NR 548 Exam 3 Weeks 1 to 8 Psychiatric Assessment for the
Psychiatric-Mental Health Nurse Practitioner :Questions & Answers
Bipolar Disorder and Lithium Management
1. Which nursing response demonstrates accurate information for a patient
diagnosed with bipolar disorder and their support system?
o A) "Antidepressant therapy is never used."
o B) "Alcohol and caffeine can trigger a relapse of your symptoms."
o C) "Manic episodes are only triggered by medication non-
compliance."
o D) "Support systems should avoid involvement to promote
independence."
o Correct Answer: B
o Rationale: Patients and families must be educated that alcohol and
caffeine are significant triggers for symptom relapse.
2. A patient newly prescribed lithium shows an understanding of its effective
use by stating:
o A) "I will limit my fluids to four glasses a day."
o B) "I must consistently drink six 12-ounce glasses of fluid every day."
o C) "I will stop taking the medication once my mood stabilizes."
o D) "I should take it on an empty stomach for better absorption."
o Correct Answer: B
o Rationale: Maintaining a consistent fluid intake is essential for
managing lithium levels and preventing toxicity.
3. Which early signs of lithium toxicity should a nurse stress to a patient?
o A) Increased energy and clear vision.
, o B) An upset stomach for no reason and shaky hands.
o C) Constipation and dry skin.
o D) Polyuria and increased appetite.
o Correct Answer: B
o Rationale: Gastrointestinal distress and fine tremors (shaky hands)
are classic early indicators of lithium toxicity.
4. If a patient reports a lithium level of 1.7 mEq/L, what is the priority
intervention?
o A) Advise them to drink more water and continue the dose.
o B) Instruct the patient to hold the next dose and contact the
prescriber.
o C) Notify the family to monitor for seizures.
o D) Tell the patient this is a normal therapeutic level.
o Correct Answer: B
o Rationale: A level of 1.7 mEq/L is above the therapeutic range; the
dose must be held until a provider is consulted.
5. What dietary intervention is appropriate for a patient in an acute manic
state?
o A) Low-sodium, high-fiber snacks.
o B) Frequent milkshakes and protein drinks.
o C) Three large, balanced meals in the dining room.
o D) Clear liquids only to prevent choking.
o Correct Answer: B
o Rationale: Manic patients often cannot sit for meals; high-calorie
"finger foods" and drinks provide necessary nutrition.
, 6. Which statement is true regarding substance use and bipolar disorder?
o A) It is always a sign of a primary addiction.
o B) Alcohol ingestion is often a form of self-medication.
o C) It only occurs during depressive phases.
o D) Substances increase the number of available neurotransmitters.
o Correct Answer: B
o Rationale: Patients often use alcohol to numb or manage the distress
of their psychiatric symptoms.
7. What is recommended to reduce mania in a patient with a history of IV
drug abuse and Hepatitis C who is non-responsive to lithium?
o A) Fluoxetine.
o B) Electroconvulsive therapy (ECT).
o C) High-dose benzodiazepines.
o D) Increased dietary protein.
o Correct Answer: B
o Rationale: ECT is a treatment option for reducing acute mania when
pharmacological options are insufficient or contraindicated.
8. During the maintenance therapy stage of bipolar I, the lithium dosage is
typically:
o A) Doubled.
o B) Lowered.
o C) Stopped completely.
o D) Switched to a PRN (as needed) schedule.
o Correct Answer: B
Psychiatric-Mental Health Nurse Practitioner :Questions & Answers
Bipolar Disorder and Lithium Management
1. Which nursing response demonstrates accurate information for a patient
diagnosed with bipolar disorder and their support system?
o A) "Antidepressant therapy is never used."
o B) "Alcohol and caffeine can trigger a relapse of your symptoms."
o C) "Manic episodes are only triggered by medication non-
compliance."
o D) "Support systems should avoid involvement to promote
independence."
o Correct Answer: B
o Rationale: Patients and families must be educated that alcohol and
caffeine are significant triggers for symptom relapse.
2. A patient newly prescribed lithium shows an understanding of its effective
use by stating:
o A) "I will limit my fluids to four glasses a day."
o B) "I must consistently drink six 12-ounce glasses of fluid every day."
o C) "I will stop taking the medication once my mood stabilizes."
o D) "I should take it on an empty stomach for better absorption."
o Correct Answer: B
o Rationale: Maintaining a consistent fluid intake is essential for
managing lithium levels and preventing toxicity.
3. Which early signs of lithium toxicity should a nurse stress to a patient?
o A) Increased energy and clear vision.
, o B) An upset stomach for no reason and shaky hands.
o C) Constipation and dry skin.
o D) Polyuria and increased appetite.
o Correct Answer: B
o Rationale: Gastrointestinal distress and fine tremors (shaky hands)
are classic early indicators of lithium toxicity.
4. If a patient reports a lithium level of 1.7 mEq/L, what is the priority
intervention?
o A) Advise them to drink more water and continue the dose.
o B) Instruct the patient to hold the next dose and contact the
prescriber.
o C) Notify the family to monitor for seizures.
o D) Tell the patient this is a normal therapeutic level.
o Correct Answer: B
o Rationale: A level of 1.7 mEq/L is above the therapeutic range; the
dose must be held until a provider is consulted.
5. What dietary intervention is appropriate for a patient in an acute manic
state?
o A) Low-sodium, high-fiber snacks.
o B) Frequent milkshakes and protein drinks.
o C) Three large, balanced meals in the dining room.
o D) Clear liquids only to prevent choking.
o Correct Answer: B
o Rationale: Manic patients often cannot sit for meals; high-calorie
"finger foods" and drinks provide necessary nutrition.
, 6. Which statement is true regarding substance use and bipolar disorder?
o A) It is always a sign of a primary addiction.
o B) Alcohol ingestion is often a form of self-medication.
o C) It only occurs during depressive phases.
o D) Substances increase the number of available neurotransmitters.
o Correct Answer: B
o Rationale: Patients often use alcohol to numb or manage the distress
of their psychiatric symptoms.
7. What is recommended to reduce mania in a patient with a history of IV
drug abuse and Hepatitis C who is non-responsive to lithium?
o A) Fluoxetine.
o B) Electroconvulsive therapy (ECT).
o C) High-dose benzodiazepines.
o D) Increased dietary protein.
o Correct Answer: B
o Rationale: ECT is a treatment option for reducing acute mania when
pharmacological options are insufficient or contraindicated.
8. During the maintenance therapy stage of bipolar I, the lithium dosage is
typically:
o A) Doubled.
o B) Lowered.
o C) Stopped completely.
o D) Switched to a PRN (as needed) schedule.
o Correct Answer: B
