1|Page
NUR 114 Final Exam Questions and Answers with
Solutions
Bipolar I disorder characterized by - ANSWER at least one week
long manic episode that results in excessive activity. Mostly
mania with mix of depression
Mania can be - ANSWER euphoric or dysphoric
Bipolar II disorder - ANSWER mostly depression and hypomania.
Early ages of 20 and 60 years old. Not severe enough to impair
social/occupational life.
Cyclothymic disorder - ANSWER cycle in and out of hypomania
(no delusions and hallucinations) and depression. Two years for
an adult, 1 year for a child
Bipolar II disorders are more common - ANSWER among
females
,2|Page
More than half the people with bipolar disorder have - ANSWER
have another psychiatric disorder, most being panic attacks,
social phobia, etc.
Bipolar disorders have a strong - ANSWER heritability
Diathesis stress model - ANSWER genetic predisposition or
chemical imbalance may never experience symptoms, until an
event triggers the disorder.
Bipolar disorder may be more common in - ANSWER upper
socioeconomic classes
For Bipolar, Early diagnosis and treatment is key in - ANSWER
preventing suicide attempts, alcohol/substance abuse,
marital/work problems, etc.
Mania characteristics - ANSWER ○ Mood - highly unstable. May
laugh or joke or speak in a continuous stream. Mood can
quickly change to irritation or anger. Patients have high self
confidence and know no strangers. Excessive spending,
elaborate schemes.
,3|Page
○ Behavior- constant activity and reduced need for sleep
prevent proper rest. Non stop physical activity can lead to
physical exhaustion and death if not treated; this is an
EMERGENCY! Act on impulses.
○ Thought processes and speech patterns- flight of ideas is
continuous flow of accelerated speech- change in topic and
plays on word. Speech is usually loud, vulgar and sexua. Clang
associations are stringing words together based on their
rhyming sounds.
For Mania, Always assess if the patient is - ANSWER a danger to
self or others
With people with mania, nurses need to - ANSWER SET LIMITS!
Consistency is key among staff if limit setting is to be carried out
consistently.
Big diagnosis for mania is - ANSWER RISK FOR INJURY
Acute phase - ANSWER primary outcome is injury prevention-
stabilizing the patient (hydrating, maintaining cardiac status,
getting enough sleep and rest)
, 4|Page
Continuation phase - ANSWER focuses on adhering to the
medication regimen and preventing relapse
Maintenance therapy - ANSWER focuses on relapse prevention
and limitation of further episodes
Meds to use during acute phase - ANSWER use Lithium and
Lamictal are the first line of treatment for someone with bipolar
disorder
Lithium - ANSWER naturally occurring salt in the body- effective
in tx of bipolar I disorder- start low and go slow- takes about 10-
21 days to be effective- must reach therapeutic level to be
effective (7-14 days)- 0.4-1.3 mEq/L-levels should not exceed
1.5 (considered toxic)- Should be taken 5 days after beginning
lithium therapy- after therapeutic levels are reached, check
every month- after 6 months of stability, levels should be
checked every 3 months. Risks are hypothyroidism and
impairment of the kidneys. Be sure patients know they need to
continually take medication. IF DIARRHEA, VOMITING OR
SWEATING OCCURS STOP LITHIUM AND CONTACT YOUR
PHYSICIAN. Take with meal, do not take with diuretics.
NUR 114 Final Exam Questions and Answers with
Solutions
Bipolar I disorder characterized by - ANSWER at least one week
long manic episode that results in excessive activity. Mostly
mania with mix of depression
Mania can be - ANSWER euphoric or dysphoric
Bipolar II disorder - ANSWER mostly depression and hypomania.
Early ages of 20 and 60 years old. Not severe enough to impair
social/occupational life.
Cyclothymic disorder - ANSWER cycle in and out of hypomania
(no delusions and hallucinations) and depression. Two years for
an adult, 1 year for a child
Bipolar II disorders are more common - ANSWER among
females
,2|Page
More than half the people with bipolar disorder have - ANSWER
have another psychiatric disorder, most being panic attacks,
social phobia, etc.
Bipolar disorders have a strong - ANSWER heritability
Diathesis stress model - ANSWER genetic predisposition or
chemical imbalance may never experience symptoms, until an
event triggers the disorder.
Bipolar disorder may be more common in - ANSWER upper
socioeconomic classes
For Bipolar, Early diagnosis and treatment is key in - ANSWER
preventing suicide attempts, alcohol/substance abuse,
marital/work problems, etc.
Mania characteristics - ANSWER ○ Mood - highly unstable. May
laugh or joke or speak in a continuous stream. Mood can
quickly change to irritation or anger. Patients have high self
confidence and know no strangers. Excessive spending,
elaborate schemes.
,3|Page
○ Behavior- constant activity and reduced need for sleep
prevent proper rest. Non stop physical activity can lead to
physical exhaustion and death if not treated; this is an
EMERGENCY! Act on impulses.
○ Thought processes and speech patterns- flight of ideas is
continuous flow of accelerated speech- change in topic and
plays on word. Speech is usually loud, vulgar and sexua. Clang
associations are stringing words together based on their
rhyming sounds.
For Mania, Always assess if the patient is - ANSWER a danger to
self or others
With people with mania, nurses need to - ANSWER SET LIMITS!
Consistency is key among staff if limit setting is to be carried out
consistently.
Big diagnosis for mania is - ANSWER RISK FOR INJURY
Acute phase - ANSWER primary outcome is injury prevention-
stabilizing the patient (hydrating, maintaining cardiac status,
getting enough sleep and rest)
, 4|Page
Continuation phase - ANSWER focuses on adhering to the
medication regimen and preventing relapse
Maintenance therapy - ANSWER focuses on relapse prevention
and limitation of further episodes
Meds to use during acute phase - ANSWER use Lithium and
Lamictal are the first line of treatment for someone with bipolar
disorder
Lithium - ANSWER naturally occurring salt in the body- effective
in tx of bipolar I disorder- start low and go slow- takes about 10-
21 days to be effective- must reach therapeutic level to be
effective (7-14 days)- 0.4-1.3 mEq/L-levels should not exceed
1.5 (considered toxic)- Should be taken 5 days after beginning
lithium therapy- after therapeutic levels are reached, check
every month- after 6 months of stability, levels should be
checked every 3 months. Risks are hypothyroidism and
impairment of the kidneys. Be sure patients know they need to
continually take medication. IF DIARRHEA, VOMITING OR
SWEATING OCCURS STOP LITHIUM AND CONTACT YOUR
PHYSICIAN. Take with meal, do not take with diuretics.
