ELITE COMPREHENSIVE
BIPOLAR AND RELATED DISORDERS
Comprehensive Psychiatric–Mental Health
Nursing Review
NCLEX-RN • ATI • HESI • Mental Health
Nursing Final Exam Preparation
SPRING SEMESTER EXAMINATION MAY 2026
A patient diagnosed with bipolar disorder is dressed in a red leotard and bright scarves.
The patient twirls and shadow boxes. The patient says gaily, "Do you like my scarves?
Here; they are my gift to you." How should the nurse document the patient's mood?
a. Euphoric
b. Irritable
c. Suspicious
d. Confident
• ANS: A
• The patient has demonstrated clang associations and pleasant,
happy behavior. Excessive happiness indicates euphoria. Irritability,
belligerence, excessive happiness, and confidence are not the best
terms for the patient's mood. Suspiciousness is not evident.
1|Page
,A person was directing traffic on a busy street, rapidly shouting, "To work, you jerk, for
perks" and making obscene gestures at cars. The person has not slept or eaten for 3
days. Which assessment findings will have priority concern for this patient's plan of
care?
a. Insulting, aggressive behavior
b. Pressured speech and grandiosity
c. Hyperactivity; not eating and sleeping
d. Poor concentration and decision making
• ANS: C
• Hyperactivity, poor nutrition, hydration, and not sleeping take priority
in terms of the needs listed above because they threaten the physical
integrity of the patient. The other behaviors are less threatening to the
patient's life.
A patient diagnosed with acute mania has distributed pamphlets about a new business
venture on a street corner for 2 days. Which nursing diagnosis has priority?
a. Risk for injury
b. Ineffective coping
c. Impaired social interaction
d. Ineffective therapeutic regimen management
• ANS: A
• Although each of the nursing diagnoses listed is appropriate for a
patient having a manic episode, the priority lies with the patient's
physiological safety. Hyperactivity and poor judgment put the patient
at risk for injury.
2|Page
, A patient diagnosed with bipolar disorder becomes hyperactive after discontinuing
lithium. The patient threatens to hit another patient. Which comment by the nurse is
appropriate?
a. "Stop that! No one did anything to provoke an attack by you."
b. "If you do that one more time, you will be secluded immediately."
c. "Do not hit anyone. If you are unable to control yourself, we will help you."
d. "You know we will not let you hit anyone. Why do you continue this behavior?"
• ANS: C
• When the patient is unable to control his or her behavior and violates
or threatens to violate the rights of others, limits must be set in an
effort to deescalate the situation. Limits should be set in simple,
concrete terms. The incorrect responses do not offer appropriate
assistance to the patient, threaten the patient with seclusion as
punishment, and ask a rhetorical question.
This nursing diagnosis applies to a patient with acute mania: Imbalanced nutrition: less
than body requirements related to insufficient caloric intake and hyperactivity as
evidenced by 5-pound weight loss in 4 days. Select an appropriate outcome. The
patient will:
a. ask staff for assistance with feeding with-in 4 days.
b. drink six servings of a high-calorie, high-protein drink each day.
c. consistently sit with others for at least 30 minutes at meal time within 1 week.
d. consistently wear appropriate attire for age and sex within 1 week while on the
psychiatric unit.
• ANS: B
• High-calorie, high-protein food supplements will provide the additional
calories needed to offset the patient's extreme hyperactivity. Sitting
with others or asking for assistance does not mean the patient ate or
drank. The other indicator is unrelated to the nursing diagnosis.
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BIPOLAR AND RELATED DISORDERS
Comprehensive Psychiatric–Mental Health
Nursing Review
NCLEX-RN • ATI • HESI • Mental Health
Nursing Final Exam Preparation
SPRING SEMESTER EXAMINATION MAY 2026
A patient diagnosed with bipolar disorder is dressed in a red leotard and bright scarves.
The patient twirls and shadow boxes. The patient says gaily, "Do you like my scarves?
Here; they are my gift to you." How should the nurse document the patient's mood?
a. Euphoric
b. Irritable
c. Suspicious
d. Confident
• ANS: A
• The patient has demonstrated clang associations and pleasant,
happy behavior. Excessive happiness indicates euphoria. Irritability,
belligerence, excessive happiness, and confidence are not the best
terms for the patient's mood. Suspiciousness is not evident.
1|Page
,A person was directing traffic on a busy street, rapidly shouting, "To work, you jerk, for
perks" and making obscene gestures at cars. The person has not slept or eaten for 3
days. Which assessment findings will have priority concern for this patient's plan of
care?
a. Insulting, aggressive behavior
b. Pressured speech and grandiosity
c. Hyperactivity; not eating and sleeping
d. Poor concentration and decision making
• ANS: C
• Hyperactivity, poor nutrition, hydration, and not sleeping take priority
in terms of the needs listed above because they threaten the physical
integrity of the patient. The other behaviors are less threatening to the
patient's life.
A patient diagnosed with acute mania has distributed pamphlets about a new business
venture on a street corner for 2 days. Which nursing diagnosis has priority?
a. Risk for injury
b. Ineffective coping
c. Impaired social interaction
d. Ineffective therapeutic regimen management
• ANS: A
• Although each of the nursing diagnoses listed is appropriate for a
patient having a manic episode, the priority lies with the patient's
physiological safety. Hyperactivity and poor judgment put the patient
at risk for injury.
2|Page
, A patient diagnosed with bipolar disorder becomes hyperactive after discontinuing
lithium. The patient threatens to hit another patient. Which comment by the nurse is
appropriate?
a. "Stop that! No one did anything to provoke an attack by you."
b. "If you do that one more time, you will be secluded immediately."
c. "Do not hit anyone. If you are unable to control yourself, we will help you."
d. "You know we will not let you hit anyone. Why do you continue this behavior?"
• ANS: C
• When the patient is unable to control his or her behavior and violates
or threatens to violate the rights of others, limits must be set in an
effort to deescalate the situation. Limits should be set in simple,
concrete terms. The incorrect responses do not offer appropriate
assistance to the patient, threaten the patient with seclusion as
punishment, and ask a rhetorical question.
This nursing diagnosis applies to a patient with acute mania: Imbalanced nutrition: less
than body requirements related to insufficient caloric intake and hyperactivity as
evidenced by 5-pound weight loss in 4 days. Select an appropriate outcome. The
patient will:
a. ask staff for assistance with feeding with-in 4 days.
b. drink six servings of a high-calorie, high-protein drink each day.
c. consistently sit with others for at least 30 minutes at meal time within 1 week.
d. consistently wear appropriate attire for age and sex within 1 week while on the
psychiatric unit.
• ANS: B
• High-calorie, high-protein food supplements will provide the additional
calories needed to offset the patient's extreme hyperactivity. Sitting
with others or asking for assistance does not mean the patient ate or
drank. The other indicator is unrelated to the nursing diagnosis.
3|Page
