NR 548 Exam 3: 100 Questions & Answers with Rationales
1. Which of the following is considered a trigger for a relapse of symptoms in a
patient with bipolar disorder?
• A. High-protein diets
• B. Alcohol and caffeine
• C. Consistent exercise
• D. Increased social interaction
• Correct Answer: B
• Rationale: Alcohol and caffeine are specifically noted to trigger a relapse of
symptoms in patients diagnosed with bipolar disorder.
2. Which statement indicates a patient understands how to manage newly
prescribed lithium?
• A. "I will limit my water intake to one glass a day."
• B. "I must consistently drink six 12-ounce glasses of fluid every day."
• C. "I can stop taking it once my mood is stable."
• D. "I should take it on an empty stomach for better absorption."
• Correct Answer: B
• Rationale: Adequate and consistent fluid intake is necessary for safe lithium
therapy.
3. Which of the following are considered early signs of lithium toxicity?
• A. Increased attentiveness and improved vision
• B. Upset stomach for no reason and shaky hands making it hard to hold a
cup
• C. Constipation and dry mouth
• D. Weight loss and increased energy
, • Correct Answer: B
• Rationale: Early signs of lithium toxicity that nurses should stress to
patients include unexplained gastrointestinal distress and fine hand tremors
that interfere with tasks.
4. If a patient’s lithium level is 1.7 mEq/L, what is the priority nursing
intervention?
• A. Inform the patient this is a therapeutic level.
• B. Instruct the patient to hold the next dose and contact the prescriber.
• C. Advise the patient to go to the emergency room immediately.
• D. Tell the patient to double their fluid intake and continue the medication.
• Correct Answer: B
• Rationale: A level of 1.7 mEq/L is above the standard therapeutic range,
necessitating the holding of the dose and provider notification.
5. What is an appropriate dietary intervention for a patient demonstrating
manic behavior?
• A. Large, three-course meals in a quiet dining room
• B. Frequent milkshakes and protein drinks
• C. Low-calorie snacks and water
• D. Caffeine-free tea and crackers
• Correct Answer: B
• Rationale: Patients in a manic state often cannot sit for meals, so high-
calorie, portable "finger foods" or drinks like milkshakes are used to
maintain nutrition.
6. Why might a patient with bipolar disorder consume alcohol instead of
prescribed medication?
• A. It is more effective at stabilizing mood.
, • B. Alcohol ingestion is often a form of self-medication.
• C. It increases the number of neurotransmitters in the brain.
• D. It is used only when the patient is in a depressed phase.
• Correct Answer: B
• Rationale: Patients frequently use substances like alcohol to cope with or
"self-medicate" their symptoms.
7. Which treatment is recommended to reduce mania in a patient with a history
of IV drug abuse and Hepatitis C who is taking lithium as scheduled?
• A. Clonazepam
• B. Fluoxetine
• C. Electroconvulsive therapy (ECT)
• D. Lurasidone
• Correct Answer: C
• Rationale: ECT is recommended as a treatment for mania when other
interventions or medications are not sufficient or when medical
comorbidities are present.
8. When a patient enters the maintenance therapy stage for bipolar disorder,
how is the lithium dosage typically adjusted?
• A. The dose is increased to prevent future episodes.
• B. The dose is changed to once-a-week administration.
• C. The dosage is lowered.
• D. The patient is switched to a different class of medication.
• Correct Answer: C
• Rationale: Maintenance doses of lithium are typically lower than those
used for the acute treatment of mania.
, 9. Which assessment findings indicate lithium toxicity in a hospitalized patient?
• A. Shortness of breath and chronic cough
• B. Ataxia, severe hypotension, and large volumes of dilute urine
• C. Increased thirst and nystagmus
• D. Chest pain and dizziness
• Correct Answer: B
• Rationale: Advanced signs of lithium toxicity include loss of coordination
(ataxia), low blood pressure, and significant changes in urine output.
10. A medic finds a manic patient with several empty containers on his desk.
Which of the following is most likely to exacerbate mania?
• A. Fast food wrappers
• B. Energy drink containers
• C. Soda cans
• D. Water bottles
• Correct Answer: D
• Rationale: Energy drinks contain high levels of stimulants that can trigger or
worsen manic episodes.
11. Which symptom is commonly observed in a teenager diagnosed with Major
Depressive Disorder (MDD)?
• A. Inability to sit still (restlessness)
• B. Excessive studying to get into college
• C. Waking up at 3 a.m. and being unable to return to sleep
• D. Moderate weight loss over several months
• Correct Answer: D
1. Which of the following is considered a trigger for a relapse of symptoms in a
patient with bipolar disorder?
