C HAPTER 13: B IPOLAR AND R ELATED
D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9 th Edition
MULTIPLE CHOICE
1. A client waves a newspaper and says, “I must have m y credit card and use
the computer right now. A store is having a big sale, and I need to order
10 dresses and four pairs of shoes.” What is the nurse’s appropriate
intervention?
a. suggesting the client have a friend do the shopping and bring
purchases to the unit.
b. inviting the client to sit together and look at new fashion
magazines.
c. telling the client computer use is not allowed until self -control
improves.
d. asking whether the client has enough money to pay for the
purchases.
ANS: B
Situations such as this offer an opportunity to use the client’s
distractibilit y to staff’s advantage. Clients become frustrated when
staff deny requests that the clie nt sees as entirel y reasonable.
Distracting the client can avoid power struggles. Suggesting that a
friend do the shopping would not satisfy the client’s need for
immediacy and would ultimatel y result in the extravagant expenditure.
, Asking whether the clie nt has enough money would likel y precipitate
an angry response.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
2. A client diagnosed with bipolar disorder who takes lithiu m carbonate 300
mg three times dail y reports nausea. To reduce the nausea most
effectivel y, the nurse suggests that the lithium be taken with what?
a. food.
b. an antacid.
c. an antiemetic.
d. a large glass of juice.
ANS: A
Some clients find that taking lithium with food diminishes nausea. The
incorrect options are less helpful.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Physiological Integrit y
3. A health teaching plan for a client taking lithium shou ld include which
instructions?
a. maintain normal salt and fluids in the diet.
b. drink twice the usual dail y amount of fluid.
c. double the lithium dose if diarrhea or vomiting occurs.
, d. avoid eating aged cheese, processed meats, and red wine.
ANS: A
Sodium depletion and dehydration increase the chance for development
of lithium toxicit y. The other options offer inappropriate information.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Planning MSC: Client Needs:
Physiological Integrity
4. Which nursing diagnosis would most likely appl y to a client diagnosed
with major depressive disorder as well as one experiencing acute mania?
a. Deficient diversional activit y
b. Disturbed sleep pattern
c. Fluid volume excess
d. Defensive coping
ANS: B
Clients with mood disorders, both depression and mania, experience
sleep pattern disturbances. Assessment data should be routinely
gathered about this possible problem. Deficient diversional activit y is
more relevant for clients with depression. Defensive coping is m ore
relevant for clients with mania. Fluid volume excess is less relevant for
clients with mood disorders than is deficient fluid volume.
D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9 th Edition
MULTIPLE CHOICE
1. A client waves a newspaper and says, “I must have m y credit card and use
the computer right now. A store is having a big sale, and I need to order
10 dresses and four pairs of shoes.” What is the nurse’s appropriate
intervention?
a. suggesting the client have a friend do the shopping and bring
purchases to the unit.
b. inviting the client to sit together and look at new fashion
magazines.
c. telling the client computer use is not allowed until self -control
improves.
d. asking whether the client has enough money to pay for the
purchases.
ANS: B
Situations such as this offer an opportunity to use the client’s
distractibilit y to staff’s advantage. Clients become frustrated when
staff deny requests that the clie nt sees as entirel y reasonable.
Distracting the client can avoid power struggles. Suggesting that a
friend do the shopping would not satisfy the client’s need for
immediacy and would ultimatel y result in the extravagant expenditure.
, Asking whether the clie nt has enough money would likel y precipitate
an angry response.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
2. A client diagnosed with bipolar disorder who takes lithiu m carbonate 300
mg three times dail y reports nausea. To reduce the nausea most
effectivel y, the nurse suggests that the lithium be taken with what?
a. food.
b. an antacid.
c. an antiemetic.
d. a large glass of juice.
ANS: A
Some clients find that taking lithium with food diminishes nausea. The
incorrect options are less helpful.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Physiological Integrit y
3. A health teaching plan for a client taking lithium shou ld include which
instructions?
a. maintain normal salt and fluids in the diet.
b. drink twice the usual dail y amount of fluid.
c. double the lithium dose if diarrhea or vomiting occurs.
, d. avoid eating aged cheese, processed meats, and red wine.
ANS: A
Sodium depletion and dehydration increase the chance for development
of lithium toxicit y. The other options offer inappropriate information.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Planning MSC: Client Needs:
Physiological Integrity
4. Which nursing diagnosis would most likely appl y to a client diagnosed
with major depressive disorder as well as one experiencing acute mania?
a. Deficient diversional activit y
b. Disturbed sleep pattern
c. Fluid volume excess
d. Defensive coping
ANS: B
Clients with mood disorders, both depression and mania, experience
sleep pattern disturbances. Assessment data should be routinely
gathered about this possible problem. Deficient diversional activit y is
more relevant for clients with depression. Defensive coping is m ore
relevant for clients with mania. Fluid volume excess is less relevant for
clients with mood disorders than is deficient fluid volume.
