Bipolar 1
A nurse is assessing a patient with Bipolar Type 1 who has a history of suicide attempts. What factors increase the risk of suicidality in this patient? (Select all that apply.)
A) Early onset of disease
B) History of suicide among first-degree relatives
C) History of substance abuse
D) Previous suicide attempt
E) High socioeconomic status
Correct Answers: A) Early onset of disease, B) History of suicide among first-degree relatives, D) Previous suicide attempt
A nurse is caring for a patient with Bipolar Type 2 disorder. Which symptom is associated with hypomania?
A) Psychotic symptoms
B) Low energy and activity levels
C) Excessive activity and energy
D) Severe mood swings requiring hospitalization
Correct Answer: C) Excessive activity and energy
Which statement is true regarding the educational and occupational achievements of individuals with bipolar disorders compared to those with unipolar depression?
A) Lower levels of education and occupational status
B) Higher levels of education and higher occupational status
C) Similar levels of education but lower occupational status
D) Higher levels of education but similar occupational status
Correct Answer: B) Higher levels of education and higher occupational status
Which scale is used to self-rate mania in patients with bipolar disorder?
A) Beck Depression Inventory
B) Altman’s Self-Rating Mania Scale
C) Hamilton Anxiety Rating Scale
D) Mini-Mental State Examination
Correct Answer: B) Altman’s Self-Rating Mania Scale
Which medication is used to reduce manic behavior and stabilize bipolar disorder?
A) Sertraline
B) Lithium
C) Haloperidol
D) Lorazepam
Correct Answer: B) Lithium
A nurse is caring for a patient with Bipolar Type 1 disorder who is experiencing intense euphoria and constant motion. What initial intervention should the nurse prioritize?
A) Encouraging the patient to take frequent naps
B) Providing a quiet environment with minimal stimulation
C) Allowing the patient to participate in all desired activities
D) Giving the patient caffeine to maintain energy levels
Correct Answer: B) Providing a quiet environment with minimal stimulation
Which of the following must be present to diagnose Bipolar Type 2 disorder?
A) At least one manic episode
B) At least one hypomanic episode and one major depressive episode
C) Multiple manic episodes
D) Continuous hypomanic episodes with no depressive episodes
Correct Answer: B) At least one hypomanic episode and one major depressive episode
A patient with cyclothymic disorder is assessed for comorbid conditions. Which disorder is important to assess for due to its common occurrence with cyclothymia?
A) Attention-deficit/hyperactivity disorder (ADHD)
B) Alzheimer’s disease
C) Parkinson’s disease
D) Bipolar I disorder
Correct Answer: A) Attention-deficit/hyperactivity disorder (ADHD)
Which type of speech involves adding unnecessary details but eventually reaching the point?
A) Pressured speech
B) Circumstantial speech
C) Tangential speech
D) Loose associations
Correct Answer: B) Circumstantial speech
Which of the following is an important dietary consideration for a patient taking lithium?
A) Increase sodium intake
B) Decrease calcium intake
C) Maintain consistent sodium intake
D) Increase potassium intake
Correct Answer: C) Maintain consistent sodium intake
A patient with Bipolar Type 1 experiences delusions during a manic episode. Which type of delusion is most commonly observed?
A) Persecutory delusions
B) Delusions of grandeur
C) Delusions of guilt
D) Somatic delusions
Correct Answer: B) Delusions of grandeur
Which symptom is never present during a hypomanic episode in Bipolar Type 2 disorder?
A) Increased energy
B) Psychosis
C) Elevated mood
D) Increased activity
Correct Answer: B) Psychosis
Which criteria must be met for a diagnosis of cyclothymic disorder in adults?
A) Symptoms of hypomania and moderate depression for at least 1 year
B) Symptoms of hypomania and mild to moderate depression for at least 2 years
C) Continuous severe depressive episodes for more than 2 years
D) Manic episodes alternating with periods of stable mood for 2 years
Correct Answer: B) Symptoms of hypomania and mild to moderate depression for at least 2 years
A patient in a manic state is giving away money and prized possessions. What should the nurse prioritize?
A) Encourage more spending
B) Provide financial advice
C) Intervene to prevent financial ruin
D) Allow the patient to continue
Correct Answer: C) Intervene to prevent financial ruin
Which laboratory test is most important to monitor regularly for a patient on long-term lithium therapy?
A) Complete blood count (CBC)
B) Liver function tests (LFTs)
C) Serum lithium levels
D) Hemoglobin A1C
Correct Answer: C) Serum lithium levels
A patient with Bipolar Type 1 disorder is admitted in a manic state. Which symptom would the nurse expect to observe?
A) Increased sleep and lethargy
B) Persistent elevation in mood, irritability, and extreme goal-directed activity
C) Social withdrawal and lack of interest in activities
D) Consistent adherence to treatment regimen
Correct Answer: B) Persistent elevation in mood, irritability, and extreme goal-directed activity
Why is Bipolar Type 2 disorder often underdiagnosed?
A) Symptoms are mild and not noticeable
B) It is commonly mistaken for personality disorders
C) Patients do not seek medical help
D) It is a rare disorder with limited information
Correct Answer: B) It is commonly mistaken for personality disorders
A nurse is assessing a patient with cyclothymic disorder. What type of comorbid substance use disorder is the patient most at risk for?
A) Cannabis use disorder
B) Alcohol use disorder
C) Opioid use disorder
D) Hallucinogen use disorder
Correct Answer: B) Alcohol use disorder
What type of speech is characterized by a continuous flow of accelerated speech with abrupt changes from topic to topic?
A) Circumstantial speech
B) Tangential speech
C) Pressured speech
D) Flight of ideas
Correct Answer: D) Flight of ideas
When a patient with mania exhibits loose associations and tangential speech, what should the nurse do?
A) Encourage competitive activities
B) Provide a structured environment and reorient to reality
C) Leave the patient alone
D) Allow the patient to make all decisions
Correct Answer: B) Provide a structured environment and reorient to reality
A patient experiencing a manic episode refuses treatment and does not recognize their behavior as problematic. This lack of insight is known as:
A) Anhedonia
B) Anosognosia
C) Agnosia
D) Dysphoria
Correct Answer: B) Anosognosia
Which statement about hypomania in Bipolar Type 2 disorder is accurate?
A) It often requires hospitalization
B) It is accompanied by psychosis
C) It involves low-level and less dramatic mania
D) It is a severe form of mania
Correct Answer: C) It involves low-level and less dramatic mania
A patient with cyclothymic disorder is likely to experience impairments in which areas?
A) Social and occupational functioning
B) Physical and sensory capabilities
C) Financial management only
D) Long-term memory retention
Correct Answer: A) Social and occupational functioning
A nurse observes a patient with bipolar disorder exhibiting pressured speech. How should the nurse describe this speech pattern?
A) Slow and deliberate
B) Fast, ranging from rapid to frenetic
C) Coherent and well-organized
D) Consistent with long pauses
Correct Answer: B) Fast, ranging from rapid to frenetic
Which statement indicates that a patient understands the discharge instructions for lithium therapy?
A) "I will avoid drinking caffeine."
B) "I will adjust my dose based on how I feel."
C) "I will drink plenty of water each day."
D) "I can stop taking lithium if I feel better."
Correct Answer: C) "I will drink plenty of water each day."