaret that she will be on room restriction until she starts gaining weight. -
Answer-c. Provide high-calorie, nutritious finger foods and snacks that Margaret can eat
"on the run."
The physician orders lithium carbonate 600 mg tid for a client newly diagnosed with
Bipolar I Dis- order. There is a narrow margin between the therapeutic and toxic levels
of lithium. What is the therapeutic range for acute mania?
a. 1.0 to 1.5 mEq/L
b. 10 to 15 mEq/L
c. 0.5 to 1.0 mEq/L
d. 5 to 10 mEq/L - Answer-a. 1.0 to 1.5 mEq/L
Although historically lithium has been the medication of choice for mania, several others
have been used with good results. Which of the following are used in the treatment of
bipolar disorder? Select all that apply.
,a. Olanzepine (Zyprexa)
b. Oxycodone (Oxycontin)
c. Carbamazepine (Tegretol)
d. Gabapentin (Neurontin)
e. Tranylcypromine (Parnate) - Answer-a. Olanzepine (Zyprexa)
c. Carbamazepine (Tegretol)
d. Gabapentin (Neurontin)
Margaret, a 68 year old widow experiencing a manic episode, is admitted to the
psychiatric unit after being brought to the emergency department by her sister in law.
Margaret yells, "My sister in law is just jealous of me! She's trying to make it look like I'm
insane!" This behavior is an example of?
a) delusion of grandeur
b) delusion of persecution
c) delusion of reference
d) delusion of control or influence - Answer-b. A delusion of persecution
Which of the following is the most common comorbid condition in children with bipolar
disorder?
a. Schizophrenia
b. Substance disorders
c. Oppositional defiant disorder
d. Attention deficit/hyperactivity disorder - Answer-d. Attention deficit/hyperactivity
disorder
A nurse is educating a client about his lithium therapy. She is explaining signs and
symptoms of lithium toxicity. Which of the following would she instruct the client to be on
the alert for?
a. Fever, sore throat, malaise
b. Tinnitus, severe diarrhea, ataxia
c. Occipital headache, palpitations, chest pain d. Skin rash, marked rise in blood
pressure, bradycardia - Answer-b. Tinnitus, severe diarrhea, ataxia
A client experiencing a manic episode enters the milieu area dressed in a provocative
and physically revealing outfit. Which of the following is the most appropriate
intervention by the nurse?
a. Tell the client she cannot wear this outfit while she is in the hospital.
b. Do nothing, and allow her to learn from the responses of her peers.
c. Quietly walk with her back to her room and help her change into something more
appropriate.
d. Explain to her that if she wears this outfit, she must remain in her room. - Answer-c.
Quietly walk with her back to her room and help her change into something more
appropriate.
, The nurse is prioritizing nursing diagnoses in the plan of care for a client experiencing a
manic episode. Number the diagnoses in order of the appropriate priority.
a. Disturbed sleep pattern evidenced by sleeping only 4 to 5 hours per night
b. Risk for injury related to manic hyperactivity
c. Impaired social interaction evidenced by manipulation of others
d. Imbalanced nutrition: Less than body requirements evidenced by loss of weight and
poor skin turgor - Answer-b. Risk for injury related to manic hyperactivity
d. Imbalanced nutrition: Less than body requirements evidenced by loss of weight and
poor skin turgor
a. Disturbed sleep pattern evidenced by sleeping only 4 to 5 hours per night
c. Impaired social interaction evidenced by manipulation of others
A child with bipolar disorder also has attention deficit/hyperactivity disorder (ADHD).
How would these comorbid conditions most likely be treated?
a. No medication would be given for either condition.
b. Medication would be given for both conditions simultaneously.
c. The bipolar condition would be stabilized first before medication for the ADHD would
be given.
d. The ADHD would be treated before consideration of the bipolar disorder. - Answer-c.
The bipolar condition would be stabilized first before medication for the ADHD would be
given.
D. Agitated and pacing. Exhibiting grandiosity. Mood labile.
The nurse should document that this clients behavior is Agitated and pacing. Exhibiting
grandiosity. Mood labile. The client is exhibiting signs of irritation accompanied by
aggressive behavior. Grandiosity refers to an exaggerated sense of power, importance,
knowledge, or identity. - Answer-1. A highly agitated client paces the unit and states, I
could buy and sell this place. The clients mood fluctuates from fits of laughter to
outbursts of anger. Which is the most accurate documentation of this clients behavior?
A. Rates mood 8/10. Exhibiting looseness of association. Euphoric.
B. Mood euthymic. Exhibiting magical thinking. Restless.
C. Mood labile. Exhibiting delusions of reference. Hyperactive.
D. Agitated and pacing. Exhibiting grandiosity. Mood labile.
B. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss
The nurse should identify that the priority nursing diagnosis for this client is altered
nutrition: less than body requirements R/T hyperactivity AEB weight loss. Due to the
