Nokea
A health teaching plan for a patient taking lithium should include which instructions?
- A. Maintain normal salt and fluids in the diet.
- B. Drink twice the usual daily amount of fluids.
- C. Double the lithium dose if diarrhea or vomiting occurs.
- D. Avoid eating aged cheese, processed meats, and red wine.
Correct Answer: A
Rationale: Maintaining normal salt and fluid intake prevents lithium toxicity. Other options are incorrect or unrelated to lithium therapy.
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A patient experiencing acute mania waves a newspaper and says, 'I must have my 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 most appropriate intervention?
- A. Suggesting to the patient to ask a friend to do the shopping and bring purchases to the unit
- B. Inviting the patient to sit with the nurse and look at new fashion magazines
- C. Telling the patient that computer use is not allowed until self-control improves
- D. Asking whether the patient has enough money to pay for the purchases
Correct Answer: B
Rationale: Distraction with fashion magazines leverages the patient's distractibility to avoid power struggles and reduce impulsive behavior. Other options may escalate frustration.
A patient diagnosed with bipolar disorder is hyperactive and manic after discontinuing lithium. The patient threatens to hit another patient. Which comment by the nurse is appropriate?
- A. Stop that! No one did anything to provoke an attack by you.'
- B. If you do that one more time, you will be secluded immediately.'
- C. Do not hit anyone. If you are unable to control yourself, we will help you.'
- D. You know we will not let you hit anyone. Why do you continue this behavior?'
Correct Answer: C
Rationale: Setting limits in simple, concrete terms helps de-escalate the situation while offering assistance. The other options either threaten punishment or fail to provide environmental safety.
After hospital discharge, what is the priority intervention for a patient diagnosed with bipolar disorder who is taking antimanic medication?
- A. Decreasing physical activity
- B. Increasing food and fluids
- C. Meeting self-care needs
- D. Psychoeducation
Correct Answer: D
Rationale: Psychoeducation promotes medication adherence and relapse prevention, which are critical post-discharge. Other options are less prioritized.
The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. What response supported by research should the nurse provide?
- A. A high proportion of patients diagnosed with bipolar disorders are found among creative writers.'
- B. A higher rate of relatives diagnosed with bipolar disorder is found among patients with bipolar disorder.'
- C. Patients diagnosed with bipolar disorder have higher rates of relatives who respond in an exaggerated way to daily stresses.'
- D. More individuals diagnosed with bipolar disorder come from high socioeconomic and educational backgrounds.'
Correct Answer: B
Rationale: Higher incidence of bipolar disorder among relatives supports genetic transmission. Other options do not provide direct evidence for genetic links.
This is the primary reason that the cause of bipolar disorder has not been determined?
- A. Several factors, including genetics, are implicated.
- B. Brain structures were altered by trauma early in life.
- C. Excess norepinephrine is probably a major factor.
- D. Excess sensitivity in dopamine receptors may exist.
Correct Answer: A
Rationale: The interplay of multiple factors, including genetics and neurotransmitter imbalances, is the most likely explanation for bipolar disorder. Other options are too specific or narrow.