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NCLEX PN Exam Bank: Bipolar Disorder and
Mood Stabilizer Education
Table of Contents
Subtopic 1: Understanding Bipolar Disorder – Signs, Symptoms, and Phases .................... 2
Subtopic 2: Pharmacologic Management – Mood Stabilizers and Antipsychotics ............... 9
Subtopic 3: Nursing Considerations and Monitoring for Mood Stabilizers ........................ 17
Subtopic 4: Patient and Family Education – Safe Use and Adherence to Mood Stabilizers . 25
Subtopic 5: Managing Acute Mania and Nursing Safety Interventions .............................. 33
Subtopic 6: Assessing Therapeutic Effects and Managing Side Effects of Mood Stabilizers 40
Subtopic 7: Nursing Responsibilities in Monitoring and Managing Side Effects of Mood
Stabilizers .................................................................................................................. 47
Subtopic 8: Patient-Centered Education and Family Involvement in Bipolar Care ............ 55
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Subtopic 1: Understanding Bipolar Disorder – Signs,
Symptoms, and Phases
Question 1:
A client experiencing a manic episode is most likely to exhibit which of the following
behaviors?
A. Social withdrawal and feelings of worthlessness
B. Increased energy, decreased need for sleep, and impulsive spending
C. Excessive sleeping and slowed movements
D. Poor appetite and persistent sadness
Correct Answer: B. Increased energy, decreased need for sleep, and impulsive spending
Rationale: Manic episodes are characterized by heightened energy levels, decreased need
for sleep, increased talkativeness, impulsivity (e.g., excessive spending), and grandiosity.
Question 2:
Which of the following is a key difference between Bipolar I and Bipolar II disorder?
A. Bipolar II includes psychotic features during mania
B. Bipolar I involves full manic episodes, while Bipolar II includes hypomanic episodes
C. Bipolar I includes seasonal depressive patterns
D. Bipolar II involves hallucinations in both mood states
Correct Answer: B. Bipolar I involves full manic episodes, while Bipolar II includes
hypomanic episodes
Rationale: Bipolar I is diagnosed when a client has experienced at least one manic episode;
Bipolar II involves hypomania and at least one major depressive episode.
Question 3:
A client with bipolar disorder in the depressive phase is likely to report:
A. Euphoria and grandiosity
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B. Feelings of hopelessness and lack of interest in activities
C. Pressured speech and flight of ideas
D. Risk-taking behavior
Correct Answer: B. Feelings of hopelessness and lack of interest in activities
Rationale: During the depressive phase, clients often present with classic symptoms of
depression, including low mood, anhedonia, and hopelessness.
Question 4:
Which symptom would the nurse expect to observe in a client experiencing hypomania?
A. Hallucinations
B. Catatonia
C. Elevated mood without significant impairment in functioning
D. Psychomotor retardation
Correct Answer: C. Elevated mood without significant impairment in functioning
Rationale: Hypomania includes symptoms similar to mania but is less severe and does not
cause marked impairment in social or occupational functioning.
Question 5:
Which of the following best describes cyclothymic disorder?
A. Episodes of psychosis followed by depression
B. Chronic fluctuating mood with hypomania and mild depression for at least 2 years
C. Mania alternating with schizophrenia
D. Severe depression without periods of elevated mood
Correct Answer: B. Chronic fluctuating mood with hypomania and mild depression for at
least 2 years
Rationale: Cyclothymic disorder is a mood disorder with less severe but chronic symptoms
that do not meet full criteria for bipolar I or II.
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Question 6:
Which nursing observation indicates a manic phase?
A. Slumped posture, slow speech
B. Rapid speech, inability to stay seated, and inflated self-esteem
C. Tearfulness and guilt
D. Suspiciousness and withdrawal
Correct Answer: B. Rapid speech, inability to stay seated, and inflated self-esteem
Rationale: Mania presents with hyperactivity, pressured speech, distractibility, and
grandiose thinking.
Question 7:
Which is a common trigger for manic episodes in bipolar clients?
A. Sleep deprivation
B. Exposure to cold weather
C. High-fat diet
D. Dehydration
Correct Answer: A. Sleep deprivation
Rationale: Lack of sleep is a well-known trigger that can precipitate manic episodes in
bipolar clients.
