NR 443 Chapter 12: Mood Disorders: Depression,
Bipolar, and Adjustment Disorders
Fortinash: Psychiatric Mental Health Nursing, 5th Edition
Chapter 12: Mood Disorders: Depression, Bipolar, and Adjustment Disorders
Test Bank
MULTIPLE CHOICE
1. The nurse learns at report that a newly admitted manic patient is demonstrating grandiosity.
Which statement would be most consistent with this symptom?
a. “I can’t do anything anymore.”
b. “I’m the world’s most astute financier.”
c. “I can understand why my wife is upset that I overspend.”
d. “I can’t understand where all the money in our family goes.”
ANS: B
An individual who is demonstrating grandiosity has an exaggerated view of his abilities. The
other options are more moderate statements and lack that element of exaggeration.
DIF: Cognitive Level: Application REF: Page 233 | Page 235
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
2. The nurse will base a discussion of dysthymia on the fact that the condition:
a. Typically has an acute onset
b. Involves delusional thinking
c. Is chronic low-level depression
d. Does not include suicidal ideation
ANS: C
,Dysthymia is identified as a chronic low-level depression frequently lasting over a period of
several years without remitting. Dysthymia has a slow, insidious onset. Delusional thinking is
not a common manifestation of dysthymia. Suicidal thoughts are seen among dysthymic patients.
DIF: Cognitive Level: Comprehension REF: Pages 232-233
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
3. What is the priority nursing diagnosis for a patient exhibiting signs of acute mania that include
exaggerated physical activity, agitation, insomnia, and anorexia?
a. Risk for injury
b. Chronic low self-esteem
c. Noncompliance
d. Insomnia
ANS: A
Risk for injury is the priority diagnosis. Possible injuries include dehydration, which may result
from not drinking and trauma, which may result from bumping into objects or from physical
altercations. The other options are valid diagnoses, but not of highest priority.
DIF: Cognitive Level: Analysis REF: Page 242 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Psychosocial Integrity
4. A patient has been admitted with a diagnosis of atypical depression. In planning interventions,
the nurse would expect to consider the characteristic symptom of:
a. Seasonal episodes
b. Leaden paralysis
c. Psychomotor agitation
d. Increased depression in the morning
ANS: B
Behavioral characteristics of atypical depression include the feeling that one’s limbs are so heavy
they cannot be lifted or moved (leaden paralysis). Seasonal mood changes are characteristic of
seasonal affective disorder. Psychomotor agitation and depression that is greater in the morning
than in the evening are characteristics more likely to be observed in patients with melancholic
depression.
, DIF: Cognitive Level: Application REF: Page 237 TOP: Nursing Process: Planning
MSC: NCLEX: Psychosocial Integrity
5. An inappropriately dressed patient has not slept for 3 days while making excessive, expensive
long-distance phone calls. When the patient can be heard singing loudly in the examining room,
the nurse makes initial plans to focus on:
a. Assessing needs for food, liquids, and rest
b. Setting strict limits on dress and behavior
c. Conducting an in-depth suicide assessment
d. Obtaining a complete psychosocial assessment
ANS: A
Patients with mania frequently ignore their basic physiologic needs, as evidenced by not sleeping
for 3 days, thus making these assessments the priority. Limits, although appropriate to consider,
are not the priority. The manic state precludes a thorough assessment initially. Suicide
assessment is not a priority at this time but reckless behavior could result in personal injury.
DIF: Cognitive Level: Application REF: Page 245 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
6. Which statement by the patient would indicate the need for additional education regarding the
prescribed lithium treatment regimen?
a. “I will restrict my daily salt intake.”
b. “I will take my medications with food.”
c. “I will have my blood drawn on schedule.”
d. “I will drink 8 to 12 glasses of liquids daily.”
ANS: A
Patients taking lithium must maintain a normal sodium intake or risk symptoms of lithium
toxicity. The patient should have 2 to 3 liters of fluid daily. Taking lithium with food minimizes
gastrointestinal side effects. Regular monitoring of lithium levels is important to prevent toxicity.
