Chapter 17: Bipolar and Other Related Disorders

Chapter 17: Bipolar and Other Related Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   A highly agitated client paces the unit and states, “I could buy and sell this place.” The client’s mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client’s behavior?

1.	“Rates mood 8/10. Exhibiting looseness of association. Euphoric.”
2.	“Mood euthymic. Exhibiting magical thinking. Restless.”
3.	“Mood labile. Exhibiting delusions of reference. Hyperactive.”
4.	“Agitated and pacing. Exhibiting grandiosity. Mood labile.”

 

 

____     2.   A client diagnosed with bipolar disorder is distraught over insomnia experienced over the last 3 nights and a 12-lb. weight loss over the past 2 weeks. Which should be this client’s priority nursing diagnosis?

1.	Knowledge deficit R/T bipolar disorder AEB concern about symptoms
2.	Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss
3.	Risk for suicide R/T powerlessness AEB insomnia and anorexia
4.	Altered sleep patterns R/T mania AEB insomnia for the past 3 nights

 

 

____     3.   A nurse is planning care for a client diagnosed with bipolar disorder: manic episode. In which order should the nurse prioritize the client outcomes in the exhibit? The following are the outcomes: 1. Maintains nutritional status. 2. Interacts appropriately with peers. 3. Remains free from injury. 4. Sleeps 6 to 8 hours a night.

1.	2, 1, 3, 4
2.	4, 1, 2, 3
3.	3, 1, 4, 2
4.	1, 4, 2, 3

 

 

____     4.   A client diagnosed with bipolar disorder: depressive episode intentionally overdoses on sertraline (Zoloft). Family members report that the client has experienced anorexia, insomnia, and recent job loss. Which nursing diagnosis should a nurse prioritize?

1.	Risk for suicide R/T hopelessness
2.	Anxiety: severe R/T hyperactivity
3.	Imbalanced nutrition: less than body requirements R/T refusal to eat
4.	Dysfunctional grieving R/T loss of employment

 

 

____     5.   A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate (Lithobid) because of excessive weight gain. In order to increase adherence, which medication should a nurse anticipate that a physician may prescribe?

1.	Sertraline (Zoloft)
2.	Valproic acid (Depakote)
3.	Trazodone (Desyrel)
4.	Paroxetine (Paxil)

 

MULTIPLE CHOICE

 

1. ANS:  4

Chapter: Chapter 17, Bipolar and Other Related Disorders

Objective: Identify symptomatology associated with bipolar disorder and use this information in client assessment.

Page: 419–422

Heading: Types of Bipolar Disorder

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Cognition

Difficulty: Moderate

 

	Feedback
1	Exhibiting looseness of association and being euphoric is not associated with bipolar disorder.
2	Magical thinking is not associated with bipolar disorder.
3	Labile mood and delusions of reference are not associated with bipolar disorder.
4	The nurse should document that this client’s behavior is “Agitated and pacing. Exhibiting grandiosity. Mood labile.” The client is exhibiting mood swings from euphoria to irritability. Grandiosity refers to the attitude that one’s abilities are better than everyone else’s.

 

 

PTS:   1                    CON:  Cognition

 

2. ANS:  2

Chapter: Chapter 17, Bipolar and Other Related Disorders

Objective: Identify symptomatology associated with bipolar disorder and use this information in client assessment.

Page: 419–422

Heading: Types of Bipolar Disorder

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Cognition

Difficulty: Moderate

 

	Feedback
1	Knowledge deficit R/T bipolar disorder AEB concern about symptoms does not identify the client’s sudden 12-lb. weight loss.
2	The nurse should identify that the priority nursing diagnosis for this client is altered nutrition: less than body requirements R/T hyperactivity AEB weight loss. Because of the client’s rapid weight loss, the nurse should prioritize interventions to ensure proper nutrition and physical health.
3	Risk for suicide R/T powerlessness AEB insomnia and anorexia does not identify the client’s sudden 12-lb. weight loss.
4	Altered sleep patterns R/T mania AEB insomnia for the past 3 nights does not identify the client’s sudden 12-lb. weight loss.

 

 

PTS:   1                    CON:  Cognition

 

3. ANS:  3

Chapter: Chapter 17, Bipolar and Other Related Disorders

Objective: Identify symptomatology associated with bipolar disorder and use this information in client assessment.

Page: 419–422

Heading: Types of Bipolar Disorder

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Cognition

Difficulty: Moderate

 

	Feedback
1	The client’s safety and physical health is the most important.
2	Safety is the priority.
3	The nurse should order client outcomes based on priority in the following order: Remains free of injury, maintains nutritional status, sleeps 6 to 8 hours a night, and interacts appropriately with peers. The nurse should prioritize the client’s safety and physical health as most important
4	The nurse should always prioritize safety.

 

 

PTS:   1                    CON:  Cognition

 

4. ANS:  1

Chapter: Chapter 17, Bipolar and Other Related Disorders

Objective: Identify symptomatology associated with bipolar disorder and use this information in client assessment.

Page: 427–430

Heading: Table 17-2 Care Plan for the Client Experiencing a Manic Episode

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Cognition

Difficulty: Moderate

 

	Feedback
1	The priority nursing diagnosis for this client should be risk for suicide R/T hopelessness. The nurse should always prioritize client safety. This client is at risk for suicide because of his or her recent suicide attempt.
2	Anxiety: severe R/T hyperactivity does not address the client’s risk for suicide.
3	Imbalanced nutrition: less than body requirements R/T refusal to eat does not address the client’s risk for suicide.
4	Dysfunctional grieving R/T loss of employment does not address the client’s risk for suicide.

 

 

PTS:   1                    CON:  Cognition

 

5. ANS:  2

Chapter: Chapter 17, Bipolar and Other Related Disorders

Objective: Identify symptomatology associated with bipolar disorder and use this information in client assessment.

Page: 435–438

Heading: Table 17-3 Mood Stabilizing Agents

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Cognition

Difficulty: Moderate

 

	Feedback
1	Sertraline (Zoloft) does not counteract the weight-increasing effects of lithium.
2	The nurse should anticipate that the physician may prescribe valproic acid in order to increase this client’s medication adherence. Valproic acid is an anticonvulsant medication that can be used to treat bipolar disorder. One of the side effects of this medication is weight loss.
3	Trazodone (Desyrel) does not counteract the weight increasing effects of lithium.
4	Paroxetine (Paxil) does not counteract the weight increasing effects of lithium.