Question 8:
The most concerning behavior in a manic client from a safety standpoint is:
A. Talking loudly
B. Risky sexual behaviors
C. Pacing the room
D. Complaining of boredom
NCLEX PN Exam Bank: Bipolar Disorder and
Mood Stabilizer Education
Table of Contents
Subtopic 1: Understanding Bipolar Disorder – Signs, Symptoms, and Phases .................... 2
Subtopic 2: Pharmacologic Management – Mood Stabilizers and Antipsychotics ............... 9
Subtopic 3: Nursing Considerations and Monitoring for Mood Stabilizers ........................ 17
Subtopic 4: Patient and Family Education – Safe Use and Adherence to Mood Stabilizers . 25
Subtopic 5: Managing Acute Mania and Nursing Safety Interventions .............................. 33
Subtopic 6: Assessing Therapeutic Effects and Managing Side Effects of Mood Stabilizers 40
Subtopic 7: Nursing Responsibilities in Monitoring and Managing Side Effects of Mood
Stabilizers .................................................................................................................. 47
Subtopic 8: Patient-Centered Education and Family Involvement in Bipolar Care ............ 55
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Subtopic 1: Understanding Bipolar Disorder – Signs,
Symptoms, and Phases
Question 1:
A client experiencing a manic episode is most likely to exhibit which of the following
behaviors?
A. Social withdrawal and feelings of worthlessness
B. Increased energy, decreased need for sleep, and impulsive spending
C. Excessive sleeping and slowed movements
D. Poor appetite and persistent sadness
Correct Answer: B. Increased energy, decreased need for sleep, and impulsive spending
Rationale: Manic episodes are characterized by heightened energy levels, decreased need
for sleep, increased talkativeness, impulsivity (e.g., excessive spending), and grandiosity.
Question 2:
Which of the following is a key difference between Bipolar I and Bipolar II disorder?
A. Bipolar II includes psychotic features during mania
B. Bipolar I involves full manic episodes, while Bipolar II includes hypomanic episodes
C. Bipolar I includes seasonal depressive patterns
D. Bipolar II involves hallucinations in both mood states
Correct Answer: B. Bipolar I involves full manic episodes, while Bipolar II includes
hypomanic episodes
Rationale: Bipolar I is diagnosed when a client has experienced at least one manic episode;
Bipolar II involves hypomania and at least one major depressive episode.
Question 3:
A client with bipolar disorder in the depressive phase is likely to report:
A. Euphoria and grandiosity
, 3
B. Feelings of hopelessness and lack of interest in activities
C. Pressured speech and flight of ideas
D. Risk-taking behavior
Correct Answer: B. Feelings of hopelessness and lack of interest in activities
Rationale: During the depressive phase, clients often present with classic symptoms of
depression, including low mood, anhedonia, and hopelessness.
Question 4:
Which symptom would the nurse expect to observe in a client experiencing hypomania?
A. Hallucinations
B. Catatonia
C. Elevated mood without significant impairment in functioning
D. Psychomotor retardation
Correct Answer: C. Elevated mood without significant impairment in functioning
Rationale: Hypomania includes symptoms similar to mania but is less severe and does not
cause marked impairment in social or occupational functioning.
Question 5:
Which of the following best describes cyclothymic disorder?
A. Episodes of psychosis followed by depression
B. Chronic fluctuating mood with hypomania and mild depression for at least 2 years
C. Mania alternating with schizophrenia
D. Severe depression without periods of elevated mood
Correct Answer: B. Chronic fluctuating mood with hypomania and mild depression for at
least 2 years
Rationale: Cyclothymic disorder is a mood disorder with less severe but chronic symptoms
that do not meet full criteria for bipolar I or II.
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Question 6:
Which nursing observation indicates a manic phase?
A. Slumped posture, slow speech
B. Rapid speech, inability to stay seated, and inflated self-esteem
C. Tearfulness and guilt
D. Suspiciousness and withdrawal
Correct Answer: B. Rapid speech, inability to stay seated, and inflated self-esteem
Rationale: Mania presents with hyperactivity, pressured speech, distractibility, and
grandiose thinking.
Question 7:
Which is a common trigger for manic episodes in bipolar clients?
A. Sleep deprivation
B. Exposure to cold weather
C. High-fat diet
D. Dehydration
Correct Answer: A. Sleep deprivation
Rationale: Lack of sleep is a well-known trigger that can precipitate manic episodes in
bipolar clients.
Question 8:
The most concerning behavior in a manic client from a safety standpoint is:
A. Talking loudly
B. Risky sexual behaviors
C. Pacing the room
D. Complaining of boredom
