lOMoARcPSD|16049338
VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
ANS:
Chapter 13: Bipolar and Related Disorders Halter: Varcarolis’ Foundations of Psychiatric
Mental Health Nursing: A Clinical Approach, 8th Edition
MULTIPLE CHOICE
1. 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. Increased muscle tension and anxiety
b. Vegetative signs and poor grooming
c. Poor judgment and hyperactivity
d. Cognitive deficits and paranoia
ANS: C
Hyperactivity (activity without sleep) and poor judgment (posting rhymes on government
websites) are characteristic of manic episodes. The distracters do not specifically apply to
mania.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 13-11, 12, 15, 16, 44 (Table 13-2)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
2. A patient diagnosed with bipolar disorder is dressed in a red leotard and bright scarves. The
patient twirls and shadow boxes. The patient says gaily, “Do you like my scarves? Here they
are my gift to you.” How shoul nursingdoc.comument the patient’s mood? a. Euphoric
b. Irritable
c. Suspicious
d. Confident
ANS: A
The patient has demonstrated clang associations and pleasant, happy behavior. Excessive
happiness indicates euphoria. Irritability, belligerence, excessive happiness, and confidence
are not the best terms for the patient’s mood. Suspiciousness is not evident.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-10, 11 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
3. A person was directing traffic on a busy street, 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,
aggressive behavior
b. Pressured speech and grandiosity
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VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
c. Hyperactivity; not eating and sleeping
d. Poor concentration and decision making
ANS: C
Safety and physiological needs have the highest priority. Hyperactivity, poor nutrition,
hydration, and not sleeping take priority in terms of the needs listed above because they
threaten the physical integrity of the patient. The other behaviors are less threatening to the
patient’s life.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 13-18, 19 (Case Study and Nursing Care Plan)
TOP: Nursing Process: Planning
MSC: Client Needs: Safe, Effective Care Environment
4. A patient diagnosed with acute mania has distributed pamphlets about a new business venture
on a street corner for 2 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 physiological safety. Hyperactivity and poor
judgment put the patient at risk for injury.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-18, 44 (Table 13-2) | Page 13-19 (Case Study and Nursing Care Plan)
TOP: Nursing Process: Diagnosis/Analysis
MSC: Client Needs: Safe, Effective Care Environment
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5. 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. “Stop
that! No one did anything to provoke an attack by you.”
b. “If you do that one more time, you will be secluded immediately.”
c. “Do not hit anyone. If you are unable to control yourself, we will help you.”
d. “You know we will not let you hit anyone. Why do you continue this behavior?”
ANS: C
When the patient is unable to control his or her behavior and violates or threatens to violate
the rights of others, limits must be set in an effort to de-escalate the situation. Limits should
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VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
be set in simple, concrete terms. The incorrect responses do not offer appropriate assistance
to the patient, threaten the patient with seclusion as punishment, and ask a rhetorical
question.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-18, 19, 30, 31, 46 (Table 13-3) | Page 13-19 (Case Study and Nursing Care
Plan) TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
6. This nursing diagnosis applies to a patient experiencing acute mania: Imbalanced nutrition:
less than body requirements related to insufficient caloric intake and hyperactivity as
evidenced by 5-pound weight loss in 4 days. Select an appropriate outcome. The patient will a.
ask staff for assistance with feeding within 4 days.
b. drink six servings of a high-calorie, high-protein drink each day.
c. consistently sit with others for at least 30 minutes at meal time within 1 week.
d. consistently wear appropriate attire for age and sex within 1 week while on the
psychiatric unit.
ANS: B
High-calorie, high-protein food supplements will provide the additional calories needed to
offset the patient’s extreme hyperactivity. Sitting with others or asking for assistance does
not mean the patient ate or drank. The other indicator is unrelated to the nursing diagnosis.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-18, 19, 46 (Table 13-3) | Page 13-19 (Case Study and Nursing Care Plan)
TOP: Nursing Process: Outcomes Identification
MSC: Client Needs: Physiological Integrity
7. A patient demonstrating characteristics of acute mania relapsed after discontinuing lithium.
New orders are written to resume lithium twice daily and begin olanzapine. What is the
rationale for the addition of olanzapine to the medication regimen? It will a. minimize the side
effects of lithium.
b. bring hyperactivity under rapid control.
c. enhance the antimanic actions of lithium.
d. be used for long-term control of hyperactivity.
