31- Bipolar Disorder - Psychiatric Mental Health (Level Up RN‬)

Source: https://www.youtube.com/watch?v=M70q5UYGEaI&list=PLj9YgcGzjQqxb8eR0DCKHFWt3MEHSz2GY&index=31

Correct Answer: C. Mood swings that include episodes of mania or hypomania and depression

Explanation:
Bipolar disorder involves mood swings, specifically episodes of mania or hypomania alternating with periods of depression. This is the defining feature of the disorder.

Bipolar disorder is best described as a mental health disorder characterized by:

A. Chronic anxiety and compulsive behaviors
B. Alternating episodes of schizophrenia and depression
C. Mood swings that include episodes of mania or hypomania and depression
D. Persistent depressive symptoms without mood elevation

Correct Answer: B. Bipolar I includes episodes of severe mania

Explanation:
Bipolar I disorder is characterized by severe manic episodes, whereas bipolar II disorder involves hypomania, which is a milder form of mania, along with depression.

Which feature distinguishes bipolar I disorder from bipolar II disorder?

A. Bipolar I includes hypomania only
B. Bipolar I includes episodes of severe mania
C. Bipolar II does not include depressive episodes
D. Bipolar I has milder symptoms overall

Correct Answer: C. A milder form of mania

Explanation:
The prefix “hypo” means below, indicating that hypomania is less severe than full mania.

Hypomania differs from mania in that hypomania is:

A. A more severe form of mania
B. Associated only with depression
C. A milder form of mania
D. Always accompanied by psychosis

Correct Answer: C. Racing thoughts and inability to stay still

Explanation:
Mania is characterized by racing thoughts, increased talkativeness, distractibility, and psychomotor agitation, making it difficult for the patient to remain still.

Which behavior would the nurse most likely observe in a patient experiencing a manic episode?

A. Flat affect and slowed speech
B. Excessive sleep and increased appetite
C. Racing thoughts and inability to stay still
D. Social withdrawal and hopelessness

Correct Answer: C. Decreased appetite and increased activity

Explanation:
During mania, patients often have decreased appetite and high activity levels, which can lead to inadequate nutritional intake.

During manic episodes, patients with bipolar disorder are at increased risk for malnutrition primarily due to:

A. Nausea and vomiting
B. Intentional food restriction
C. Decreased appetite and increased activity
D. Difficulty swallowing

Correct Answer: C. Anhedonia

Explanation:
Anhedonia, or lack of pleasure, is a hallmark symptom of depression, along with flat affect, slow speech, and feelings of worthlessness.

Which symptom is most commonly associated with the depressive phase of bipolar disorder?

A. Racing thoughts
B. Excessive spending
C. Anhedonia
D. Increased energy

Correct Answer: C. Impact the patient’s ability to function socially or occupationally

Explanation:
Bipolar disorder is diagnosed when mood episodes significantly impair functioning or disrupt social and occupational roles.

A diagnosis of bipolar disorder is made when mood episodes:

A. Occur at least once per year
B. Are present only during adolescence
C. Impact the patient’s ability to function socially or occupationally
D. Require hospitalization

Correct Answer: B. Substance use and thyroid dysfunction

Explanation:
Conditions such as substance use and thyroid dysfunction can mimic mood disorder symptoms and must be ruled out.

Before diagnosing bipolar disorder, it is important to rule out:

A. Hypertension and diabetes
B. Substance use and thyroid dysfunction
C. Personality disorders only
D. Sleep disorders

Correct Answer: C. Mood stabilizers

Explanation:
Mood stabilizers are a primary treatment for bipolar disorder and help prevent mood swings.

Which medication class is commonly used to treat bipolar disorder?

A. Antidepressants only
B. Benzodiazepines
C. Mood stabilizers
D. Stimulants

Correct Answer: C. Assertive Community Treatment (ACT)

Explanation:
ACT (Assertive Community Treatment) focuses on community-based care using a multidisciplinary team to reduce hospitalizations.

Which therapy approach uses a multidisciplinary team to treat patients with severe, persistent bipolar disorder in the community?

