MENTAL HEALTH EXAM
2 MODULES
QNS & ANS
2023/2024
,A nurse receives this laboratory result for a patient diagnosed with bipolar disorder: lithium level 1 mEq/L.
This result is:
a. within therapeutic limits
b. below therapeutic limits
c. above therapeutic limits
d. incorrect because of inaccurate testing
Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), and gabapentin (Neurontin).
Which drug also belongs to this group?
a. clonazepam (Klonopin)
b. risperidone (Risperdal)
c. lamotrigine (Lamictal)
d. aripiprazole (Abilify)
When a hyperactive patient experiencing acute mania is hospitalized, what initial nursing intervention is a
priority?
a. Allow the patient to act out his or her feelings.
b. Set limits on the patient's behavior as necessary.
c. Provide verbal instructions to the patient to remain calm.
d. Restrain the patient to reduce hyperactivity and aggression.
At a unit meeting, staff members discuss the decor for a special room for patients experiencing mania. Select
the best option.
a. Extra-large window with a view of the street
b. Neutral walls with pale, simple accessories
c. Brightly colored walls and print drapes
d. Deep colors for walls and upholstery
A patient experiencing acute mania has exhausted the staff members by noon. The patient has joked,
manipulated, insulted, and fought all morning. Staff members are feeling defensive and fatigued. Which is the
best action?
a. Confer with the health care provider regarding use of seclusion for this patient.
b. Hold a staff meeting to discuss consistency and limit-setting approaches.
c. Conduct a meeting with all patients to discuss the behavior.
d. Explain to the patient that the behavior is unacceptable.
A patient experiencing acute mania undresses in the group room and dances. The nurse's first intervention
would be to:
a. quietly ask the patient, "Why don't you put on your clothes?"
b. firmly tell the patient, "Stop dancing, and put on your clothing."
c. put a blanket around the patient, and walk with the patient to a quiet room.
d. allow the patient stay in the group room. Move the other patients to a different area.
A patient experiencing acute mania waves a newspaper and says, "I must have my credit card and use the
computer right now. A store is having a big sale and I need to order 10 dresses and four pairs of shoes." Select
,the nurse's most appropriate intervention.
a. Suggest to the patient to ask a friend do the shopping and bring purchases to the unit.
b. Invite the patient to sit with the nurse and look at new fashion magazines.
c. Tell the patient that computer use is not allowed until self-control improves.
d. Ask whether the patient has enough money to pay for the purchases.
A patient diagnosed with bipolar disorder is being treated on an outpatient basis with lithium carbonate 300
mg three times daily. The patient complains of nausea. To reduce the nausea, the nurse can suggest that the
lithium be taken with:
a. meals.
b. an antacid.
c. a large glass of juice.
d. an antiemetic medication.
A health teaching plan for a patient taking lithium should include instructions to:
a. maintain normal salt and fluids in the diet.
b. drink twice the usual daily amount of fluids.
c. double the lithium dose if diarrhea or vomiting occurs.
d. avoid eating aged cheese, processed meats, and red wine
Which nursing diagnosis would most likely apply to both a patient diagnosed with major depressive disorder
(MDD) as well as one experiencing acute mania?
a. Deficient diversional activity
b. Disturbed sleep pattern
c. Fluid volume excess
d. Defensive coping
Which dinner menu is best suited for the patient diagnosed with bipolar disorder experiencing acute mania?
a. Spaghetti and meatballs, salad, a banana
b. Beef and vegetable stew, a roll, chocolate pudding
c. Broiled chicken breast on a roll, an ear of corn, apple
d. Chicken casserole, green beans, flavored gelatin with whipped cream
Outcome identification for the treatment plan of a patient with grandiose thinking associated with acute
mania focuses on:
a. maintaining an interest in the environment.
b. developing an optimistic outlook.
c. self-control of distorted thinking.
d. stabilizing the sleep pattern.
Which documentation indicates that the treatment plan for a patient experiencing acute mania has been
effective?
a. "Converses without interrupting; clothing matches; participates in activities."
b. "Irritable, suggestible, distractible; napped for 10 minutes in afternoon."
c. "Attention span short; writing copious notes; intrudes in conversations."
d. "Heavy makeup; seductive toward staff; pressured speech."
A patient experiencing mania dances around the unit, seldom sits, monopolizes conversations, interrupts, and
intrudes. Which nursing intervention will best assist the patient with energy conservation?
a. Monitor physiologic functioning
b. Provide a subdued environment
c. Supervise personal hygiene
d. Observe for mood changes
A patient diagnosed with bipolar disorder has been hospitalized for 7 days and has taken lithium 600 mg
three times daily. Staff members observe increased agitation, pressured speech, poor personal hygiene,
, hyperactivity, and bizarre clothing. What is the nurse's best intervention?
a. Educate the patient about the proper ways to perform personal hygiene and coordinate clothing.
b. Continue to monitor and document the patient's speech patterns and motor activity.
c. Ask the health care provider to prescribe an increased dose and frequency of lithium.
d. Consider the need to check the lithium level. The patient may not be swallowing medications.
