1. Which statement about the development of bipolar disorder is from a biochemical perspective?
a. Family studies have shown that if one parent is
... [Show More] diagnosed with bipolar disorder, the risk that a child will have the disorder is around 28%.
b. In bipolar disorder, there may be possible alterations in normal electrolyte transfer across cell membranes, resulting in elevated levels of intracellular calcium and sodium.
c. Magnetic resonance imaging studies have revealed enlarged third ventricles, subcortical white matter, and periventricular hyperintensity in individuals diagnosed with bipolar disorder.
d. Twin studies have indicated a concordance rate among monozygotic twins of 60% to 80%.
b
2. Which nursing charting entry is documentation of a behavioral symptom of mania?
a. "Thoughts fragmented, flight of ideas noted."
b. "Mood euphoric and expansive. Rates mood a 10/10."
c. "Pacing halls throughout the day. Exhibits poor impulse control."
d. "Easily distracted, unable to focus on goals."
c
3. A client diagnosed with cyclothymia is newly admitted to an inpatient psychiatric unit. A client has a history of irritability and grandiosity and is currently sleeping 2 hours a night. Which nursing diagnoses take priority?
a. Altered thought processes related to biochemical alterations.
b. Social isolation related to grandiosity.
c. Disturbed sleep patterns related to agitation.
d. Risk for violence: self-directed related to depressive symptoms.
c
4. A client diagnosed with bipolar I disorder and experiencing a manic episode is newly admitted to the inpatient psychiatric unit. Which nursing diagnosis is a priority at this time?
a. Risk for violence: other-directed related to poor impulse control.
b. Disturbed sensory perception related to hallucinations.
c. Social isolation related to manic excitement.
d. Low self-esteem related to guilt about promiscuity.
a
5. A client diagnosed with bipolar I disorder has a nursing diagnosis of disturbed thought process related to biochemical alterations. Based on this diagnosis, which outcome would be appropriate?
a. The client will not experience injury throughout the shift.
b. The client will interact appropriately with others by day 3.
c. The client will be compliant with prescribed medications.
d. The client will distinguish reality from delusions by day 6.
d
6. A client diagnosed with bipolar II disorder has a nursing diagnosis of impaired social interactions related to egocentrism. Which short-term outcome is an appropriate expectation for this client problem?
a. The client will have an appropriate one-on-one interaction with a peer by day 4.
b. The client will exchange personal information with peers at lunchtime.
c. The client will verbalize the desire to interact with peers by day 2.
d. The client will initiate an appropriate social relationship with a peer.
a
7. A client experiencing mania states, "Everything I do is great." Using a cognitive approach, which nursing response would be most appropriate?
a. "Is there a time in your life when things didn't go as planned?"
b. "Everything you do is great."
c. "What are some other things you do well?"
d. "Let's talk about the feelings you have about your childhood."
a
8. A client newly admitted to an inpatient psychiatric unit is experiencing a manic episode. The client's nursing diagnosis is imbalanced nutrition, less than body requirements. Which meal is most appropriate for this client?
a. Chicken fingers and sweet potato fries
b. Grilled chicken and a baked potato
c. Spaghetti and meatballs
d. Chili and crackers
a
9. A provocatively dressed client diagnosed with bipolar I disorder is observed laughing loudly with peers in the milieu. Which nursing action is a priority in this situation?
a. Join the milieu to assess the appropriateness of the laughter.
b. Redirect clients in the milieu to structured social activities, such as cards.
c. Privately discuss with the client the inappropriateness of provocative dress during hospitalization.
d. Administer PRN antianxiety medication to calm the client.
c
10. A client diagnosed with bipolar I disorder in the manic phase is yelling at another peer in the milieu. Which nursing intervention takes priority?
a. Calmly redirect and remove the client from the milieu.
b. Administer prescribed PRN intramuscular injection for agitation.
c. Notify the client to lower his/her voice.
d. Obtain an order for seclusion to help decrease external stimuli.
a
11. A client newly admitted with bipolar I disorder has a nursing diagnosis of risk for injury related to extreme hyperactivity. Which nursing intervention is appropriate?
a. Place the client in a room with another client experiencing similar symptoms.
b. Use PRN antipsychotic medications as ordered by the physician.
c. Discuss consequences of the client's behaviors with the client daily.
d. Reinforce previously learned coping skills to decrease agitation.
b
12. A nursing instructor is teaching about the psychosocial theory related to the development of bipolar disorder. Which student statement would indicate that learning has occurred?
a. "The credibility of psychosocial theories in the etiology of bipolar disorder has strengthened in recent years."
b. "Bipolar disorder is viewed as a purely genetic disorder."
c. "Following steroid, antidepressant, or amphetamine use, individuals can experience manic episodes."
d. "The etiology of bipolar disorder is unclear, but it is possible that biological and psychosocial factors are influential."
d
13. A nursing instructor is teaching about the criteria for the diagnosis of bipolar II disorder. Which student statement indicates that learning has occurred?
a. "Clients diagnosed with bipolar II disorder experience a full syndrome of mania and have a history of symptoms of depression."
b. "Clients diagnosed with bipolar II disorder experience numerous episodes of hypomania and dysthymia for at least 2 years."
c. "Clients diagnosed with bipolar II disorder have mood disturbances that are directly associated with the physiological effects of a substance."
d. "Clients diagnosed with bipolar II disorder experience recurrent bouts of depression with episodic occurrences of hypomania."
d [Show Less]