Psych Ch. 13 Bipolar and Related Disorders NCLEX Review

Psych Ch. 13 Bipolar and Related Disorders NCLEX Review Questions Leave the first rating Students also studied Terms in this set (21) Science MedicinePsychiatry Save

Varcarolis: Chapter 13 - Bipolar and ...

48 terms Will-S-Preview

Chapter 17: Bipolar and Related Dis...

46 terms Olivia_Bouchard Preview

Chapter 9: Health Promotion of the I...

45 terms gaby5511Preview Mental 58 terms Shir A client diagnosed with bipolar disorder has a nursing care plan that includes several nursing diagnoses listed.Match the nursing diagnosis to the level of priority (1 to 4).

• Risk for Injury
• Self-care deficit, bathing, hygiene
• Knowledge, deficient
• Nonadherence

Which of the following is true of the relationship between bipolar disorder and suicide?Suicide is a serious risk those diagnosed with bipolar disorder commit suicide.Mortality rates for bipolar disorder are severe because substantial numbers of individuals with bipolar disorder will make a suicide attempt at least once in their lifetime. Suicides occur in both the depressed and the manic phase. Bipolar clients are always considered high risk for suicide because of impulsivity while in the manic phase and hopelessness when in the depressed phase. Although staying on medications may decrease risk, there is no evidence to suggest that only clients who stop medications commit suicide.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?Grandiosity Grandiosity is inflated self-regard. People with mania may exaggerate their achievements or importance, state that they know famous people, or believe they have great powers. Although clients with mania are unpredictable, the scenario does not describe unpredictability: rapid cycling is switching between mania and depression in a given time period. The scenario does not describe flight of ideas, which means a continuous flow of speech with abrupt topic changes.

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?Decreased sleep Changes in sleep patterns are especially important because they usually precede mania. Even a single night of unexplainable sleep loss can be taken as an early warning of impending mania. The other options do not indicate impending mania.Which of the following describe the symptoms of the manic phase of bipolar disorder? (Select all that apply.) Distractibility Excessive Energy Racing Thoughts Purposeless Movement Pressure Speech What is the first-line drug used to treat mania?Lithium carbonate Lithium, a mood stabilizer, is the first-line drug for use in treating bipolar disorder.The other options are prescribed to manage other related symptoms of bipolar disorder.An acute phase nursing intervention aimed at reducing hyperactivity is demonstrated by which intervention?Writing in a diary Manic clients often respond well to the invitation to write. They will fill reams of paper. While writing they are less physically active. None of the remaining options presents this opportunity to reduce physical activity.What term is used to identify the condition demonstrated by a person who has numerous hypomanic and dysthymic episodes over a two-year period?Cyclothymia Cyclothymia refers to mood swings involving hypomania and dysthymia of 2 years duration. The mood swings are not severe enough to prompt hospitalization.None of the other options meet that criteria.Which behavior would be characteristic of a client during a manic episode?Going rapidly from one activity to another.Hyperactivity and distractibility are basic to manic episodes. None of the other options demonstrate such characteristics.The nurse can expect a client demonstrating typical manic behavior to be attired in clothing that includes with characteristics?Colorful and inappropriate.Manic clients often manage to dress and apply makeup in ways that create a colorful, inappropriate, even bizarre, appearance. None of the remaining options meet that criteria.When a client experiences four or more mood episodes in a 12-month period, which term is used to describe this behavior?Rapid Cycling.Rapid cycling implies four or more mood episodes in a 12-month period, as well as more severe symptomatology. None of the other options are associated with this characteristic behavior.When a client reports that lithium causes an upset stomach, the nurse should make which suggestion associated with taking the medication?With meals.Many clients find that taking lithium with or shortly after meals minimizes gastric distress. None of the other options present accurate information.

When the partner of a manic client asks about genetic transmission of bipolar disorder, the nurse's answer should be predicated on which information?The rate of bipolar disorder is higher in relatives of people with bipolar disorder.This understanding will allow the nurse to directly address the question.Responses based on the other statements would be tangential or untrue.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?Distracting the client by suggesting, "It's time to work on your art project." Distractibility works as the nurse's friend. Rather than discuss the invitation, the nurse may be more effective by redirecting the client. This intervention is both therapeutic and less restrictive.What is the priority nursing diagnosis for a hyperactive manic client during the acute phase of treatment?Risk for injury/suicide Risk for injury is high, related to the client's hyperactivity and poor judgment.Safety is always the priority when considering client care.What is a desired outcome for the maintenance phase of treatment for a manic client?Adhere to follow-up medical appts.The client would be living in the community during the maintenance phase.Keeping follow-up appointments is highly desirable. None of the other options are accurate.What action should the nurse take on learning that a manic client's serum lithium level is 1.8 mEq/L?Withhold medication and notify the physician.The client's lithium level has exceeded desirable limits. Additional doses of the medication should be withheld, and the physician notified. None of the other options are accurate interventions.Which side effects of lithium can be expected at therapeutic levels?Fine hand tremor and polyuria The fact that fine hand tremor and polyuria are present at therapeutic levels is quite annoying to some clients. These and other side effects are factors in noncompliance.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?Grandiosity Exaggerated belief in one's own importance, identity, or capabilities is seen with grandiosity. None of the other options are associated with this behavior.Which room placement would be best for a client experiencing a manic episode?A single room near the nurses' station The room placement that provides a non-stimulating environment is best.Nearness to the nurses' station means close supervision can be provided. None of the other options provide low stimulation.When a hyperactive manic client expresses the intent to strike another client, what is the initial nursing intervention?Set verbal limits Verbal limit setting should always precede more restrictive measures. Questioning motives does not address the safety issue that exists.