NCLEX CRUSADE ACADEMY TEST - 13 BIPOLAR DISORDER

1. Bipolar disorder is primarily characterized by: Continuous depressive mood only. Alternating episodes of mania/hypomania and depression. Chronic anxiety and panic attacks. Persistent hallucinations without mood changes.

2. Which manifestation is most consistent with mania?. Psychomotor retardation. Flight of ideas and euphoria. Persistent fatigue. Social withdrawal.

3. Which symptom is typical of severe depression in bipolar disorder?. Hypersexual behavior. Increased appetite for stimulation. Psychomotor retardation. Excessive energy.

4. According to psychiatric prioritization, what is the highest nursing priority?. Psychosocial education. Physiological comfort. Safety. Family involvement.

5. What is the therapeutic serum lithium range?. 0.1-0.5 mEq/L. 0.6-1.2 mEq/L. 1.5-2.5 mEq/L. >3.0 mEq/L.

6. Lithium toxicity becomes severe at levels greater than: 1.2 mEq/L. 1.5 mEq/L. 2.5 mEq/L. 0.8 mEq/L.

7. Lithium blood levels should typically be drawn: Immediately after dose. 6 hours after dose. 12 hours after dose. 24 hours after dose.

8. Which condition increases lithium toxicity risk?. Increased sodium intake. Dehydration. Drinking excess water. High protein diet.

9. Which medication class should NOT be combined with MAOIs?. Antihistamines. SSRIs. Beta blockers. Antacids.

10. Which symptom suggests serotonin syndrome?. Bradycardia. Hypothermia. Hyperreflexia and agitation. Constipation.

11. A patient taking MAOIs should avoid foods high in: Vitamin C. Potassium. Tyramine. Calcium.

12. Which mood stabilizer requires monitoring of liver function tests?. Lamotrigine. Divalproex. Carbamazepine. Lithium.

13. Carbamazepine therapy requires monitoring for: Hyperglycemia. Bone marrow suppression. Kidney failure. Hypertension.

14. Which therapy may be indicated for severe depression unresponsive to medication?. Dialysis. Electroconvulsive therapy. Radiation therapy. Cognitive testing.

15. What is required before ECT?. High protein meal. Informed consent. Exercise test. CT scan.

16. What common temporary side effect occurs after ECT?. Permanent paralysis. Memory loss. Kidney failure. Blindness.

17. A manic patient becomes aggressive. The nurses first action is to: Argue with the patient. Maintain physical distance and de escalate. Ignore behavior. Immediately discharge.

18. When managing manipulative manic behavior, the nurse should: Ignore rules. Set consistent limits. Allow exceptions. Use threats.

19. Which patient has the highest suicide risk?. Patient with stable mood. Patient recovering from depression with increased energy. Patient with mild anxiety. Patient with mania.

20. Which nursing intervention is appropriate when suicide risk is suspected?. Avoid discussing suicide. Ask direct questions about plans. Leave patient alone. Encourage sleep only.

21. Which medication is commonly used as a mood stabilizer besides lithium?. Ibuprofen. Divalproex. Metformin. Warfarin.

22. Lithium crosses which barrier causing fetal toxicity?. Blood brain barrier. Placental barrier. Skin barrier. Liver barrier.

23. Which symptom may indicate lithium toxicity?. Tremors. Improved concentration. Increased appetite. Decreased urination.

24. Which nursing teaching is essential for patients taking lithium?. Restrict sodium intake. Maintain stable sodium intake. Avoid fluids. Drink alcohol daily.

25. Which medication class may cause cardiac toxicity in overdose?. SSRIs. TCAs. NSAIDs. Antihistamines.

26. Which symptom is associated with serotonin syndrome?. Bradycardia. Diaphoresis. Hypothermia. Constipation.

27. Which lab should be monitored during lithium therapy?. Hemoglobin only. Lithium serum levels. Glucose levels. Cholesterol levels.

28. A manic patient frequently changes clothing to inappropriate outfits. This indicates: Impaired judgment. Improved insight. Normal behavior. Depression.

29. Which symptom best differentiates mania from depression?. Sleep disturbance. Increased motor activity. Appetite changes. Fatigue.

30. What is the nurses role when lithium toxicity is suspected?. Continue medication. Stop lithium and notify provider. Give another dose. Ignore symptoms.