A patient experiencing acute mania has disrobed in the hall three times in 2 hours. The nurse should:
a. direct the patient to wear clothes at all times.
b. ask if the patient finds clothes bothersome.
c. tell the patient that others feel embarrassed.
d. arrange for one-on-one supervision.
A patient experiencing acute mania is dancing atop the pool table in the recreation room. The patient waves a
cue in one hand and says, "I'll throw the pool balls if anyone comes near me." The nurse's first intervention is
to:
a. tell the patient, "You need to be secluded."
b. help the patient down from the table.
c. clear the room of all other patients.
d. assemble a show of force.
After hospital discharge, what is the priority intervention for a patient diagnosed with bipolar disorder who is
taking antimanic medication, as well as for the patient's family?
a. Decreasing physical activity
b. Increasing food and fluids
c. Meeting self-care needs
d. Psychoeducation
A patient receiving lithium should be assessed for which evidence of complications?
a. Pharyngitis, mydriasis, and dystonia
b. Alopecia, purpura, and drowsiness
c. Diaphoresis, weakness, and nausea
d. Ascites, dyspnea, and edema
A patient diagnosed with bipolar disorder is in the maintenance phase of treatment. The patient asks, "Do I
have to keep taking this lithium even though my mood is stable now?" Select the nurse's most appropriate
response.
a. "You will be able to stop the medication in approximately 1 month."
b. "Taking the medication every day helps prevent relapses and recurrences."
c. "Usually patients take this medication for approximately 6 months after discharge."
d. "It's unusual that the health care provider has not already stopped your medication."
A patient diagnosed with bipolar disorder and who takes lithium telephones the nurse at the clinic to say,
"I've had severe diarrhea 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has
gotten worse. What should I do?" The nurse should advise the patient:
a. "Restrict oral fluids for 24 hours and stay in bed."
b. "Have someone bring you to the clinic immediately."
c. "Drink a large glass of water with 1 teaspoon of salt added."
d. "Take an over-the-counter antidiarrheal medication hourly until the diarrhea subsides."
Lithium is prescribed for a new patient. Which information from the patient's history indicates that
monitoring serum concentrations of the drug will be especially challenging and critical?
a. Arthritis
b. Epilepsy
c. Psoriasis
d. Congestive heart failure
2 MODULES
QNS & ANS
2023/2024
,A nurse receives this laboratory result for a patient diagnosed with bipolar disorder: lithium level 1 mEq/L.
This result is:
a. within therapeutic limits
b. below therapeutic limits
c. above therapeutic limits
d. incorrect because of inaccurate testing
Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), and gabapentin (Neurontin).
Which drug also belongs to this group?
a. clonazepam (Klonopin)
b. risperidone (Risperdal)
c. lamotrigine (Lamictal)
d. aripiprazole (Abilify)
When a hyperactive patient experiencing acute mania is hospitalized, what initial nursing intervention is a
priority?
a. Allow the patient to act out his or her feelings.
b. Set limits on the patient's behavior as necessary.
c. Provide verbal instructions to the patient to remain calm.
d. Restrain the patient to reduce hyperactivity and aggression.
At a unit meeting, staff members discuss the decor for a special room for patients experiencing mania. Select
the best option.
a. Extra-large window with a view of the street
b. Neutral walls with pale, simple accessories
c. Brightly colored walls and print drapes
d. Deep colors for walls and upholstery
A patient experiencing acute mania has exhausted the staff members by noon. The patient has joked,
manipulated, insulted, and fought all morning. Staff members are feeling defensive and fatigued. Which is the
best action?
a. Confer with the health care provider regarding use of seclusion for this patient.
b. Hold a staff meeting to discuss consistency and limit-setting approaches.
c. Conduct a meeting with all patients to discuss the behavior.
d. Explain to the patient that the behavior is unacceptable.
A patient experiencing acute mania undresses in the group room and dances. The nurse's first intervention
would be to:
a. quietly ask the patient, "Why don't you put on your clothes?"
b. firmly tell the patient, "Stop dancing, and put on your clothing."
c. put a blanket around the patient, and walk with the patient to a quiet room.
d. allow the patient stay in the group room. Move the other patients to a different area.
A patient experiencing acute mania waves a newspaper and says, "I must have my credit card and use the
computer right now. A store is having a big sale and I need to order 10 dresses and four pairs of shoes." Select
,the nurse's most appropriate intervention.
a. Suggest to the patient to ask a friend do the shopping and bring purchases to the unit.
b. Invite the patient to sit with the nurse and look at new fashion magazines.
c. Tell the patient that computer use is not allowed until self-control improves.
d. Ask whether the patient has enough money to pay for the purchases.
