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A patient diagnosed with bipolar disorder is being treated as an outpatient during a hypomanic episode. Which suggestions should the nurse provide to the family to assist in managing these behaviors?
- A. Provide structure.
- B. Limit credit card access.
- C. Encourage group social interaction.
- D. Limit work to half days.
- E. Monitor the patient's sleep patterns.
Correct Answer: A,B,E
Rationale: Structure, limited financial access, and sleep monitoring help manage hypomania by reducing stimulation and impulsivity. Group interaction and partial work may exacerbate symptoms.
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A patient experiencing acute mania has exhausted the staff members by noon. The patient has joked, manipulated, insulted, and been aggressive all morning. Staff members are feeling defensive and fatigued. Which is the best action?
- A. Confer with the health care provider regarding use of seclusion for this patient.
- B. Hold a staff meeting to discuss consistency and limit setting approaches.
- C. Conduct a meeting with all patients to discuss the behavior.
- D. Explain to the patient that the behavior is unacceptable.
Correct Answer: B
Rationale: A staff meeting promotes consistency and limit setting, reducing staff splitting and frustration. Seclusion is not warranted, and other options are less effective.
The nurse is monitoring a patient closely for signs and symptoms of Stevens-Johnson syndrome. Which medication is likely the trigger for such a syndrome?
- A. Clonazepam
- B. Risperidone
- C. Lamotrigine
- D. Aripiprazole
Correct Answer: C
Rationale: Lamotrigine is associated with Stevens-Johnson syndrome, a rare but serious dermatological reaction. Other medications listed are not linked to this complication.
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.
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.
Lithium is prescribed for a new patient. Which information from the patient's history indicates that monitoring serum concentrations of the drug will be especially challenging and critical?
- A. Arthritis
- B. Epilepsy
- C. Exercise-induced asthma
- D. Congestive heart failure
Correct Answer: D
Rationale: Congestive heart failure and diuretic use complicate fluid balance, increasing lithium toxicity risk. Other conditions do not directly affect lithium monitoring.