Chapter 19: Mood Disorders: Bipolar

Chapter 19: Mood Disorders: Bipolar

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1)   Three policemen bring a client to the mental health unit for admission. She had been directing traffic on a busy city street and shouting rhymes such as “to work, you jerk, for perks” and making obscene gestures at cars that came too close to her. When her husband was contacted at work, he reported that his wife had stopped taking her lithium 3 weeks ago and had not slept or eaten for 3 days, telling her husband she was “too busy.” When making an assessment, the two features characteristic of the disorder the nurse can identify are

A.	increased muscle tension and anxiety.
B.	cognitive deficit and low mood.
C.	poor judgment and hyperactivity.
D.	vegetative signs and poor grooming.

 

ANS:   C

Hyperactivity (directing traffic) and poor judgment (putting herself in a dangerous position) are characteristic of manic episodes. None of the other characteristics is specifically alluded to in this scenario.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 364

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Psychosocial Integrity

 

 

2)   A client, brought to the mental health unit by police, had been directing traffic and shouting rhymes on a busy city street. Her husband reported that she had stopped taking her lithium 3 weeks ago and had not slept or eaten for 3 days. She was dressed in a red leotard, an exercise bra, and an assortment of chains and brightly colored scarves on her head, waist, wrists, and ankles. Her first words to the nurse were “I’ll punch you, munch you, crunch you,” as she danced into the room, shadow boxing. Then she shook the nurse’s hand and said gaily, “We need to become better acquainted. I have the world’s greatest intellect and you are probably an intellectual midget.” The nurse should assess the client’s mood as

A.	irritable and belligerent.
B.	excessively happy and confident.
C.	unstable and unpredictable.
D.	highly suspicious and haughty.

 

ANS:   C

 

The client has demonstrated angry behavior and pleasant, happy behavior within seconds of each other. Mood swings are often rapid and seemingly without understandable reason in manic clients. Options A and B are not entirely correct. Option D is not described in the scenario.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 362, Text Page: 364

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Psychosocial Integrity

 

 

3)   Three policemen bring a client to the mental health unit. She had been directing traffic and shouting rhymes on a busy city street. Her husband reported that the client had stopped taking her lithium 3 weeks ago and had not slept or eaten for 3 days. Which behaviors listed below will be of priority concern as the nurse begins a care plan for the client?

A.	Bizarre, colorful, inappropriate dress
B.	Grandiose thinking, poor concentration
C.	Insulting, provocative behavior directed at staff
D.	Hyperactivity, ignoring eating and sleeping

 

ANS:   D

Hyperactivity, poor nutrition, hydration, and not sleeping take priority in terms of the needs listed above because they threaten the physical integrity of the client. The other behaviors are less threatening to the client’s life.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 364

TOP:    Nursing Process: Assessment

MSC:   NCLEX: Safe, Effective Care Environment;

 

 

4)   A client with bipolar disorder who became hyperactive after discontinuing lithium has not eaten or slept for 3 days. Which of the following nursing diagnoses would be of priority importance?

A.	Ineffective coping
B.	Risk for injury
C.	Caregiver role strain
D.	Impaired social interaction

 

ANS:   B

Although each of the nursing diagnoses listed is appropriate for a client having a manic episode, the priority lies with the client’s physiological safety. Hyperactivity and poor judgment put the client at high risk for injury.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 368

TOP:    Nursing Process: Nursing Diagnosis

MSC:   NCLEX: Safe, Effective Care Environment;