Chapter 26: Bipolar Disorders
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. Which indicator of disordered communication is the nurse most likely to assess in a patient
having a manic episode?
a. Loose associations
b. Flight of ideas
c. Echolalia
d. Mutism
ANS: B
Flight of ideas is a continuous flow of speech marked by jumping from topic to topic. The
other options are most likely to be assessed in patients with schizophrenia.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
2. Which principle is most useful and effective when interacting with a patient experiencing a
manic episode?
a. Encourage the patient to freely express feelings.
b. Use a calm, matter-of-fact approach.
c. Do not interrupt the patient.
d. Frequently use silence.
, ANS: B
A calm, matter-of-fact approach minimizes the need for the patient to respond defensively and
avoids power struggles. Using this approach, the nurse conveys both control of the situation and
empathy. The other options are not principles related to therapeutic interactions with a patient
experiencing a manic episode. The distracters allow for manipulation of the nurse and for the
patient to control the interaction.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. A nurse assesses a new patient experiencing a manic episode. Which behavior is most likely to
have occurred before hospitalization?
a. Watching others closely but avoiding interaction
b. Taking frequent rest periods during the day c. Going rapidly from one activity to another d.
Remaining at home for long periods
ANS: C
There is increased physical and mental activity exhibited during a manic episode. Moving
rapidly from one activity to another is characteristic behavior during a manic episode. The other
behaviors mentioned are not consistent with what occurs during a manic episode.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
4. A patient offers to lead the next medication group session stating, ―I have studied all the effects
and problems with drugs on the Internet, so I can answer patients‘ questions.‖ How should the
nurse document this finding?
a. Flight of ideas
b. Distractibility
c. Limit-testing
d. Grandiosity
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. Which indicator of disordered communication is the nurse most likely to assess in a patient
having a manic episode?
a. Loose associations
b. Flight of ideas
c. Echolalia
d. Mutism
ANS: B
Flight of ideas is a continuous flow of speech marked by jumping from topic to topic. The
other options are most likely to be assessed in patients with schizophrenia.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
2. Which principle is most useful and effective when interacting with a patient experiencing a
manic episode?
a. Encourage the patient to freely express feelings.
b. Use a calm, matter-of-fact approach.
c. Do not interrupt the patient.
d. Frequently use silence.
, ANS: B
A calm, matter-of-fact approach minimizes the need for the patient to respond defensively and
avoids power struggles. Using this approach, the nurse conveys both control of the situation and
empathy. The other options are not principles related to therapeutic interactions with a patient
experiencing a manic episode. The distracters allow for manipulation of the nurse and for the
patient to control the interaction.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. A nurse assesses a new patient experiencing a manic episode. Which behavior is most likely to
have occurred before hospitalization?
a. Watching others closely but avoiding interaction
b. Taking frequent rest periods during the day c. Going rapidly from one activity to another d.
Remaining at home for long periods
ANS: C
There is increased physical and mental activity exhibited during a manic episode. Moving
rapidly from one activity to another is characteristic behavior during a manic episode. The other
behaviors mentioned are not consistent with what occurs during a manic episode.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
4. A patient offers to lead the next medication group session stating, ―I have studied all the effects
and problems with drugs on the Internet, so I can answer patients‘ questions.‖ How should the
nurse document this finding?
a. Flight of ideas
b. Distractibility
c. Limit-testing
d. Grandiosity
