Managing Patients With Bipolar Disorder at Home: A Family Affair and a Psychiatric Challenge in Home Healthcare
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CE TEST QUESTIONS
GENERAL PURPOSE: To present registered professional nurses with information related to psychiatric nursing in home care and specifically to bipolar disease.
LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to:
1. Discuss the characteristics and prevalence of bipolar disorder, and the findings of the authors' review of the literature.
2. Plan the appropriate interventions for home health patients who have bipolar disorder.
1. Reports of the incidence of depression among the homebound elderly are as high as
2. When home care clinicians use OASIS-C to assess depression, what is the cutoff score at which they must complete a more thorough screening for depression?
3. Depression screening was added to the OASIS-C for several reasons, one of which was to
a. lead to screening for bipolar and other disorders.
b. refer patients to services outside of home care.
c. reduce inpatient readmission rates.
d. add psychiatric care to home health services.
4. According to Zeltzer and Kohn, what percentage of home health care agencies (HHAs) they surveyed referred patients who were yelling, hitting, or demonstrating other forms of agitation to the physician for treatment?
5. Zeltzer and Kohn also reported that about what percentage of HHAs said they would consider making a referral to a mental health provider whether or not the provider made home visits?
6. A study by Vanderhorst and colleagues reported that what percentage of a group of patients who were offered psychiatric home care interventions were stable at discharge?
7. Bipolar disorder most often begins in
c. young adulthood.
d. middle age.
8. The National Institute of Mental Health reported an overall bipolar spectrum rate of
9. Which of the following countries has the highest prevalence of bipolar disorder?
c. New Zealand
d. United States
10. The most prevalent disorders coexisting with bipolar disorder were
a. eating disorders.
b. anxiety disorders.
c. panic disorders.
d. personality disorders.
11. The drug therapy of choice for bipolar disorder is
c. mood stabilizers.
12. Which of the following medications used to treat bipolar disorder puts patients at risk for hypothyroidism?
a. bupropion (Wellbutrin)
b. lithium (Eskalith)
c. quetiapine (Seroquel)
d. topiramate (Topamax)
13. Lithium poses particular risks for patients who also take
a. beta blockers.
d. thiazide diuretics.
14. An alternative to lithium that was approved by the FDA in 1995 for treating mania is
a. paroxetine (Paxil).
b. valproic acid (Depakote).
c. aripiprazole (Abilify).
d. olanzapine (Zyprexa).
15. Many anticonvulsant medications have an FDA warning that states that their use may increase the risk of
a. renal failure.
b. gastric ulceration.
d. suicidal thoughts.
16. sIt is the primary goal of which of the following treatment approaches to help people with bipolar disorder learn to change harmful or negative thought patterns and behaviors?
a. Family-focused therapy
b. Individual psychotherapy
c. Cognitive behavioral therapy
d. Interpersonal therapy
17. Using the Young Mania Rating Scale, which of these would be given a score of 6?
a. Threatens interviewer, shouting, interview difficult
b. Assaultive, destructive, interview impossible
c. Sarcastic, loud at times, guarded
d. Demanding, threats
18. Adverse effects of aripiprazole (Abilify, Aripiprex) include
d. neuroleptic malignant syndrome
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