Chapter 16: Bipolar Spectrum Disorders

Essentials of Psychiatric Mental Health Nursing ,2nd Edition by Elizabeth M. Varcarolis

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Chapter 16: Bipolar Spectrum Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. A person is directing traffic on a busy street and shouting, “To work, you jerk, for perks,” and making obscene gestures at cars. The person has not slept or eaten for 3 days. What features of mania are evident?
a. Increased muscle tension and anxiety
b. Vegetative signs and poor grooming
c. Poor judgment and hyperactivity
d. Cognitive deficit and sad mood

 

 

ANS:  C

Hyperactivity (directing traffic) and poor judgment (putting self in a dangerous position) are characteristic of manic episodes. The distracters do not specifically apply to mania.

 

DIF:    Cognitive Level: Application           REF:   Pages: 281-282

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

 

  1. A patient with bipolar disorder is dressed in a red leotard and brightly colored scarves. The patient says, “I’ll punch you, munch you, crunch you,” while twirling and shadowboxing. Then the patient says gaily, “Do you like my scarves? Here…they are my gift to you.” How should the nurse document the patient’s mood?
a. Labile and euphoric
b. Irritable and belligerent
c. Highly suspicious and arrogant
d. Excessively happy and confident

 

 

ANS:  A

The patient has demonstrated angry behavior and pleasant, happy behavior within seconds of each other. Excessive happiness indicates euphoria. Mood swings are often rapid and seemingly without understandable reason in patients who are manic. These swings are documented as labile. Irritability, belligerence, excessive happiness, and confidence are not entirely correct terms for the patient’s mood. A high level of suspicion is not evident.

 

DIF:    Cognitive Level: Application           REF:   Pages: 279-282

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

 

  1. A person is directing traffic on a busy street and rapidly shouting, “To work, you jerk, for perks,” and making obscene gestures at cars. The person has not slept or eaten for 3 days. Which assessment findings will have priority concern for this patient’s plan of care?
a. Insulting, provocative behavior
b. Pressured speech and grandiosity
c. Hyperactivity; not eating and sleeping
d. Poor concentration and decision making

 

 

ANS:  C

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

 

DIF:    Cognitive Level: Analysis                REF:   Pages: 283-285

TOP:   Nursing Process: Planning               MSC:  NCLEX: Safe, Effective Care Environment

 

  1. A patient with mania has not eaten or slept for 3 days. Which nursing diagnosis has priority?
a. Risk for injury
b. Ineffective coping
c. Impaired social interaction
d. Ineffective therapeutic regimen management

 

 

ANS:  A

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

 

DIF:    Cognitive Level: Application           REF:   Pages: 283-285

TOP:   Nursing Process: Diagnosis| Nursing Process: Analysis

MSC:  NCLEX: Safe, Effective Care Environment

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