BIPOLAR DISORDER | SITUATIONAL EXAMPLES Flashcards
A patient with bipolar disorder is admitted to the psychiatric unit in a manic state. Which nursing intervention is the priority?
A. Encourage the patient to participate in group therapy
B. Provide finger foods high in protein and calories
C. Assign the patient to a shared room with a calm roommate
D. Allow the patient to exercise until exhaustion
Answer: B
Rationale: In a manic state, the patient has high energy and often neglects food and sleep. Providing high-protein, high-calorie finger foods ensures adequate nutrition while accommodating their hyperactivity.
- A patient on lithium therapy reports nausea, vomiting, and hand tremors. What is the nurse’s best action?
A. Reassure the patient that these are common side effects
B. Withhold the next dose and notify the healthcare provider
C. Administer an antiemetic and continue monitoring
D. Encourage increased fluid and salt intake
Answer: B
Rationale: Nausea, vomiting, and hand tremors are early signs of lithium toxicity. The nurse should withhold the next dose and inform the healthcare provider immediately
- During an assessment, a bipolar patient in a manic state tells the nurse, “I’m the best nurse in the world! Everyone loves me here!” What term best describes this symptom?
A. Looseness of association
B. Grandiosity
C. Flight of ideas
D. Erotomania
Answer: B
Rationale: Grandiosity refers to an inflated sense of self-importance, commonly seen during manic episodes.
- A patient with bipolar disorder is prescribed valproic acid. What adverse effect should the nurse monitor for?
A. Blood dyscrasias
B. Stevens-Johnson syndrome
C. Hepatotoxicity
D. Renal toxicity
Answer: C
Rationale: Valproic acid can cause hepatotoxicity. Liver function tests should be monitored regularly.
- A nurse is preparing a bipolar patient for electroconvulsive therapy (ECT). Which pre-procedure instruction is correct?
A. “You can have a light breakfast 2 hours before the procedure.”
B. “Remove all jewelry and nail polish before the procedure.”
C. “Void after the procedure to prevent complications.”
D. “Do not take your prescribed atropine sulfate before ECT.”
Answer: B
Rationale: Removing jewelry and nail polish prevents burns and allows accurate monitoring of oxygenation during ECT.
- A bipolar patient on anticonvulsant therapy develops a rash and blisters. What is the nurse’s priority action?
A. Apply a topical cream and monitor the rash
B. Continue the medication and report it at the next appointment
C. Discontinue the medication and notify the healthcare provider
D. Document the findings and continue observation
Answer: C
Rationale: A rash with blisters may indicate Stevens-Johnson syndrome, a serious side effect of anticonvulsants like lamotrigine. Immediate discontinuation and medical attention are required.
- A patient undergoing ECT experiences seizure activity for more than 150 seconds. What medication should the nurse anticipate administering?
A. Atropine sulfate
B. Diazepam
C. Brevital (Methohexiatal)
D. Anectine (Succinylcholine)
Answer: B
Rationale: Diazepam is given as a STAT dose to stop prolonged seizure activity.
- Which medication is most likely to trigger a manic episode in a patient with bipolar disorder?
A. Prednisone
B. Losartan
C. Metoprolol
D. Acetaminophen
Answer: A
Rationale: Steroids like prednisone can trigger mania by increasing serotonin, dopamine, and norepinephrine levels.
- A nurse is caring for a patient in the manic phase of bipolar disorder. Which activity is most appropriate for this patient?
A. Group yoga class
B. Competitive board game
C. Walking in the garden
D. Watching a documentary
Answer: C
Rationale: Non-competitive, energy-consuming activities like walking help the patient release excess energy while promoting calmness.
- A patient receiving lithium therapy asks how they can avoid toxicity. What is the nurse’s best response?
A. “Avoid foods high in sodium to maintain balance.”
B. “Drink plenty of fluids and maintain a normal salt intake.”
C. “Limit your fluid intake to prevent lithium dilution.”
D. “Take the medication on an empty stomach for better absorption.”
Answer: B
Rationale: Adequate fluid and normal salt intake are crucial to prevent lithium toxicity.
