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    Exam Review

    1. A newly diagnosed patient is prescribed lithium. Which information from the patient's history indicates that monitoring of serum concentrations of the drug will be challenging and critical?
      A)Arthritis
      B)Heart failure
      C)Psoriasis
      D)Epilepsy
    2. A person was online continuously for over 24 hours, posting rhymes on official government websites and inviting politicians to join social networks. The person has not slept or eaten for 3 days. What features of mania are evident?
      A)Poor judgment and hyperactivity
      B)Increased muscle tension and anxiety
      C)Vegetative signs and poor grooming
      D)Cognitive deficits and paranoia
    3. The nurse understands that the client alternating between hypomania and mild to moderate depression is experiencing which disorder?
      A)Bipolar I disorder
      B)Bipolar II disorder
      C)Cyclothymic disorder
      D)Schizophrenia
    4. An outpatient diagnosed with bipolar disorder is prescribed lithium. The patient telephones the nurse to say, "I've had severe diarrhea for 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" The nurse will advise the patient to
      A)have someone bring the patient to the clinic immediately.
      B)restrict food and fluids for 24 hours and stay in bed.
      C)take one dose of an over-the-counter antidiarrheal medication now.
      D)drink a large glass of water with 1 teaspoon of salt added.
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    Exam Review

    1. A nurse prepares the plan of care for a patient experiencing an acute manic episode. Which nursing diagnoses are most likely? (Select all that apply).(SATA)
      A)Social isolation
      B)Impaired mood regulation
      C)Imbalanced nutrition: more than body requirements
      D)Chronic confusion
      E)Sleep deprivation
    2. The nurse is creating a plan of care for a client with mania and determines that the client is experiencing disturbed thoughts. Which activity related to disturbed thoughts should the nurse provide for the client initially?
      A)Painting
      B)Playing cards
      C)Playing board games
      D)Playing checkers
    3. An outpatient diagnosed with bipolar disorder takes lithium carbonate 300 mg three times daily. The patient reports nausea. To reduce the nausea most effectively, the nurse suggests that the lithium be taken with
      A)lemonade
      B)meals
      C)large glass of juice
      D)an antacid
    4. When a hyperactive patient diagnosed with acute mania is hospitalized, what is the initial nursing intervention?
      A)Restrain the patient to reduce hyperactivity and aggression
      B)Allow the patient to act out feelings
      C)Set limits on patient behavior as necessary
      D)Provide verbal instructions to the patient to remain calm
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    Exam Review

    1. A patient diagnosed with bipolar disorder is in the maintenance phase of treatment. The patient asks, "Do I have to keep taking this lithium even though my mood is stable now?" Select the nurse's appropriate response.
      A)"It's unusual that the health care provider hasn't already stopped your medication."
      B)"Most patients take medication for approximately 6 months after discharge."
      C)"Taking the medication every day helps reduce the risk of a relapse."
      D)"You will be able to stop the medication in about 1 month."
    2. Which dinner menu is best suited for a patient with acute mania?
      A)Beef and vegetable stew, a roll, and chocolate pudding.
      B)Chicken casserole, green beans, and flavored gelatin with whipped cream.
      C)Spaghetti and meatballs, salad, and a banana.
      D)Finger foods, high protein shake and sliced apples.
    3. A nurse knows that lithium should be measured at least how many days after beginning lithium therapy and after any dosage change when?
      A)Two weeks
      B)1 month
      C)5 days
      D)1 day
    4. Four new patients were admitted to the behavioral health unit in the past 12 hours. The nurse directs a psychiatric technician to monitor these patients for safety. Which patient will need the most watchful supervision? A patient diagnosed with
      A)dysthymic disorder
      B)bipolar II disorder
      C)bipolar I disorder
      D)cyclothymic disorder
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    Exam Review

    1. Luc's family comes home one evening to find him extremely agitated and they suspect he is in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting?
      A)Energy drink containers
      B)Hypodermic needles
      C)Empty soda cans
      D)Fast food wrappers
    2. The nurse receives a laboratory report indicating a patient's serum level is 1 mEq/L. The patient's last dose of lithium was 8 hours ago. This result is
      A)within therapeutic limits
      B)above therapeutic limits
      C)invalid because of the time lapse since the last dose
      D)below therapeutic limits
    3. A patient has been admitted and the nurse suspect lithium toxicity. What symptoms should be suspected with a patient who has to
      A)shortness of breath, gastrointestinal distress, chronic cough
      B)weakness, nausea, diarrhea
      C)ECG changes, chest pain, dizziness
      D)gastrointestinal distress, thirst, nystagmus
    4. Which documentation indicates that the treatment plan for a patient diagnosed with acute mania has been effective?
      A)"Attention span short; writing copious notes; intrudes in conversations."
      B)"Irritable, suggestible, distractible; napped for 10 minutes in afternoon."
      C)"Converses with few interruptions; clothing matches; participates in activities."
      D)"Heavy makeup; seductive toward staff; pressured speech."
    Page 4 of 5

    Exam Review

    1. A nurse is caring for a patient with mania. She knows this person would experience issues with disorganized thoughts and speech patterns. Select the evident ways in which disorganized speech might be manifested. (Select all that apply).(SATA)
      A)Flight of ideas
      B)Delusions of grandeur
      C)Tangential speech
      D)Circumstantial speech
      E)Pressured speech
    2. A nurse is teaching a new RN about the use of electroconvulsive therapy (ECT) for the treatment of bipolar disorder. Which of the following statements by the new RN indicates understanding?
      A)"ECT is contraindicated for clients who have suicidal ideation."
      B)"ECT is prescribed to prevent relapse of bipolar disorder."
      C)"ECT is effective for clients who are experiencing severe mania."
      D)"ECT is the recommended initial treatment for bipolar disorder."
    3. A 28-year-old patient who has diagnosis of bipolar disorder I, drinks alcohol instead of taking her prescribed medications. The nursing caring for this patient recognizes that:
      A)The patient is using alcohol because she is depressed
      B)Alcohol ingestion is a form of self-medication
      C)The patient lacks the neurotransmitters to control behavior
      D)Anxiety may be present.
    4. A patient diagnosed with bipolar disorder becomes hyperactive after discontinuing lithium. The patient threatens to hit another patient. Which comment by the nurse is appropriate?
      A)"You know we will not let you hit anyone. Why do you continue this behavior?"
      B)"Do not hit anyone. If you are unable to control yourself, we will help you."
      C)"Stop that! No one did anything to provoke an attack by you."
      D)"If you do that one more time, you will be secluded immediately."
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