DIF: Cognitive Level: Application REF: Page 246 | Page 250
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
Bipolar, and Adjustment Disorders
Fortinash: Psychiatric Mental Health Nursing, 5th Edition
Chapter 12: Mood Disorders: Depression, Bipolar, and Adjustment Disorders
Test Bank
MULTIPLE CHOICE
1. The nurse learns at report that a newly admitted manic patient is demonstrating grandiosity.
Which statement would be most consistent with this symptom?
a. “I can’t do anything anymore.”
b. “I’m the world’s most astute financier.”
c. “I can understand why my wife is upset that I overspend.”
d. “I can’t understand where all the money in our family goes.”
ANS: B
An individual who is demonstrating grandiosity has an exaggerated view of his abilities. The
other options are more moderate statements and lack that element of exaggeration.
DIF: Cognitive Level: Application REF: Page 233 | Page 235
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
2. The nurse will base a discussion of dysthymia on the fact that the condition:
a. Typically has an acute onset
b. Involves delusional thinking
c. Is chronic low-level depression
d. Does not include suicidal ideation
ANS: C
,Dysthymia is identified as a chronic low-level depression frequently lasting over a period of
several years without remitting. Dysthymia has a slow, insidious onset. Delusional thinking is
not a common manifestation of dysthymia. Suicidal thoughts are seen among dysthymic patients.
DIF: Cognitive Level: Comprehension REF: Pages 232-233
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
3. What is the priority nursing diagnosis for a patient exhibiting signs of acute mania that include
exaggerated physical activity, agitation, insomnia, and anorexia?
a. Risk for injury
b. Chronic low self-esteem
c. Noncompliance
d. Insomnia
ANS: A
Risk for injury is the priority diagnosis. Possible injuries include dehydration, which may result
from not drinking and trauma, which may result from bumping into objects or from physical
altercations. The other options are valid diagnoses, but not of highest priority.
DIF: Cognitive Level: Analysis REF: Page 242 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Psychosocial Integrity
4. A patient has been admitted with a diagnosis of atypical depression. In planning interventions,
the nurse would expect to consider the characteristic symptom of:
a. Seasonal episodes
b. Leaden paralysis
c. Psychomotor agitation
d. Increased depression in the morning
ANS: B
Behavioral characteristics of atypical depression include the feeling that one’s limbs are so heavy
they cannot be lifted or moved (leaden paralysis). Seasonal mood changes are characteristic of
seasonal affective disorder. Psychomotor agitation and depression that is greater in the morning
than in the evening are characteristics more likely to be observed in patients with melancholic
depression.
, DIF: Cognitive Level: Application REF: Page 237 TOP: Nursing Process: Planning
MSC: NCLEX: Psychosocial Integrity
5. An inappropriately dressed patient has not slept for 3 days while making excessive, expensive
long-distance phone calls. When the patient can be heard singing loudly in the examining room,
the nurse makes initial plans to focus on:
a. Assessing needs for food, liquids, and rest
b. Setting strict limits on dress and behavior
c. Conducting an in-depth suicide assessment
d. Obtaining a complete psychosocial assessment
ANS: A
Patients with mania frequently ignore their basic physiologic needs, as evidenced by not sleeping
for 3 days, thus making these assessments the priority. Limits, although appropriate to consider,
are not the priority. The manic state precludes a thorough assessment initially. Suicide
assessment is not a priority at this time but reckless behavior could result in personal injury.
DIF: Cognitive Level: Application REF: Page 245 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
6. Which statement by the patient would indicate the need for additional education regarding the
prescribed lithium treatment regimen?
a. “I will restrict my daily salt intake.”
b. “I will take my medications with food.”
c. “I will have my blood drawn on schedule.”
d. “I will drink 8 to 12 glasses of liquids daily.”
ANS: A
Patients taking lithium must maintain a normal sodium intake or risk symptoms of lithium
toxicity. The patient should have 2 to 3 liters of fluid daily. Taking lithium with food minimizes
gastrointestinal side effects. Regular monitoring of lithium levels is important to prevent toxicity.
DIF: Cognitive Level: Application REF: Page 246 | Page 250
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
