ATI LPN
Test Bank for Psychiatric Nursing: Contemporary Practice
Chapter 24 : Bipolar Disorders: Management of Mood Lability Questions
Question 1 of 5
A client with bipolar disorder is receiving divalproex sodium as part of the treatment plan. When monitoring the client?s blood level for this drug, which level would alert the nurse to the need to change the dosage?
Correct Answer: D
Rationale: The therapeutic range for divalproex sodium (valproic acid) is 50?100 µg/mL (often reported as ng/mL in some contexts). A level of 115 ng/mL (
D) is above this range, indicating potential toxicity and the need for dosage reduction. Levels of 30, 55, and 75 ng/mL (A, B,
C) are below or within the therapeutic range.
Question 2 of 5
A client with bipolar disorder having experienced a depressive episode is prescribed lamotrigine. After teaching the client about this medication, the nurse determines that the teaching was successful when the client states which of the following?
Correct Answer: A
Rationale: Lamotrigine (
A) carries a risk of serious skin rashes, such as Stevens-Johnson syndrome, requiring immediate reporting. Blood testing (
B) is not routine for lamotrigine, salt intake (
C) is irrelevant, and liver function (
D) is less commonly affected compared to other mood stabilizers.
Question 3 of 5
A nurse is preparing to administer medications to a female client with bipolar disorder who is experiencing acute mania. Which of the following would be most appropriate for the nurse to do?
Correct Answer: B
Rationale: Allowing the client to participate in treatment decisions (
B) fosters autonomy and therapeutic alliance, appropriate unless the client is too impaired to decide. Firm insistence (
A) may escalate agitation, restraint (
C) is a last resort, and notifying the physician (
D) assumes refusal prematurely.
Question 4 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 5 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.