ATI RN
Mental Health Nursing Practice Questions Questions
Question 1 of 5
Which response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar disorder and her support system? Select the incorrect one.
Correct Answer: B
Rationale: In managing bipolar disorder, it is vital to educate the patient and their support system about triggers like alcohol and caffeine, the significance of good sleep, and the need for family involvement. However, the statement in choice B is incorrect. While antidepressants need to be carefully monitored in bipolar disorder, they can be used in conjunction with mood stabilizers to manage depression in some cases.
Question 2 of 5
The healthcare provider is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the healthcare provider stress to the patient? Select one that does not apply.
Correct Answer: C
Rationale: Lithium is a mood stabilizer commonly used for bipolar disorder, but it has a narrow therapeutic index, making early recognition of toxicity crucial. The correct answer is C (Improved vision) because this is never listed as a sign of lithium toxicity in clinical guidelines or pharmacological literature. Vision changes associated with lithium are typically **blurred vision** (a sign of severe toxicity) rather than improved vision, which has no pathophysiological basis in lithium's mechanism of action or side effect profile. **Why the other options are incorrect:** **A: Increased attentiveness** – While this may seem unrelated, it can actually be an early sign of mild lithium toxicity. Lithium affects the central nervous system (CNS), and subtle cognitive changes, including unusual alertness or cognitive hyperactivity, can precede more severe neurological symptoms like tremors or confusion. Early toxicity may manifest as paradoxical effects before progressing to impairment. **B: Getting up at night to urinate** – Polyuria (excessive urination) is a classic **early** side effect of lithium due to its interference with renal concentrating ability, often leading to nephrogenic diabetes insipidus. Patients frequently report nocturia (nighttime urination) before other symptoms arise. This is a well-documented and clinically significant warning sign. **D: An upset stomach for no apparent reason** – Gastrointestinal disturbances (nausea, vomiting, diarrhea) are among the **earliest** and most common signs of lithium toxicity. These symptoms result from lithium's irritation of the gastric mucosa and its impact on the CNS at higher serum levels. Patients are routinely advised to monitor for unexplained GI distress as a potential red flag. **Why C is correct:** Improved vision is not associated with lithium toxicity or its therapeutic effects. While blurred vision or difficulty focusing can occur in severe toxicity, **enhanced** visual acuity has no physiological correlation with lithium’s pharmacological actions (e.g., altered sodium transport in neurons and kidneys). This distractor is included to test the student’s ability to differentiate between plausible side effects and unrelated, implausible symptoms. The question reinforces the importance of recognizing **early** versus **late** and **severe** toxicity signs. Nocturia, GI upset, and subtle CNS changes precede life-threatening symptoms (ataxia, seizures, coma), whereas improved vision is irrelevant to lithium’s adverse effects. Students must prioritize memorizing clinically validated symptoms and disregarding distractors without a pathophysiological basis.
Question 3 of 5
A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?
Correct Answer: B
Rationale: A lithium level of 1.7 mEq/L is above the therapeutic range, indicating a potential risk of toxicity. The initial nursing intervention should be to instruct the patient to hold the next dose of medication and promptly contact the prescriber for further guidance and management. This action aims to prevent adverse effects and ensure the patient's safety by addressing the elevated lithium level appropriately.
Question 4 of 5
Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select one that doesn't apply.
Correct Answer: B
Rationale: When caring for a patient demonstrating manic behavior, it is crucial to monitor vital signs frequently to ensure the patient's physical health is stable. Providing nutrition, such as milkshakes and protein drinks, is essential to meet the patient's dietary needs. Diminishing environmental stimuli by reducing the volume on the television and dimming bright lights can help create a calmer environment. However, keeping the patient distracted with group-oriented activities may not be the most appropriate intervention as it could potentially exacerbate the manic behavior by overstimulating the patient. Therefore, this choice is the one that doesn't apply in managing manic behavior effectively.
Question 5 of 5
Substance abuse is often present in individuals diagnosed with bipolar disorder. Laura, a 28-year-old with a bipolar disorder diagnosis, chooses to drink alcohol instead of taking her prescribed medications. The nurse caring for this patient recognizes that:
Correct Answer: B
Rationale: Individuals with bipolar disorder may turn to alcohol as a form of self-medication to cope with their symptoms. This behavior is often seen as an attempt to manage mood swings and alleviate distress. It is important for healthcare providers to address and manage substance abuse issues in patients with bipolar disorder to ensure proper treatment and overall well-being.