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A nurse reviewing the laboratory results for a patient diagnosed with bipolar disorder notes the lithium level as 1 mEq/L. How will the nurse interpret this information about the medication level?
- A. It requires no additional nursing intervention.
- B. It is below recognized therapeutic serum limits.
- C. It is above recognized therapeutic serum limits.
- D. It indicates a need for immediate medical intervention.
Correct Answer: A
Rationale: A lithium level of 1 mEq/L is within the therapeutic range (0.4-1 mEq/L), requiring no further intervention.
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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.
A person is directing traffic on a busy street while shouting and making obscene gestures at passing cars. The person has not slept or eaten for 3 days. What features of mania are evident?
- A. Increased muscle tension and anxiety
- B. Vegetative signs and poor grooming
- C. Poor judgment and hyperactivity
- D. Cognitive deficit and sad mood
Correct Answer: C
Rationale: Hyperactivity (directing traffic) and poor judgment (putting self in a dangerous position) are characteristic of manic episodes. The distractors do not specifically apply to mania.
A patient experiencing mania has not eaten or slept for 3 days. Which nursing diagnosis has priority?
- A. Risk for injury
- B. Ineffective coping
- C. Impaired social interaction
- D. Ineffective therapeutic regimen management
Correct Answer: A
Rationale: Hyperactivity and poor judgment place the patient at risk for injury, making this the priority nursing diagnosis to ensure physiological safety.
A patient diagnosed with bipolar disorder has rapid cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed?
- A. Phenytoin
- B. Clonidine
- C. Carbamazepine
- D. Chlorpromazine
Correct Answer: C
Rationale: Carbamazepine is effective for rapid-cycling bipolar disorder. Phenytoin and chlorpromazine are not used for mood stabilization, and clonidine is not an anticonvulsant for this purpose.
When a hyperactive patient experiencing acute mania is hospitalized, what initial nursing intervention is a priority?
- A. Allowing the patient to act out his or her feelings
- B. Setting limits on the patient's behavior as necessary
- C. Providing verbal instructions to the patient to remain calm
- D. Restraining the patient to reduce hyperactivity and aggression
Correct Answer: B
Rationale: Setting limits provides structure and support while the patient's control is tenuous, prioritizing safety. Other options may escalate behavior or are inappropriate initially.