HESI Exit Exam Master Guide: Mood
Disorders, Bipolar & Depression Care
Table of Contents
Subtopic 1: Clinical Assessment and Diagnostic Criteria for Bipolar & Depression............. 2
Subtopic 2: Pharmacologic Management of Bipolar Disorder & Depression..................... 11
Subtopic 3: Non-Pharmacologic and Psychotherapeutic Interventions ........................... 21
Subtopic 4: Crisis Management and Suicide Prevention in Mood Disorders ..................... 30
Subtopic 5: Nursing Care Plans and Prioritization in Mood Disorders .............................. 40
Subtopic 6: Pharmacologic Treatments – Antidepressants and Mood Stabilizers ............. 49
Subtopic 7: Non-Pharmacologic and Psychosocial Interventions ................................... 58
Subtopic 8: Emergency & Crisis Interventions for Mood Disorders .................................. 68
Subtopic 9: Cultural, Ethical, and Legal Considerations in Mood Disorder Care ............... 77
Subtopic 10: Emergency Management and Crisis Stabilization in Mood Disorders ........... 87
,Subtopic 1: Clinical Assessment and Diagnostic Criteria
for Bipolar & Depression
Question 1
A nurse is assessing a patient who reports periods of feeling “on top of the world” followed
by times of extreme sadness. Which of the following assessments would best support a
diagnosis of bipolar disorder?
A. Lack of motivation during depressive episodes
B. Increased appetite and weight gain during depressive episodes
C. Alternating periods of mania and depression
D. Persistent sadness lasting more than two years
Correct answer: C
Rationale: Bipolar disorder is characterized by cycles of mania (elevated mood, increased
energy) and depression. The key diagnostic feature is the alternation between these states.
Question 2
Which assessment finding would a nurse most likely observe in a patient experiencing a
manic episode?
A. Low energy and slow speech
B. Pressured speech and flight of ideas
C. Social withdrawal and sleepiness
D. Suicidal ideation and anhedonia
Correct answer: B
,Rationale: Manic episodes include signs such as pressured speech, flight of ideas,
decreased need for sleep, and impulsive behavior.
Question 3
A patient with major depressive disorder has been sleeping excessively, feels hopeless,
and lacks energy. What term best describes this cluster of symptoms?
A. Euphoric affect
B. Manic episode
C. Depressive episode
D. Delusional thinking
Correct answer: C
Rationale: These are classic symptoms of a depressive episode: hypersomnia,
hopelessness, and fatigue.
Question 4
Which of the following screening tools is most appropriate for assessing depression in
adults?
A. MMSE
B. CAGE Questionnaire
C. PHQ-9
D. Braden Scale
Correct answer: C
, Rationale: The PHQ-9 (Patient Health Questionnaire) is a validated tool used to screen for
and measure the severity of depression in adults.
Question 5
A client is suspected of having bipolar II disorder. What is a defining feature of this disorder
compared to bipolar I?
A. Delusional thinking
B. Presence of hypomanic episodes instead of full mania
C. Psychotic features during depressive episodes
D. Increased severity of manic phases
Correct answer: B
Rationale: Bipolar II involves hypomanic episodes (less severe than full mania) and major
depressive episodes. Bipolar I includes full manic episodes.
Question 6
Which of the following best indicates a patient is experiencing psychomotor retardation in
depression?
A. Excessive talking
B. Slowed physical movement and speech
C. Nail-biting and restlessness
D. Sudden bursts of laughter
Correct answer: B
Disorders, Bipolar & Depression Care
Table of Contents
Subtopic 1: Clinical Assessment and Diagnostic Criteria for Bipolar & Depression............. 2
Subtopic 2: Pharmacologic Management of Bipolar Disorder & Depression..................... 11
Subtopic 3: Non-Pharmacologic and Psychotherapeutic Interventions ........................... 21
Subtopic 4: Crisis Management and Suicide Prevention in Mood Disorders ..................... 30
Subtopic 5: Nursing Care Plans and Prioritization in Mood Disorders .............................. 40
Subtopic 6: Pharmacologic Treatments – Antidepressants and Mood Stabilizers ............. 49
Subtopic 7: Non-Pharmacologic and Psychosocial Interventions ................................... 58
Subtopic 8: Emergency & Crisis Interventions for Mood Disorders .................................. 68
Subtopic 9: Cultural, Ethical, and Legal Considerations in Mood Disorder Care ............... 77
Subtopic 10: Emergency Management and Crisis Stabilization in Mood Disorders ........... 87
,Subtopic 1: Clinical Assessment and Diagnostic Criteria
for Bipolar & Depression
Question 1
A nurse is assessing a patient who reports periods of feeling “on top of the world” followed
by times of extreme sadness. Which of the following assessments would best support a
diagnosis of bipolar disorder?
A. Lack of motivation during depressive episodes
B. Increased appetite and weight gain during depressive episodes
C. Alternating periods of mania and depression
D. Persistent sadness lasting more than two years
Correct answer: C
Rationale: Bipolar disorder is characterized by cycles of mania (elevated mood, increased
energy) and depression. The key diagnostic feature is the alternation between these states.
Question 2
Which assessment finding would a nurse most likely observe in a patient experiencing a
manic episode?
A. Low energy and slow speech
B. Pressured speech and flight of ideas
C. Social withdrawal and sleepiness
D. Suicidal ideation and anhedonia
Correct answer: B
,Rationale: Manic episodes include signs such as pressured speech, flight of ideas,
decreased need for sleep, and impulsive behavior.
Question 3
A patient with major depressive disorder has been sleeping excessively, feels hopeless,
and lacks energy. What term best describes this cluster of symptoms?
A. Euphoric affect
B. Manic episode
C. Depressive episode
D. Delusional thinking
Correct answer: C
Rationale: These are classic symptoms of a depressive episode: hypersomnia,
hopelessness, and fatigue.
Question 4
Which of the following screening tools is most appropriate for assessing depression in
adults?
A. MMSE
B. CAGE Questionnaire
C. PHQ-9
D. Braden Scale
Correct answer: C
, Rationale: The PHQ-9 (Patient Health Questionnaire) is a validated tool used to screen for
and measure the severity of depression in adults.
Question 5
A client is suspected of having bipolar II disorder. What is a defining feature of this disorder
compared to bipolar I?
A. Delusional thinking
B. Presence of hypomanic episodes instead of full mania
C. Psychotic features during depressive episodes
D. Increased severity of manic phases
Correct answer: B
Rationale: Bipolar II involves hypomanic episodes (less severe than full mania) and major
depressive episodes. Bipolar I includes full manic episodes.
Question 6
Which of the following best indicates a patient is experiencing psychomotor retardation in
depression?
A. Excessive talking
B. Slowed physical movement and speech
C. Nail-biting and restlessness
D. Sudden bursts of laughter
Correct answer: B
