A 32-year-old patient diagnosed with bipolar disorder presents to the emergency department in a manic state. The patient is exhibiting rapid speech, decreased need for sleep, and grandiosity. Which intervention should the nurse prioritize?
A) Administer a sedative medication
B) Encourage the patient to engage in physical exercise
C) Initiate a cognitive-behavioral therapy session
D) Implement a structured routine for the patient
E) Provide educational materials about bipolar disorder
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Rationale: In a manic state, patient safety is paramount. Administering a sedative helps to calm the patient, reducing agitation and preventing harm or injury. Other interventions may be valuable in managing bipolar disorder in the long term, but during acute mania, the priority is to reduce the intensity of symptoms to ensure the patient’s safety.
NCLEX Practice Questions: Understanding Bipolar Disorder Causes and Symptoms
A client diagnosed with bipolar disorder is prescribed lithium carbonate. Which information should the nurse include when teaching the client about this medication?
A) Take the medication with a high-fat meal
B) Increase sodium intake while on this medication
C) Maintain a consistent fluid intake
D) Discontinue the medication if experiencing mood swings
E) Take the medication as needed for symptom relief
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Rationale: Lithium is a mood stabilizer that requires careful monitoring of blood levels. Adequate fluid intake is crucial to prevent toxicity, as dehydration can increase lithium levels in the blood. Encouraging consistent fluid intake helps maintain therapeutic levels and reduces the risk of adverse effects.
Understanding Bipolar Disorder: Causes and Symptoms
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A 25-year-old patient with bipolar disorder is prescribed valproic acid (Depakote). What should the nurse monitor to assess for potential adverse effects of this medication?
A) Liver function tests
B) Blood glucose levels
C) Cardiac enzymes
D) Serum potassium levels
E) Pulmonary function tests
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Rationale: Valproic acid can cause hepatotoxicity, especially in the initial months of therapy. Regular monitoring of liver function tests is essential to detect any signs of liver damage. While other laboratory values might be monitored for some medications, liver function tests are specifically pertinent for valproic acid due to its potential hepatotoxic effects.
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Understanding Bipolar Disorder: NCLEX Priority Questions
A 28-year-old patient with a history of bipolar disorder is brought to the psychiatric unit by family members. The patient’s mood fluctuates from extreme elation to profound sadness within a short period. Which assessment finding should the nurse prioritize during the initial assessment?
A) Level of anxiety
B) Sleep patterns
C) Appetite changes
D) Suicidal ideation
E) Blood pressure
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Rationale: Assessing for suicidal ideation is paramount in bipolar disorder, given the high risk of self-harm during depressive phases. Prompt identification allows for immediate intervention to ensure the patient’s safety. While other options are essential aspects of the assessment, identifying suicidal ideation takes precedence due to its critical implications.
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A client diagnosed with bipolar disorder is experiencing a manic episode and is prescribed divalproex sodium (Depakote). What should the nurse prioritize when monitoring for adverse effects of this medication?
A) Blood glucose levels
B) Serum potassium levels
C) Thyroid function tests
D) Liver function tests
E) Cardiac enzymes
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Rationale: Divalproex sodium can lead to hepatotoxicity, necessitating regular monitoring of liver function tests. While other laboratory values may be important for different medications, in the context of divalproex sodium, monitoring liver function helps detect potential adverse effects promptly, ensuring patient safety.
A 35-year-old patient with bipolar disorder is prescribed lithium carbonate. Which instruction should the nurse provide regarding dietary habits?
A) Limit fluid intake
B) Increase caffeine consumption
C) Maintain a consistent sodium intake
D) Avoid foods high in potassium
E) Limit dietary fiber intake
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Rationale: Consistent sodium intake is crucial for patients on lithium to maintain stable lithium levels. Fluctuations in sodium intake can affect lithium absorption and excretion, potentially leading to subtherapeutic or toxic levels. Educating the patient on maintaining a stable sodium intake assists in optimizing lithium’s therapeutic effects.
A 30-year-old patient with bipolar disorder is prescribed olanzapine (Zyprexa) for mood stabilization. What potential adverse effect should the nurse monitor for and educate the patient about?
A) Extrapyramidal symptoms
B) Hypoglycemia
C) Bradycardia
E) Weight gain
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Rationale: Olanzapine is associated with weight gain and metabolic changes. Monitoring weight regularly and providing education about lifestyle modifications can help mitigate this adverse effect, reducing the risk of long-term complications like diabetes or cardiovascular disease. While other options might be relevant adverse effects for certain medications, weight gain is particularly associated with olanzapine in bipolar disorder treatment.
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NCLEX Questions: Focus on Medications for Bipolar Disorder
A 25-year-old patient diagnosed with bipolar disorder is admitted to the psychiatric unit during a manic episode. The patient displays increased energy, decreased need for sleep, and impulsivity. What is the priority nursing intervention?
A) Encourage participation in group therapy sessions
B) Administer an antipsychotic medication
C) Encourage the patient to engage in creative activities
D) Establish a quiet and structured environment
E) Initiate a conversation about future goals
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Rationale: During a manic episode, providing a calm and structured environment helps reduce stimuli that can exacerbate symptoms. Creating a quiet space assists in managing the patient’s heightened energy and impulsivity, promoting safety and reducing potential harm. While other interventions may be beneficial in long-term management, the immediate priority is to establish a calming environment.
NCLEX Questions Critical Thinking: Bipolar Disorder Symptoms
A 30-year-old patient with bipolar disorder is exhibiting pressured speech, flight of ideas, and excessive spending during a manic phase. Which nursing intervention should the nurse implement initially?
A) Administer an anxiolytic medication
B) Set limits on spending and financial transactions
C) Encourage journaling to organize thoughts
D) Initiate a mindfulness meditation session
E) Offer a variety of physical activities to engage in
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Rationale: Setting limits on spending helps prevent adverse financial consequences during a manic episode. Patients experiencing impulsivity might engage in reckless spending, leading to financial strain. Implementing limits promotes responsible behavior and prevents potential negative outcomes associated with impulsivity during mania.
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NCLEX Review: Bipoloar Disorder Treatments
A 22-year-old patient diagnosed with bipolar disorder experiences increased agitation, irritability, and talkativeness during a manic episode. What communication technique should the nurse employ when interacting with this patient?
A) Use open-ended questions to explore thoughts and feelings
B) Encourage the patient to engage in rapid speech to express thoughts
C) Redirect the patient’s focus to unrelated topics
D) Employ a calm and firm approach
E) Match the patient’s increased pace of speech
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Rationale: During mania, patients can be easily agitated and might struggle to focus. A calm and firm approach provides structure and stability in communication, helping to manage the patient’s heightened agitation and erratic behavior. While open-ended questions might be useful in certain contexts, a calm and firm demeanor is more effective in managing the intensity of a manic episode.