A patient diagnosed with bipolar disorder is being treated on an outpatient basis with lithium carbonate 300
mg three times daily. The patient complains of nausea. To reduce the nausea, the nurse can suggest that the
lithium be taken with:
a. meals.
b. an antacid.
c. a large glass of juice.
d. an antiemetic medication.
A health teaching plan for a patient taking lithium should include instructions to:
a. maintain normal salt and fluids in the diet.
b. drink twice the usual daily amount of fluids.
c. double the lithium dose if diarrhea or vomiting occurs.
d. avoid eating aged cheese, processed meats, and red wine
Which nursing diagnosis would most likely apply to both a patient diagnosed with major depressive disorder
(MDD) as well as one experiencing acute mania?
a. Deficient diversional activity
b. Disturbed sleep pattern
c. Fluid volume excess
d. Defensive coping
Which dinner menu is best suited for the patient diagnosed with bipolar disorder experiencing acute mania?
a. Spaghetti and meatballs, salad, a banana
b. Beef and vegetable stew, a roll, chocolate pudding
c. Broiled chicken breast on a roll, an ear of corn, apple
d. Chicken casserole, green beans, flavored gelatin with whipped cream
Outcome identification for the treatment plan of a patient with grandiose thinking associated with acute
mania focuses on:
a. maintaining an interest in the environment.
b. developing an optimistic outlook.
c. self-control of distorted thinking.
d. stabilizing the sleep pattern.
Which documentation indicates that the treatment plan for a patient experiencing acute mania has been
effective?
a. "Converses without interrupting; clothing matches; participates in activities."
b. "Irritable, suggestible, distractible; napped for 10 minutes in afternoon."
c. "Attention span short; writing copious notes; intrudes in conversations."
d. "Heavy makeup; seductive toward staff; pressured speech."
A patient experiencing mania dances around the unit, seldom sits, monopolizes conversations, interrupts, and
intrudes. Which nursing intervention will best assist the patient with energy conservation?
a. Monitor physiologic functioning
b. Provide a subdued environment
c. Supervise personal hygiene
d. Observe for mood changes
A patient diagnosed with bipolar disorder has been hospitalized for 7 days and has taken lithium 600 mg
three times daily. Staff members observe increased agitation, pressured speech, poor personal hygiene,
, hyperactivity, and bizarre clothing. What is the nurse's best intervention?
a. Educate the patient about the proper ways to perform personal hygiene and coordinate clothing.
b. Continue to monitor and document the patient's speech patterns and motor activity.
c. Ask the health care provider to prescribe an increased dose and frequency of lithium.
d. Consider the need to check the lithium level. The patient may not be swallowing medications.
A patient experiencing acute mania has disrobed in the hall three times in 2 hours. The nurse should:
a. direct the patient to wear clothes at all times.
b. ask if the patient finds clothes bothersome.
c. tell the patient that others feel embarrassed.
d. arrange for one-on-one supervision.
A patient experiencing acute mania is dancing atop the pool table in the recreation room. The patient waves a
cue in one hand and says, "I'll throw the pool balls if anyone comes near me." The nurse's first intervention is
to:
a. tell the patient, "You need to be secluded."
b. help the patient down from the table.
c. clear the room of all other patients.
d. assemble a show of force.
After hospital discharge, what is the priority intervention for a patient diagnosed with bipolar disorder who is
taking antimanic medication, as well as for the patient's family?
a. Decreasing physical activity
b. Increasing food and fluids
c. Meeting self-care needs
d. Psychoeducation
A patient receiving lithium should be assessed for which evidence of complications?
a. Pharyngitis, mydriasis, and dystonia
b. Alopecia, purpura, and drowsiness
c. Diaphoresis, weakness, and nausea
d. Ascites, dyspnea, and edema
A patient diagnosed with bipolar disorder is in the maintenance phase of treatment. The patient asks, "Do I
have to keep taking this lithium even though my mood is stable now?" Select the nurse's most appropriate
response.
a. "You will be able to stop the medication in approximately 1 month."
b. "Taking the medication every day helps prevent relapses and recurrences."
c. "Usually patients take this medication for approximately 6 months after discharge."
d. "It's unusual that the health care provider has not already stopped your medication."
A patient diagnosed with bipolar disorder and who takes lithium telephones the nurse at the clinic to say,
"I've had severe diarrhea 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has
gotten worse. What should I do?" The nurse should advise the patient:
a. "Restrict oral fluids for 24 hours and stay in bed."
b. "Have someone bring you to the clinic immediately."
c. "Drink a large glass of water with 1 teaspoon of salt added."
d. "Take an over-the-counter antidiarrheal medication hourly until the diarrhea subsides."
Lithium is prescribed for a new patient. Which information from the patient's history indicates that
monitoring serum concentrations of the drug will be especially challenging and critical?
a. Arthritis
b. Epilepsy
c. Psoriasis
d. Congestive heart failure
