RNSG2213/ RNSG 2213 Exam #2 Complete Test bank_ 2023/2024 LATEST UPDATE ALL ANSWERS 100% GUARANTEED GRADE A+

Bipolar Disorders BB quiz 1. A pt has been dx as having mania. The nurse anticipates the physician will most likely prescribe: a. Lithium 2. SJ Syndrome is a severe and potentially fatal syndrome that is indicated by a rash and flu- like symptoms. It sometimes is caused by which medication? a. Lamotrigine (Lamictal) 3. A pt develops mania after dc-ing Lithium. New meds are written to resume 2x daily Lithium and begin Zyprena (olanzapine). The addition of Zyprexa will: a. Bring hyperactivity under rapid control 4. A pt is admitted to the hospital w/ a dx of Bipolar Disorder. He has been taking Lithium for several yrs, but no longer effective in managing his acute manic episodes. Which type of med is likely to be prescribed now? a. Anticonvulsant 5. A pt who has been on Depakote (valproate) for bipolar disorder for 2 weeks continues to be manic. The serum valproate level is 25 . Which of the following applies? a. This is below the therapeutic range, so the dose needs to be increased 6. A pt dx w/ Bipolar disorder is hyperactive and manic after dc-ing Lithium. The pt threatens to hit another pt. Which comment by the nurse is appropriate? a. “Do not hit anyone. If you’re unable to control yourself, we’ll help you.” 7. A person is directing traffic on a busy street and making obscene gestures at passing cars. The individual has not eaten or slept for 3 days. What features of mania are evident? a. Poor judgement and hyperactivity 8. A pt dx w/ bipolar disorder has rapid cycles. The HCP prescribes an anticonvulsant. To prepare teaching materials, which drugs should the nurse anticipate will be prescribed? a. Tegretol (carbamazepine) 9. A nurse is planning activities for a pt who has bipolar disorder w/ aggressive social behavior. Which activity would be most appropriate for this pt? a. Shooting baskets 10. A manic pt announces to everyone in the dayroom that a stripper is coming to perform this evening. When the nurse firmly states that this will not happen, the manic pt becomes verbally abusive and threatens the nurse w/ physical violence. The most appropriate action by the nurse would be: a. With assistance, escort the manic pt to his/her room and offer Haldol 11. A female pt is under evaluation for imminent suicide risk. Which information given by her would be most significant? a. Reference to suicide as the best solution 12. A pt experiencing acute mania has disrobed in the hall 3 times in 2 hrs. The nurse should: a. Arrange for one-on-one supervision 13. A pt experiencing acute mania is dancing atop the pool table in the rec room. The pt waves a cue in one hand and says, “I’ll throw the pool balls if anyone comes near me!” The nurse’s first intervention is to: a. Clear the room of all other pts 14. Mood congruent psychotic features in depressed pts may include all but: a. Delusion of grandeur i. Does include: nihilistic (life is meaningless belief) delusions, delusions of guilt, delusions of poverty 15. Which is the most severe form of Bipolar Disorder? a. Bipolar Disorder Type I 16. Which nursing response demonstrates accurate information that should be discussed w/ a female pt diagnosed with bipolar disorder w/ her support system. a. “Remember that alcohol and caffeine can trigger a relapse of your symptoms” b. “It’s critical to let your HCP know immediately if you aren’t sleeping well” c. “Is your family prepared to be actively involved in helping manage this disorder?” d. “Bc symptoms tend to come and go, you need to be able to recognize the early signs” 17. Which statement by a pt demonstrates an understanding of the effective use of Lithium to manage bipolar mania? a. “I have to keep reminding myself to consistently drink six 12-oz glasses of fluid every day” b. “I discussed w/ my psychiatric care provider the diuretic my cardiologist prescribed” c. “I’ve already made arrangements for my monthly lab work” 18. Substance abuse is often present in ppl dx w/ bipolar disorder. A 28-yr-old female w/ a dx of bipolar disorder drinks alcohol instead of taking her prescribed medications. A nurse caring for this pt would recognize that: a. Alcohol ingestion is a form of self-medication 19. A 33-yr-old female dx w/ bipolar type I has been functioning well on Lithium for 11 months. At her last checkup the psychiatric NP states, “You’re ready now to enter maintenance therapy stage, so at this time i’m going to adjust your dosage by prescribing”: a. A lower dose 20. A female pt has been admitted following an acute manic episode. The admitting nurse suspects Lithium toxicity. What assessment findings would confirm the nurse’s suspicion? a. Ataxia, severe hypotension, large volume of dilute urine PowerPoint Questions 1. Lower level mania alternating w/ serious depression? a. Bipolar II 2. Full blown mania w/ severe depression? a. Bipolar I 3. Hypomania w/ mild to moderate depression? i. Cyclothymic Disorder 4. Psychosis present: a. Bipolar I 5. Pressured Speech → rapid and frantic speech 6. Flight Of ideas → speech pattern w/ rapid transition frOm tOpic tO tOpic 7. Tangential thinking → giving all manner Of extraneous detail when answering a simple question 8. Delusion → false ideas not based On reality 9. Grandiosity →exaggerated sense of One’s impOrtance/pOwer 10. The py may use humor, manipulation, power struggles, or demanding behavior to prevent you setting limits or controlling dangerous behavior. Importance of: a. Consistent setting of limits: all staff on board b. Be aware of client efforts to split staff to loosen staff limits c. Calm, firm, neutral approach. Don’t become defensive & exasperated d. State unit policy, don’t argue, debate or defend rules. Be prepared to diffuse conflict 11. Which nursing chart entry is documentation of a behavioral symptom of mania? a. Pacing halls throughout the day. Exhibits poor impulse control. 12. A client seen in the emergency department is experiencing irritability, pressured speech, and increased levels of anxiety. Which would be the nurse’s priority intervention: a. Assess VS and complete a physical assessment 13. 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 finding will priority concern for this pt’s plan of care: a. Hyperactivity; not eating and sleeping 14. When a hyperactive pt dx w/ acute manis is hospitalized, what is the initial nursing intervention? a. Set limits of pt behavior as necessary