Chapter 24: Bipolar Disorders: Management of Mood Lability - Nurselytic

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Chapter 24 : Bipolar Disorders: Management of Mood Lability Questions

Question 1 of 5

A nurse is developing a presentation for families who have members that have been diagnosed with bipolar disorders. When describing this condition to the group, which of the following would the nurse most likely include?

Correct Answer: C

Rationale: Bipolar disorder carries a high suicide risk during both depressive and manic episodes (
C), due to despair in depression and impulsivity in mania. Episodes often persist or worsen with age (
A), stressors (
B) are triggers but not primary causes, and risk-taking is more common in mania, not depression (
D).

Question 2 of 5

A client is to receive lithium therapy as part of the treatment plan for bipolar disorder. When reviewing the client?s medication history, which agents would alert the nurse to the possibility that a decrease in lithium dosage may be needed? Select all that apply.

Correct Answer: B,C

Rationale: Hydrochlorothiazide (
B) and indomethacin (
C) reduce lithium excretion, increasing lithium levels and requiring potential dose reduction to avoid toxicity. Lisinopril (
A), caffeine (
D), and aspirin (E) have minimal impact on lithium pharmacokinetics.

Question 3 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 4 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 5 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.

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