NSG-322 Exam III Comprehensive - (Latest 2026/2027 Update) Bipolar,
Schizophrenia, Psychopharmacology, & EPS Management | Q&A | Grade A |
100% Correct (Verified Answers)
Subject: Psychiatric-Mental Health Nursing / Bipolar & Schizophrenia Spectrum Disorders
Source: NSG-322 Exam III – Comprehensive Review
Format: Q&A Guide with Clinical Rationale
1: What is Bipolar I Disorder?
Correct Answer: At least 1 manic episode. Most severe form. Highest mortality rate. Cycle between
manic and severe depression. Extreme shifts in activity levels, energy, ability to function in roles and
even ability to complete ADLs. High risk and frequently require hospitalization.
1. Manic episode lasts ≥7 days or requires hospitalization.
2. Major depressive episodes are common but not required for diagnosis.
3. Often presents with psychotic features during mania.
2: What is Bipolar II Disorder?
Correct Answer: At least 1 hypomanic episode (3-4 days) AND at least 1 major depressive episode.
Less acute and can be treated outpatient. Characterized by cycles of hypomania or less severe mania
lasting at least 4 days and major depression. May seem more distractable or talkative than usual, but no
serious impairment in social or occupational functioning.
1. No full manic episodes ever.
2. Depressive episodes are often more frequent and severe than hypomania.
3. Often misdiagnosed as major depressive disorder.
3: What does DIGFAST stand for in mania assessment?
Correct Answer: Distractibility, Impulsivity, Grandiosity, Flight of ideas, Activity increase, Sleep
deficit, Talkativeness.
1. Mnemonic for manic symptoms in bipolar disorder.
2. Three or more symptoms during manic episode.
3. Helps differentiate from hypomania (milder, shorter duration).
4: What are the 5 Skills for Better Control in bipolar disorder?
Correct Answer: 48 Hour Rule: 2 full days/nights of sleep; 2 Person Feedback: Trusted, long-term;
Step Away: Disarm; Self Check-In: Reality challenge/hyper positivity risk; Limits: Temptations.
1. Sleep regulation is critical for mood stability.
2. Trusted feedback provides reality check during mania.
3. Setting limits on high-risk behaviors prevents harm.
, 5: What is Cyclothymic Disorder?
Correct Answer: Hypomania alternates with symptoms of mild to moderate depression for at least 2
years (adults). Rapid cycling possible. Mood changes are less severe and do not meet the criteria for full
depressive, manic, or even hypomanic episodes. 15%-50% progress into bipolar I/II.
1. Chronic, fluctuating mood disturbance.
2. No symptom-free period >2 months.
3. Often underdiagnosed and undertreated.
6: What is Rapid Cycling in bipolar disorder?
Correct Answer: Bipolar I or II with at least 4 mood episodes in 12 months. May be in one week or 24
hours. These episodes are distinct and separated by periods of partial or full recovery, or by a sudden
switch to an episode of opposite mood. Associated with severe symptoms, high recurrence rate, resistant
to conventional somatic treatments.
1. More common in women and bipolar II.
2. May indicate thyroid dysfunction or medication effects.
3. Often requires combination therapy.
7: What is mania?
Correct Answer: Intense mood disturbances: persistent elevation and expansiveness, irritability and
extreme goal-oriented activity or energy. Last at least one week, most of the day, every day. Psychiatric
emergency. Eat and sleep little. High risk behaviors. Psychosis. Will not realize the state they are in.
1. Impaired judgment leads to risky decisions (financial, sexual, safety).
2. Hospitalization often required for safety.
3. Lack of insight is hallmark feature.
8: What is hypomania?
Correct Answer: Features similar symptoms to mania including elevated or irritable mood and
increased activity or energy. The symptoms are less severe, last at least four consecutive days, and do
not cause significant impairment or require hospitalization. May realize the state they are in.
1. May feel productive and creative.
2. Can be pleasant or irritable.
3. Often not recognized as pathological.
9: What is the therapeutic level for lithium?
Correct Answer: 0.8-1.2 mEq/L for acute mania; maintenance 0.6-0.8 mEq/L.
