ATI LPN
Test Bank for Psychiatric Nursing: Contemporary Practice
Chapter 24 : Bipolar Disorders: Management of Mood Lability Questions
Question 1 of 5
A client who is receiving lithium comes to the clinic for an evaluation. During the visit, the client reports a fine hand tremor. Which action by the nurse would be most appropriate?
Correct Answer: B
Rationale: A fine hand tremor is a common, benign side effect of lithium. Taking the medication with meals or snacks (
B) can reduce gastrointestinal irritation and tremor severity. Immediate blood testing (
A) is unnecessary unless toxicity is suspected, stress reduction (
C) is less relevant, and elevation (
D) is ineffective.
Question 2 of 5
A client?s blood level of carbamazepine is increased. When reviewing the client?s medication history, which of the following would alert the nurse to a possible interaction?
Correct Answer: D
Rationale: Diltiazem (
D), a calcium channel blocker, inhibits the metabolism of carbamazepine, increasing its blood levels and risking toxicity. Phenobarbital (
A), primidone (
B), and phenytoin (
C) are enzyme inducers that typically decrease carbamazepine levels.
Question 3 of 5
A client is brought to the emergency department by his brother. The client has a history of bipolar disorder for which he is taking divalproex. The brother reports that he watched his brother take the medication about 2 hours ago. He stated, A little while ago, he got very disoriented and agitated. The nurse suspects toxicity based on assessment of which of the following? Select all that apply.
Correct Answer: D,E
Rationale: Divalproex toxicity may present with nystagmus (
D) and vomiting (E), alongside disorientation and agitation, due to neurological and gastrointestinal effects. Tachypnea (
A), bradycardia (
B), and hypotension (
C) are less specific to valproate toxicity.
Question 4 of 5
A client with bipolar disorder has a lithium drug level of 1.2 mEq/L. Which of the following would the nurse expect to assess? Select all that apply.
Correct Answer: A,C,F
Rationale: A lithium level of 1.2 mEq/L is within the therapeutic range (0.6?1.2 mEq/L) but at the upper limit, where mild side effects like metallic taste (
A), diarrhea (
C), and muscle weakness (F) may occur. Ataxia (
B), slurred speech (
D), and fasciculations (E) are more typical of toxicity (>1.5 mEq/L).
Question 5 of 5
The nurse is preparing a teaching plan for the family of a client who has been diagnosed with bipolar disorder. After teaching them about potential indicators for relapse, the nurse determines that the teaching was effective when they identify which of the following as suggesting mania? Select all that apply.
Correct Answer: C,E
Rationale: Mania is characterized by rapid speech (
C) and multitasking behaviors like reading multiple books simultaneously (E), reflecting increased energy and distractibility. Avoiding people (
A) and sleeping more (
B) suggest depression, and constant hunger (
D) is not specific to mania.