Which nursing diagnosis would most likely apply to both a patient diagnosed with major depressive disorder (MDD) as well as one experiencing acute mania?
- A. Deficient diversional activity
- B. Disturbed sleep pattern
- C. Fluid volume excess
- D. Defensive coping
Correct Answer: B
Rationale: Both MDD and mania involve sleep disturbances, making this diagnosis relevant. Other options are less applicable across both conditions.
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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.
This is the primary reason that the cause of bipolar disorder has not been determined?
- A. Several factors, including genetics, are implicated.
- B. Brain structures were altered by trauma early in life.
- C. Excess norepinephrine is probably a major factor.
- D. Excess sensitivity in dopamine receptors may exist.
Correct Answer: A
Rationale: The interplay of multiple factors, including genetics and neurotransmitter imbalances, is the most likely explanation for bipolar disorder. Other options are too specific or narrow.
A patient diagnosed with bipolar disorder has been hospitalized for 7 days and has taken lithium 600 mg three times daily. Staff members observe increased agitation, pressured speech, poor personal hygiene, hyperactivity, and bizarre clothing. What is the nurse's best intervention?
- A. Educate the patient about the proper ways to perform personal hygiene and coordinate clothing.
- B. Continue to monitor and document the patient's speech patterns and motor activity.
- C. Ask the health care provider to prescribe an increased dose and frequency of lithium.
- D. Consider the need to check the lithium level. The patient may not be swallowing medications.
Correct Answer: D
Rationale: Persistent manic symptoms suggest possible nonadherence, warranting a lithium level check. Increasing the dose or other options are less appropriate.
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.
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.
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