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A nurse in an acute mental health unit is admitting a client who has bipolar disorder.

Which of the following findings supports the admitting diagnosis of acute mania?

The client's spouse reports that the client has recently gained weight.

The client responds to questions with disorganized speech.

The client reports that voices are telling him to write a novel.

The client is dressed in all black.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Weight gain is not typically associated with acute mania in bipolar disorder.

Choice B rationale:

Disorganized speech can be a symptom of acute mania, which is characterized by increased energy, feelings of euphoria, racing thoughts, risky behaviors, and an inflated self-image.

Choice C rationale:

While hallucinations can occur in severe bipolar episodes, the client reporting that voices are telling him to write a novel is not specifically indicative of acute mania.

Choice D rationale:

Dressing in all black is not a specific symptom of acute mania.

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Correct Answer is D

Explanation

Choice A rationale:
High serum sodium levels do not directly cause toxic levels of valproate.
Choice B rationale:
While regular health monitoring is important, specifically performing thyroid function tests every 6 months is not a standard requirement for valproate use.
Choice C rationale:
A pretreatment electroencephalogram (EEG) is not typically required before starting valproate.
Choice D rationale:
Liver function tests must be monitored as valproate can cause liver failure that may be fatal.

A. A client who has a BUN of 22 mg/dL. B. A client who has a serum potassium of 3.3 mEq/L. C. A client who has a hematocrit of 55%. D. A client who has a WBC of 2,900 cells/mm².

Correct Answer is D

Explanation

Choice A rationale:

A BUN of 22 mg/dL is slightly elevated but not a contraindication for clozapine.

Choice B rationale:

A serum potassium of 3.3 mEq/L is slightly low but not a contraindication for clozapine.

Choice C rationale:

A hematocrit of 55% is high but not a contraindication for clozapine.

Choice D rationale:

A WBC of 2,900 cells/mm² is low and can indicate agranulocytosis, a potentially life-threatening condition. Clozapine should be discontinued.

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A nurse in an acute mental health unit is admitting a client who has bipolar disorder. Which of the following findings supports the admitting diagnosis of acute mania?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?

Correct Answer is D

Explanation

A nurse is reviewing abnormal laboratory values for four clients who have schizophrenia and take clozapine. For which of the following clients should the nurse withhold the medication and notify the provider immediately to have clozapine therapy discontinued?

Correct Answer is D

Explanation

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A nurse in an acute mental health unit is admitting a client who has bipolar disorder.

Which of the following findings supports the admitting diagnosis of acute mania?