• NSG 526 Exam 09/01/2026
Wilkes NSG 526 Exam 2 | Clinical
Modalities in Advanced Psych | Questions
& Correct Verified Answers with Rationales
| Latest 2026/2027 Update | Graded A+|
A client 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 –
P 1
, • NSG 526 Exam 09/01/2026
Correct Answer :ANS: D
Some clients 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 clients with rapid cycling and in severely
paranoid, angry manic clients. Phenytoin is also an anticonvulsant but not used for mood
stabilization. Risperidone is not an anticonvulsant.
While the exact cause of bipolar disorder has not been determined; however, what is
consistent for most clients?
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. –
Correct Answer :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
The spouse of a client 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 clients with bipolar disorders are found among creative writers."
b. "A higher rate of relatives with bipolar disorder is found among clients with bipolar
disorder."
c. "Clients with bipolar disorder have higher rates of relatives who respond in an
P 2
, • NSG 526 Exam 09/01/2026
exaggerated way to daily stress."
d. "More individuals with bipolar disorder come from high socioeconomic and educational
backgrounds. –
Correct Answer :ANS: B
Evidence of genetic transmission is supported by lifetime prevalence statistics. The incorrect
options do not support the theory of genetic transmission and other factors involved in the
etiology of bipolar disorder.
A client diagnosed with bipolar disorder commands other clients, "Get me a book. Take this
stuff out of here," and other similar demands. The nurse wants to interrupt this behavior
without entering into a power struggle. Which initial approach should the nurse select?
a. Distraction: "Let's go to the dining room for a snack."
b. Humor: "How much are you paying servants these days?"
c. Limit setting: "You must stop ordering other clients around."
d. Honest feedback: "Your controlling behavior is annoying others." –
Correct Answer :ANS: A
The distractibility characteristic of manic episodes can assist the nurse to direct the client
toward more appropriate, constructive activities without entering into power struggles.
Humor usually backfires by either encouraging the client or inciting anger. Limit setting and
honest feedback may seem heavy-handed and may incite anger.
The nurse receives a laboratory report indicating a client's serum level is 1 mEq/L. The
client's last dose of lithium was 8 hours ago. What does this result indicate?
a. within therapeutic limits.
b. below therapeutic limits.
c. above therapeutic limits.
P 3
, • NSG 526 Exam 09/01/2026
d. invalid because of the time lapse since the last dose –
Correct Answer :ANS: A
Normal range for a blood sample taken 8 to 12 hours after the last dose of lithium is 0.6 to 1.2
mEq/L.
Consider these three anticonvulsant medications: divalproex, carbamazepine, and
gabapentin. Which medication also belongs to this classification? a. clonazepam
b. risperidone
c. lamotrigine
d. aripiprazole –
Correct Answer :ANS: C
The three drugs in the stem of the question are all anticonvulsants. Lamotrigine is also an
anticonvulsant. Clonazepam is an anxiolytic; aripiprazole and risperidone are antipsychotic
drugs.
When a hyperactive client diagnosed with acute mania is hospitalized, what is the initial
nursing intervention?
a. Allow the client to act out feelings.
b. Set limits on client behavior as necessary.
c. Provide verbal instructions to the client to remain calm.
d. Restrain the client to reduce hyperactivity and aggression - Correct Answer :ANS: B
This intervention provides support through the nurse's presence and provides structure as
necessary while the client's control is tenuous. Acting out may lead to loss of behavioral
control. The client will probably be unable to focus on instructions and comply. Restraint is
used only after other interventions have proved ineffective.
P 4
Wilkes NSG 526 Exam 2 | Clinical
Modalities in Advanced Psych | Questions
& Correct Verified Answers with Rationales
| Latest 2026/2027 Update | Graded A+|
A client 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 –
P 1
, • NSG 526 Exam 09/01/2026
Correct Answer :ANS: D
Some clients 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 clients with rapid cycling and in severely
paranoid, angry manic clients. Phenytoin is also an anticonvulsant but not used for mood
stabilization. Risperidone is not an anticonvulsant.
While the exact cause of bipolar disorder has not been determined; however, what is
consistent for most clients?
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. –
Correct Answer :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
The spouse of a client 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 clients with bipolar disorders are found among creative writers."
b. "A higher rate of relatives with bipolar disorder is found among clients with bipolar
disorder."
c. "Clients with bipolar disorder have higher rates of relatives who respond in an
P 2
, • NSG 526 Exam 09/01/2026
exaggerated way to daily stress."
d. "More individuals with bipolar disorder come from high socioeconomic and educational
backgrounds. –
Correct Answer :ANS: B
Evidence of genetic transmission is supported by lifetime prevalence statistics. The incorrect
options do not support the theory of genetic transmission and other factors involved in the
etiology of bipolar disorder.
A client diagnosed with bipolar disorder commands other clients, "Get me a book. Take this
stuff out of here," and other similar demands. The nurse wants to interrupt this behavior
without entering into a power struggle. Which initial approach should the nurse select?
a. Distraction: "Let's go to the dining room for a snack."
b. Humor: "How much are you paying servants these days?"
c. Limit setting: "You must stop ordering other clients around."
d. Honest feedback: "Your controlling behavior is annoying others." –
Correct Answer :ANS: A
The distractibility characteristic of manic episodes can assist the nurse to direct the client
toward more appropriate, constructive activities without entering into power struggles.
Humor usually backfires by either encouraging the client or inciting anger. Limit setting and
honest feedback may seem heavy-handed and may incite anger.
The nurse receives a laboratory report indicating a client's serum level is 1 mEq/L. The
client's last dose of lithium was 8 hours ago. What does this result indicate?
a. within therapeutic limits.
b. below therapeutic limits.
c. above therapeutic limits.
P 3
, • NSG 526 Exam 09/01/2026
d. invalid because of the time lapse since the last dose –
Correct Answer :ANS: A
Normal range for a blood sample taken 8 to 12 hours after the last dose of lithium is 0.6 to 1.2
mEq/L.
Consider these three anticonvulsant medications: divalproex, carbamazepine, and
gabapentin. Which medication also belongs to this classification? a. clonazepam
b. risperidone
c. lamotrigine
d. aripiprazole –
Correct Answer :ANS: C
The three drugs in the stem of the question are all anticonvulsants. Lamotrigine is also an
anticonvulsant. Clonazepam is an anxiolytic; aripiprazole and risperidone are antipsychotic
drugs.
When a hyperactive client diagnosed with acute mania is hospitalized, what is the initial
nursing intervention?
a. Allow the client to act out feelings.
b. Set limits on client behavior as necessary.
c. Provide verbal instructions to the client to remain calm.
d. Restrain the client to reduce hyperactivity and aggression - Correct Answer :ANS: B
This intervention provides support through the nurse's presence and provides structure as
necessary while the client's control is tenuous. Acting out may lead to loss of behavioral
control. The client will probably be unable to focus on instructions and comply. Restraint is
used only after other interventions have proved ineffective.
P 4
