Mania & Bipolar Disorders
A hallmark symptom of acute mania is an elevated, expansive, or ______ mood.
Irritable
Which eating disorder is associated with a BMI < 17 and fear of weight gain?
Anorexia nervosa
Alcohol withdrawal typically begins within how many hours of last drink?
6–8 hours
In California, mandated reporters must report suspected abuse based on “reasonable ______.”
Suspicion
The first step of trauma-informed care is creating a sense of ______ for the patient.
Safety
What safety-related behavior often increases during manic episodes due to impulsivity?
Risk-taking (e.g., spending, sexual activity, substance use)
What dangerous metabolic condition can occur during refeeding?
Refeeding syndrome (hypophosphatemia)
Which medication is first-line for alcohol withdrawal?
Benzodiazepines (lorazepam, diazepam)
Which two populations are nurses legally required to report abuse for?
Children and elders/dependent adults
What is one grounding technique nurses can teach during distress?
5-4-3-2-1, paced breathing, touchstone object, sensory grounding
Name one essential component of therapeutic communication during manic episodes.
Short, simple statements / clear limits / firm boundaries
Name one physical finding commonly seen in bulimia nervosa.
Russell’s sign, dental erosion, parotid swelling, electrolyte imbalance
Name one symptom of opioid withdrawal.
Yawning, lacrimation, sweating, diarrhea, muscle aches
How soon must a phone report be made after suspecting abuse?
Immediately / as soon as practicable
What type of language reduces shame and supports recovery?
Nonjudgmental, strengths-based language
What is the priority nursing intervention when a manic patient has not slept for days?
Promote rest and decrease stimulation
What is the priority nursing action when a patient with anorexia refuses to eat during meals?
Supervised meals and structured expectations (non-punitive)
Which medication reduces alcohol cravings and prevents relapse?
Naltrexone
What must a nurse NOT do when a patient discloses abuse?
Investigate or interrogate the situation
Why should nurses avoid saying “calm down” to a distressed patient?
It can feel invalidating and escalate distress
Lithium requires monitoring of what lab value due to toxicity risk?
Serum lithium level (therapeutic 0.6–1.2 mEq/L)
What type of therapy is evidence-based for adolescents with anorexia?
Family-based therapy (FBT / Maudsley approach)
CIWA is used for alcohol withdrawal. What is COWS used for?
Opioid withdrawal assessment
True or False: A mandated reporter can be prosecuted for breaking confidentiality when making a report.
False — mandated reporters are legally protected.
Name the trauma-informed principle that emphasizes giving patients voice and choice.
Empowerment & collaboration