ANS: B
Manic symptoms are controlled by lithium only after a therapeutic serum level is attained.
Because this takes several days to accomplish, a drug with rapid onset is necessary to
reduce the hyperactivity initially. Anti nursingdoc.com neither enhance lithium’s antimanic
activity nor minimize the side effects. Lithium will be used for long-term control.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
nursingdoc.com
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VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
REF: Pages 13-24, 28 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
8. A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care
provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug
should the nurse anticipate will be prescribed? a. phenytoin
b. clonidine
c. risperidone
d. carbamazepine
ANS: D
Some patients diagnosed with bipolar disorder, especially those who have only short
periods between episodes, have a favorable response to the anticonvulsants carbamazepine
and valproate. Carbamazepine seems to work better in patients with rapid cycling and in
severely paranoid, angry manic patients. Phenytoin is also an anticonvulsant but not used
for mood stabilization. Risperidone is not an anticonvulsant.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-27, 51 (Table 13-5) TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
9. The exact cause of bipolar disorder has not been determined; however, for most patients
a. several factors, including genetics, are implicated.
b. brain structures were altered by stress early in life.
c. excess sensitivity in dopamine receptors may trigger episodes.
d. inadequate norepinephrine reuptake disturbs circadian rhythms.
ANS: A
The best explanation at this time is that bipolar disorder is most likely caused by interplay
of complex independent variables. Various theories implicate genetics, endocrine
imbalance, environmental stressors, and neurotransmitter imbalances.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 13-8 to 10 TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
10. The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the
possibility of genetic transmission of bipolar disorders. Which response should the nurse
provide?
a. “A high proportion of patients with bipolar disorders are found among creative writers.”
b. “A higher rate of relatives with bipolar disorder is found among patients with bipolar
disorder.”
nursingdoc.com
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VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
ANS:
Chapter 13: Bipolar and Related Disorders Halter: Varcarolis’ Foundations of Psychiatric
Mental Health Nursing: A Clinical Approach, 8th Edition
MULTIPLE CHOICE
1. 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. Increased muscle tension and anxiety
b. Vegetative signs and poor grooming
c. Poor judgment and hyperactivity
d. Cognitive deficits and paranoia
ANS: C
Hyperactivity (activity without sleep) and poor judgment (posting rhymes on government
websites) are characteristic of manic episodes. The distracters do not specifically apply to
mania.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 13-11, 12, 15, 16, 44 (Table 13-2)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
2. A patient diagnosed with bipolar disorder is dressed in a red leotard and bright scarves. The
patient twirls and shadow boxes. The patient says gaily, “Do you like my scarves? Here they
are my gift to you.” How shoul nursingdoc.comument the patient’s mood? a. Euphoric
b. Irritable
c. Suspicious
d. Confident
ANS: A
The patient has demonstrated clang associations and pleasant, happy behavior. Excessive
happiness indicates euphoria. Irritability, belligerence, excessive happiness, and confidence
are not the best terms for the patient’s mood. Suspiciousness is not evident.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-10, 11 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
3. A person was directing traffic on a busy street, 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,
aggressive behavior
b. Pressured speech and grandiosity
nursingdoc.com
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, lOMoARcPSD|16049338
VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
c. Hyperactivity; not eating and sleeping
d. Poor concentration and decision making
ANS: C
Safety and physiological needs have the highest priority. Hyperactivity, poor nutrition,
hydration, and not sleeping take priority in terms of the needs listed above because they
threaten the physical integrity of the patient. The other behaviors are less threatening to the
patient’s life.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 13-18, 19 (Case Study and Nursing Care Plan)
TOP: Nursing Process: Planning
MSC: Client Needs: Safe, Effective Care Environment
4. A patient diagnosed with acute mania has distributed pamphlets about a new business venture
on a street corner for 2 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 physiological safety. Hyperactivity and poor
judgment put the patient at risk for injury.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-18, 44 (Table 13-2) | Page 13-19 (Case Study and Nursing Care Plan)
TOP: Nursing Process: Diagnosis/Analysis
MSC: Client Needs: Safe, Effective Care Environment
nursingdoc.com
5. 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. “Stop
that! No one did anything to provoke an attack by you.”
b. “If you do that one more time, you will be secluded immediately.”
c. “Do not hit anyone. If you are unable to control yourself, we will help you.”
d. “You know we will not let you hit anyone. Why do you continue this behavior?”