• A. High-protein diets
• B. Alcohol and caffeine
• C. Consistent exercise
• D. Increased social interaction
• Correct Answer: B
• Rationale: Alcohol and caffeine are specifically noted to trigger a relapse of
symptoms in patients diagnosed with bipolar disorder.
2. Which statement indicates a patient understands how to manage newly
prescribed lithium?
• A. "I will limit my water intake to one glass a day."
• B. "I must consistently drink six 12-ounce glasses of fluid every day."
• C. "I can stop taking it once my mood is stable."
• D. "I should take it on an empty stomach for better absorption."
• Correct Answer: B
• Rationale: Adequate and consistent fluid intake is necessary for safe lithium
therapy.
3. Which of the following are considered early signs of lithium toxicity?
• A. Increased attentiveness and improved vision
• B. Upset stomach for no reason and shaky hands making it hard to hold a
cup
• C. Constipation and dry mouth
• D. Weight loss and increased energy
, • Correct Answer: B
• Rationale: Early signs of lithium toxicity that nurses should stress to
patients include unexplained gastrointestinal distress and fine hand tremors
that interfere with tasks.
4. If a patient’s lithium level is 1.7 mEq/L, what is the priority nursing
intervention?
• A. Inform the patient this is a therapeutic level.
• B. Instruct the patient to hold the next dose and contact the prescriber.
• C. Advise the patient to go to the emergency room immediately.
• D. Tell the patient to double their fluid intake and continue the medication.
• Correct Answer: B
• Rationale: A level of 1.7 mEq/L is above the standard therapeutic range,
necessitating the holding of the dose and provider notification.
5. What is an appropriate dietary intervention for a patient demonstrating
manic behavior?
• A. Large, three-course meals in a quiet dining room
• B. Frequent milkshakes and protein drinks
• C. Low-calorie snacks and water
• D. Caffeine-free tea and crackers
• Correct Answer: B
• Rationale: Patients in a manic state often cannot sit for meals, so high-
calorie, portable "finger foods" or drinks like milkshakes are used to
maintain nutrition.
6. Why might a patient with bipolar disorder consume alcohol instead of
prescribed medication?
• A. It is more effective at stabilizing mood.
, • B. Alcohol ingestion is often a form of self-medication.
• C. It increases the number of neurotransmitters in the brain.
• D. It is used only when the patient is in a depressed phase.
• Correct Answer: B
• Rationale: Patients frequently use substances like alcohol to cope with or
"self-medicate" their symptoms.
7. Which treatment is recommended to reduce mania in a patient with a history
of IV drug abuse and Hepatitis C who is taking lithium as scheduled?
• A. Clonazepam
• B. Fluoxetine
• C. Electroconvulsive therapy (ECT)
• D. Lurasidone
• Correct Answer: C
• Rationale: ECT is recommended as a treatment for mania when other
interventions or medications are not sufficient or when medical
comorbidities are present.
8. When a patient enters the maintenance therapy stage for bipolar disorder,
how is the lithium dosage typically adjusted?
• A. The dose is increased to prevent future episodes.
• B. The dose is changed to once-a-week administration.
• C. The dosage is lowered.
• D. The patient is switched to a different class of medication.
• Correct Answer: C
• Rationale: Maintenance doses of lithium are typically lower than those
used for the acute treatment of mania.
, 9. Which assessment findings indicate lithium toxicity in a hospitalized patient?
• A. Shortness of breath and chronic cough
• B. Ataxia, severe hypotension, and large volumes of dilute urine
• C. Increased thirst and nystagmus
• D. Chest pain and dizziness
• Correct Answer: B
• Rationale: Advanced signs of lithium toxicity include loss of coordination
(ataxia), low blood pressure, and significant changes in urine output.
10. A medic finds a manic patient with several empty containers on his desk.
Which of the following is most likely to exacerbate mania?
• A. Fast food wrappers
• B. Energy drink containers
• C. Soda cans
• D. Water bottles
• Correct Answer: D
• Rationale: Energy drinks contain high levels of stimulants that can trigger or
worsen manic episodes.
11. Which symptom is commonly observed in a teenager diagnosed with Major
Depressive Disorder (MDD)?
• A. Inability to sit still (restlessness)
• B. Excessive studying to get into college
• C. Waking up at 3 a.m. and being unable to return to sleep
• D. Moderate weight loss over several months
• Correct Answer: D