1. Narrow therapeutic index requires frequent monitoring.
2. Draw trough level 12 hours after last dose.
3. Monitor renal and thyroid function at baseline and regularly.
Schizophrenia, Psychopharmacology, & EPS Management | Q&A | Grade A |
100% Correct (Verified Answers)
Subject: Psychiatric-Mental Health Nursing / Bipolar & Schizophrenia Spectrum Disorders
Source: NSG-322 Exam III – Comprehensive Review
Format: Q&A Guide with Clinical Rationale
1: What is Bipolar I Disorder?
Correct Answer: At least 1 manic episode. Most severe form. Highest mortality rate. Cycle between
manic and severe depression. Extreme shifts in activity levels, energy, ability to function in roles and
even ability to complete ADLs. High risk and frequently require hospitalization.
1. Manic episode lasts ≥7 days or requires hospitalization.
2. Major depressive episodes are common but not required for diagnosis.
3. Often presents with psychotic features during mania.
2: What is Bipolar II Disorder?
Correct Answer: At least 1 hypomanic episode (3-4 days) AND at least 1 major depressive episode.
Less acute and can be treated outpatient. Characterized by cycles of hypomania or less severe mania
lasting at least 4 days and major depression. May seem more distractable or talkative than usual, but no
serious impairment in social or occupational functioning.
1. No full manic episodes ever.
2. Depressive episodes are often more frequent and severe than hypomania.
3. Often misdiagnosed as major depressive disorder.
3: What does DIGFAST stand for in mania assessment?
Correct Answer: Distractibility, Impulsivity, Grandiosity, Flight of ideas, Activity increase, Sleep
deficit, Talkativeness.
1. Mnemonic for manic symptoms in bipolar disorder.
2. Three or more symptoms during manic episode.
3. Helps differentiate from hypomania (milder, shorter duration).
4: What are the 5 Skills for Better Control in bipolar disorder?
Correct Answer: 48 Hour Rule: 2 full days/nights of sleep; 2 Person Feedback: Trusted, long-term;
Step Away: Disarm; Self Check-In: Reality challenge/hyper positivity risk; Limits: Temptations.
1. Sleep regulation is critical for mood stability.
2. Trusted feedback provides reality check during mania.
3. Setting limits on high-risk behaviors prevents harm.
, 5: What is Cyclothymic Disorder?
Correct Answer: Hypomania alternates with symptoms of mild to moderate depression for at least 2
years (adults). Rapid cycling possible. Mood changes are less severe and do not meet the criteria for full
depressive, manic, or even hypomanic episodes. 15%-50% progress into bipolar I/II.
1. Chronic, fluctuating mood disturbance.
2. No symptom-free period >2 months.
3. Often underdiagnosed and undertreated.
6: What is Rapid Cycling in bipolar disorder?
Correct Answer: Bipolar I or II with at least 4 mood episodes in 12 months. May be in one week or 24
hours. These episodes are distinct and separated by periods of partial or full recovery, or by a sudden
switch to an episode of opposite mood. Associated with severe symptoms, high recurrence rate, resistant
to conventional somatic treatments.
1. More common in women and bipolar II.
2. May indicate thyroid dysfunction or medication effects.
3. Often requires combination therapy.
7: What is mania?
Correct Answer: Intense mood disturbances: persistent elevation and expansiveness, irritability and
extreme goal-oriented activity or energy. Last at least one week, most of the day, every day. Psychiatric
emergency. Eat and sleep little. High risk behaviors. Psychosis. Will not realize the state they are in.
1. Impaired judgment leads to risky decisions (financial, sexual, safety).
2. Hospitalization often required for safety.
3. Lack of insight is hallmark feature.
8: What is hypomania?
Correct Answer: Features similar symptoms to mania including elevated or irritable mood and
increased activity or energy. The symptoms are less severe, last at least four consecutive days, and do
not cause significant impairment or require hospitalization. May realize the state they are in.
1. May feel productive and creative.
2. Can be pleasant or irritable.
3. Often not recognized as pathological.
9: What is the therapeutic level for lithium?
Correct Answer: 0.8-1.2 mEq/L for acute mania; maintenance 0.6-0.8 mEq/L.
1. Narrow therapeutic index requires frequent monitoring.
2. Draw trough level 12 hours after last dose.
3. Monitor renal and thyroid function at baseline and regularly.
