C HAPTER 13: B IPOLAR AND R ELATED
D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A patient 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 pai rs of shoes. Select the nurses appropriate
intervention. The nurse:
a. suggests the patient have a friend do the shopping and bring
purchases to the unit.
b. invites the patient to sit together and look at new fashion
magazines.
c. tells the patient computer use is not allowed until self -control
improves.
d. asks whether the patient has enough money to pay for the purchases.
ANS: B
Situations such as this offer an opportunity to use the patients
distractibilit y to staffs advantage. Patients become frustrated when
staff deny requests that the patient sees as entirel y reasonable.
Distracting the patient can avoid power struggles. Suggesting that a
friend do the shopping would not satisfy the patients need for
immediacy and would ultimatel y result in the extravagant expe nditure.
Asking whether the patient has enough money would likel y precipitate
an angry response.
, PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 229 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
2. An outpatient di agnosed with bipolar disorder takes lithium carbonate 300
mg three times dail y. The patient reports nausea. To reduce the nausea
most effectivel y, the nurse suggests that the lithium be taken with:
a. meals.
b. an antacid.
c. an antiemetic.
d. a large glass of jui ce.
ANS: A
Some patients find that taking lithium with meals diminishes nausea.
The incorrect options are less helpful.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 236 TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological I ntegrity
3. A health teaching plan for a patient taking lithium should include
instructions to:
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)
REF: 236 TOP: Nursing Process: Planning MSC:
Client Needs: Physiological Integrit y
4. Which nursing diagnosis would most likely appl y to both a patient
diagnosed with major depression as wel as one experiencing acute mania?
a. Deficient diversional activit y
b. Disturbed sleep pattern
c. Fluid volume excess
d. Defensive coping
ANS: B
Patients 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 patients with depression. Defensive coping is more
relevant for patients with mania. Fluid volume excess is less relevant
for patients with mood disorders than is deficient fluid volume.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysi s) REF: 229
TOP: Nursing Process: Diagnosis/Anal ysis MSC: Client
Needs: Psychosocial Integrit y
D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A patient 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 pai rs of shoes. Select the nurses appropriate
intervention. The nurse:
a. suggests the patient have a friend do the shopping and bring
purchases to the unit.
b. invites the patient to sit together and look at new fashion
magazines.
c. tells the patient computer use is not allowed until self -control
improves.
d. asks whether the patient has enough money to pay for the purchases.
ANS: B
Situations such as this offer an opportunity to use the patients
distractibilit y to staffs advantage. Patients become frustrated when
staff deny requests that the patient sees as entirel y reasonable.
Distracting the patient can avoid power struggles. Suggesting that a
friend do the shopping would not satisfy the patients need for
immediacy and would ultimatel y result in the extravagant expe nditure.
Asking whether the patient has enough money would likel y precipitate
an angry response.
, PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 229 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
2. An outpatient di agnosed with bipolar disorder takes lithium carbonate 300
mg three times dail y. The patient reports nausea. To reduce the nausea
most effectivel y, the nurse suggests that the lithium be taken with:
a. meals.
b. an antacid.
c. an antiemetic.
d. a large glass of jui ce.
ANS: A
Some patients find that taking lithium with meals diminishes nausea.
The incorrect options are less helpful.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 236 TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological I ntegrity
3. A health teaching plan for a patient taking lithium should include
instructions to:
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)
REF: 236 TOP: Nursing Process: Planning MSC:
Client Needs: Physiological Integrit y
4. Which nursing diagnosis would most likely appl y to both a patient
diagnosed with major depression as wel as one experiencing acute mania?
a. Deficient diversional activit y
b. Disturbed sleep pattern
c. Fluid volume excess
d. Defensive coping
ANS: B
Patients 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 patients with depression. Defensive coping is more
relevant for patients with mania. Fluid volume excess is less relevant
for patients with mood disorders than is deficient fluid volume.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysi s) REF: 229
TOP: Nursing Process: Diagnosis/Anal ysis MSC: Client
Needs: Psychosocial Integrit y