A. Cognitive Behavioral Therapy (CBT)
B. Electroconvulsive Therapy (ECT)
C. Assertive Community Treatment (ACT)
D. Psychoanalysis

Correct Answer: C. Set clear limits and remain calm

Explanation:
During mania, nurses should remain calm, decrease stimuli, and set clear limits to promote safety and structure.

Which nursing intervention is MOST appropriate when caring for a patient in a manic episode?

A. Encourage group activities
B. Increase environmental stimulation
C. Set clear limits and remain calm
D. Allow unrestricted spending

Correct Answer: C. Provide high-calorie, high-protein finger foods

Explanation:
Patients experiencing mania may not sit still to eat; high-calorie, high-protein finger foods allow them to eat “on the go.”

What is the best nursing intervention to support nutrition during manic episodes?

A. Schedule three large meals daily
B. Offer low-fat foods
C. Provide high-calorie, high-protein finger foods
D. Encourage fasting periods

Correct Answer: B. Exhaustion

Explanation:
Mania is associated with decreased need for sleep, which places patients at risk for exhaustion.

A patient experiencing a manic episode sleeps only 2–3 hours per night. This places the patient at greatest risk for:

A. Dehydration
B. Exhaustion
C. Respiratory depression
D. Infection

Correct Answer: C. Engaging in unsafe sexual practices

Explanation:
During mania, patients may engage in impulsive and risky behaviors, including unsafe sexual practices and excessive spending.

Which behavior best demonstrates poor judgment during a manic episode?

A. Refusing to attend therapy
B. Sleeping excessively
C. Engaging in unsafe sexual practices
D. Social withdrawal

Correct Answer: C. Removing dangerous items from the environment

Explanation:
Patients in mania have impaired judgment, making it essential for the nurse to remove potentially dangerous items to maintain safety.

Which nursing action is MOST important to ensure patient safety during a manic episode?

A. Encouraging independence
B. Allowing freedom of movement
C. Removing dangerous items from the environment
D. Encouraging detailed conversations

Correct Answer: C. Have persistent and severe symptoms

Explanation:
ACT is designed for patients with persistent and severe bipolar disorder and uses a multidisciplinary, community-based approach.

Assertive Community Treatment (ACT) is most appropriate for patients with bipolar disorder who:

A. Are newly diagnosed
B. Have mild symptoms
C. Have persistent and severe symptoms
D. Require short-term counseling

Correct Answer: C. Prevent hospitalizations and complications

Explanation:
ACT focuses on treating patients in the community, which helps reduce hospitalizations and complications.

The primary goal of Assertive Community Treatment (ACT) is to:

A. Eliminate the need for medication
B. Provide inpatient psychiatric care
C. Prevent hospitalizations and complications
D. Replace psychotherapy

Correct Answer: B. Minimal movement

Explanation:
Depression is associated with psychomotor retardation, including slow speech and minimal movement.

Which finding would the nurse expect during the depressive phase rather than the manic phase of bipolar disorder?

A. Racing thoughts
B. Minimal movement
C. Decreased need for sleep
D. Excessive spending

Correct Answer: C. Electroconvulsive therapy (ECT)

Explanation:
ECT is an established treatment option for bipolar disorder, particularly in severe or treatment-resistant cases.

Which treatment may be used for bipolar disorder when other therapies are ineffective?

A. Psychoanalysis
B. Occupational therapy
C. Electroconvulsive therapy (ECT)
D. Exposure therapy

Correct Answer: C. Risk for malnutrition and dehydration

Explanation:
Manic patients often have decreased appetite and high activity levels, increasing the risk for malnutrition and dehydration.

Why should the nurse closely monitor intake and output in a patient experiencing mania?

A. Risk for fluid overload
B. Risk for renal failure
C. Risk for malnutrition and dehydration
D. Risk for hypoglycemia

Correct Answer: C. Supervising behaviors related to sex and spending

Explanation:
Nursing care includes protecting patients from consequences of impaired judgment, such as unsafe sexual behavior and excessive spending.

Protecting a patient from poor judgment during a manic episode includes:

A. Encouraging social interaction
B. Allowing unrestricted financial access
C. Supervising behaviors related to sex and spending
D. Ignoring impulsive behaviors