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A patient diagnosed with bipolar disorder is being treated on an outpatient basis with lithium carbonate 300mg three times daily and has now reported being nauseated. To reduce the nausea, what will the nurse suggest the lithium be taken with?
- A. Food
- B. An antacid
- C. A large glass of juice
- D. An antiemetic medication
Correct Answer: A
Rationale: Taking lithium with food can reduce nausea. Other options are less effective or inappropriate for managing this side effect.
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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 experiencing acute mania undresses in the group room and dances. What should be the nurse's first intervention?
- A. Quietly ask the patient, 'Why don't you put on your clothes?'
- B. Firmly tell the patient, 'Stop dancing, and put on your clothing.'
- C. Put a blanket around the patient and walk with the patient to a quiet room.
- D. Allow the patient stay in the group room while moving the other patients to a different area.
Correct Answer: C
Rationale: Covering the patient and removing them from the area protects them from embarrassment and maintains safety. Other options are less effective or inappropriate.
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.
A patient diagnosed with bipolar disorder is dressed in a red leotard and brightly colored scarves. The patient cusses while twirling and shadowboxing. Then the patient says gaily, 'Do you like my scarves? Here... they are my gift to you.' How should the nurse document the patient's mood?
- A. Labile and euphoric
- B. Irritable and belligerent
- C. Highly suspicious and arrogant
- D. Excessively happy and confident
Correct Answer: A
Rationale: The patient has demonstrated angry behavior and pleasant, happy behavior within seconds of each other. Excessive happiness indicates euphoria. Mood swings are often rapid and seemingly without understandable reason in patients who are manic. These swings are documented as labile.
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.