ANS: C
When the patient is unable to control his or her behavior and violates or threatens to violate
the rights of others, limits must be set in an effort to de-escalate the situation. Limits should
nursingdoc.com
Downloaded by Kelly Davis ()
, lOMoARcPSD|16049338
VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
be set in simple, concrete terms. The incorrect responses do not offer appropriate assistance
to the patient, threaten the patient with seclusion as punishment, and ask a rhetorical
question.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-18, 19, 30, 31, 46 (Table 13-3) | Page 13-19 (Case Study and Nursing Care
Plan) TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
6. This nursing diagnosis applies to a patient experiencing acute mania: Imbalanced nutrition:
less than body requirements related to insufficient caloric intake and hyperactivity as
evidenced by 5-pound weight loss in 4 days. Select an appropriate outcome. The patient will a.
ask staff for assistance with feeding within 4 days.
b. drink six servings of a high-calorie, high-protein drink each day.
c. consistently sit with others for at least 30 minutes at meal time within 1 week.
d. consistently wear appropriate attire for age and sex within 1 week while on the
psychiatric unit.
ANS: B
High-calorie, high-protein food supplements will provide the additional calories needed to
offset the patient’s extreme hyperactivity. Sitting with others or asking for assistance does
not mean the patient ate or drank. The other indicator is unrelated to the nursing diagnosis.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-18, 19, 46 (Table 13-3) | Page 13-19 (Case Study and Nursing Care Plan)
TOP: Nursing Process: Outcomes Identification
MSC: Client Needs: Physiological Integrity
7. A patient demonstrating characteristics of acute mania relapsed after discontinuing lithium.
New orders are written to resume lithium twice daily and begin olanzapine. What is the
rationale for the addition of olanzapine to the medication regimen? It will a. minimize the side
effects of lithium.
b. bring hyperactivity under rapid control.
c. enhance the antimanic actions of lithium.
d. be used for long-term control of hyperactivity.
ANS: B
Manic symptoms are controlled by lithium only after a therapeutic serum level is attained.
Because this takes several days to accomplish, a drug with rapid onset is necessary to
reduce the hyperactivity initially. Anti nursingdoc.com neither enhance lithium’s antimanic
activity nor minimize the side effects. Lithium will be used for long-term control.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
nursingdoc.com
Downloaded by Kelly Davis ()
, lOMoARcPSD|16049338
VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
REF: Pages 13-24, 28 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
8. A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care
provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug
should the nurse anticipate will be prescribed? a. phenytoin
b. clonidine
c. risperidone
d. carbamazepine
ANS: D
Some patients diagnosed with bipolar disorder, especially those who have only short
periods between episodes, have a favorable response to the anticonvulsants carbamazepine
and valproate. Carbamazepine seems to work better in patients with rapid cycling and in
severely paranoid, angry manic patients. Phenytoin is also an anticonvulsant but not used
for mood stabilization. Risperidone is not an anticonvulsant.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 13-27, 51 (Table 13-5) TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
9. The exact cause of bipolar disorder has not been determined; however, for most patients
a. several factors, including genetics, are implicated.
b. brain structures were altered by stress early in life.
c. excess sensitivity in dopamine receptors may trigger episodes.
d. inadequate norepinephrine reuptake disturbs circadian rhythms.
ANS: A
The best explanation at this time is that bipolar disorder is most likely caused by interplay
of complex independent variables. Various theories implicate genetics, endocrine
imbalance, environmental stressors, and neurotransmitter imbalances.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 13-8 to 10 TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
10. The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the
possibility of genetic transmission of bipolar disorders. Which response should the nurse
provide?
a. “A high proportion of patients with bipolar disorders are found among creative writers.”
b. “A higher rate of relatives with bipolar disorder is found among patients with bipolar
disorder.”
nursingdoc.com
Downloaded by Kelly Davis ()
