Exam Questions with Correct Answers

Bipolar and Related Disorders NCLEX Exam Questions with Correct Answers 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 collapse!" 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

• Risk for injury related to hyperactivity
• Disturbed sleep pattern related to agitation
• 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?

• Sit with her during meals to ensure that she eats everything on her tray.
• Have her sister-in-law bring all her food from home because she knows Margaret's

likes and dislikes.

• Provide high-calorie, nutritious finger foods and snacks that Margaret can eat "on the

run."

• 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 Disorder. There is a narrow margin between the therapeutic and toxic levels of lithium. What is the therapeutic range for acute mania?

• 1.0 to 1.5 mEq/L
• 10 to 15 mEq/L
• 0.5 to 1.0 mEq/L
• 5 to 10 mEq/L - Answer-A; (1.0 to 1.5 mEq/L)

Which of the following is the most common comorbid condition in children with bipolar disorder?

• Schizophrenia 1 / 2

• Substance disorders
• Oppositional defiant disorder
• 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?

• Fever, sore throat, malaise
• Tinnitus, severe diarrhea, ataxia
• Occipital headache, palpitations, chest pain
• 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?

• Tell the client she cannot wear this outfit while she is in the hospital.
• Do nothing, and allow her to learn from the responses of her peers.
• Quietly walk with her back to her room and help her change into something more

appropriate.

• 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.) A child with bipolar disorder also has attention deficit/hyperactivity disorder (ADHD).How would these comorbid conditions most likely be treated?

• No medication would be given for either condition.
• Medication would be given for both conditions simultaneously.
• The bipolar condition would be stabilized first before medication for the ADHD would

be given.

• 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.) A highly agitated client paces the unit and states, "I could buy and sell this place." The client's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client's behavior?

• "Rates mood 8/10. Exhibiting looseness of association. Euphoric."
• "Mood euthymic. Exhibiting magical thinking. Restless."
• "Mood labile. Exhibiting delusions of reference. Hyperactive."
• "Agitated and pacing. Exhibiting grandiosity. Mood labile." - Answer-4; ("Agitated and

pacing. Exhibiting grandiosity. Mood labile.")

• / 2