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Which documentation indicates that the treatment plan for a patient experiencing acute mania has been effective?
- A. Converses without interrupting; clothing matches; participates in activities.'
- B. Irritable, suggestible, distractible; napped for 10 minutes in afternoon.'
- C. Attention span short; writing copious notes; intrudes in conversations.'
- D. Heavy makeup; seductive toward staff; pressured speech.'
Correct Answer: A
Rationale: Appropriate behavior and participation without overstimulation indicate effective treatment. Other options reflect ongoing manic symptoms.
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What is the focus of outcome identification for the treatment plan of a patient presenting with grandiose thinking associated with acute mania?
- A. Maintaining an interest in the environment
- B. Developing an optimistic outlook
- C. Self-control of distorted thinking
- D. Stabilizing the sleep pattern
Correct Answer: C
Rationale: Controlling grandiose thinking is the primary outcome, as it addresses the core symptom of mania. Other options are less directly related.
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 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.
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.