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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.
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A patient develops mania after discontinuing lithium. New prescriptions are written to resume lithium twice daily and begin olanzapine. This is the expected reaction to the addition of olanzapine to the medication regimen?
- A. Minimize the side effects of lithium.
- B. Bring hyperactivity under rapid control.
- C. Enhance the antimanic actions of lithium.
- D. Provide long-term control of hyperactivity.
Correct Answer: B
Rationale: Olanzapine has a rapid onset to control hyperactivity initially, as lithium requires time to reach therapeutic levels. It does not enhance lithium's effects or minimize side effects.
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.
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.
Which dinner menu is best suited for the patient diagnosed with bipolar disorder experiencing acute mania?
- A. Spaghetti and meatballs, salad, a banana
- B. Beef and vegetable stew, a roll, chocolate pudding
- C. Broiled chicken breast on a roll, an ear of corn, apple
- D. Chicken casserole, green beans, flavored gelatin with whipped cream
Correct Answer: C
Rationale: Finger foods like chicken on a roll and corn allow the hyperactive patient to eat on the go. Other options require utensils, which may be impractical.
A patient tells the nurse, 'I am so ashamed of being bipolar. When I'm manic, my behavior embarrasses my family. Even if I take my medication, there's no guarantee I won't have a relapse. I am such a burden to my family.' These statements support which nursing diagnoses?
- A. Powerlessness
- B. Defensive coping
- C. Chronic low self-esteem
- D. Impaired social interaction
- E. Risk-prone health behavior
Correct Answer: A,C
Rationale: The patient's shame and perceived burden reflect chronic low self-esteem and powerlessness. Other diagnoses are not supported by the statements.