Bipolar Disorder: Manic and Depressive Phases Practice Questions
19 free Bipolar Disorder: Manic and Depressive Phases practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
Which symptom is not typically seen in the manic phase of bipolar disorder?
- A Grandiosity or inflated self-esteem
- B Decreased need for sleep (feels rested after only 3 hours)
- C Marked psychomotor slowing and hypersomnia
- D Flight of ideas or racing thoughts
Correct answer: Marked psychomotor slowing and hypersomnia
Psychomotor slowing and hypersomnia are more characteristic of a depressive episode; mania generally involves increased activity, restlessness, and decreased need for sleep.
A client with bipolar II disorder experiences which of the following?
- A One or more full manic episodes with no depressive episodes ever
- B Major depressive episodes plus at least one hypomanic episode, never full mania
- C Only depressive episodes, with no periods of elevated or expansive mood
- D Only full manic episodes, with no major depressive episodes ever
Correct answer: Major depressive episodes plus at least one hypomanic episode, never full mania
Bipolar II is characterized by major depressive episodes and at least one hypomanic episode with no history of full manic episodes.
During the depressive phase of bipolar disorder, which of the following is a required duration for major depressive episode diagnosis?
- A Two weeks of five or more symptoms
- B One week of three or more symptoms
- C Four days of two or more symptoms
- D Eight weeks of one symptom
Correct answer: Two weeks of five or more symptoms
A major depressive episode requires at least two weeks of five or more symptoms representing a change from previous functioning.
Which of these describes “mixed features” specifier in bipolar episodes?
- A Only depressive symptoms occur, with no increase in energy or activity
- B Full manic symptoms occur, with no depressive symptoms present at all
- C Manic/hypomanic and depressive symptoms occur nearly every day in the same episode
- D A manic episode that is seen exclusively in children, never in adults
Correct answer: Manic/hypomanic and depressive symptoms occur nearly every day in the same episode
Mixed features occur when both elevated mood symptoms and depressive symptoms coexist nearly every day during a mood episode in bipolar disorder.
One hallmark sign during a manic episode is which of the following behaviors?
- A Excessive, risky activity with potential for painful consequences (e.g., spending sprees, sexual indiscretions)
- B Persistent feelings of worthlessness with suicidal ideation and despair
- C Excessive sleeping (hypersomnia) accompanied by significant weight gain
- D Long-standing loss of pleasure or interest in nearly all activities
Correct answer: Excessive, risky activity with potential for painful consequences (e.g., spending sprees, sexual indiscretions)
Manic episodes often include high-risk behaviors and impulsive activities which represent the increased involvement in activities with potential painful consequences.
A key difference between hypomania and mania is:
- A Hypomania always requires hospitalization, whereas mania does not
- B Mania causes marked social/occupational impairment or psychosis; hypomania does not
- C Hypomania must last at least two weeks, while mania lasts only four days
- D Mania, unlike hypomania, never includes increased energy or reduced sleep need
Correct answer: Mania causes marked social/occupational impairment or psychosis; hypomania does not
Mania is more severe than hypomania, typically causing marked impairment and possible hospitalization or psychotic features; hypomania is less disruptive.
In client education for bipolar disorder, the nurse should emphasize:
- A You can safely stop all medications as soon as you start feeling better
- B Recognize early relapse signs and keep a regular sleep and daily routine
- C Lifestyle changes alone are enough to permanently cure bipolar disorder
- D Medications become completely unnecessary once you feel emotionally stable
Correct answer: Recognize early relapse signs and keep a regular sleep and daily routine
Early recognition of warning signs and maintaining a stable routine helps prevent recurrence of mood episodes; medication adherence and lifestyle are crucial.
Which of the following is a common symptom of the depressive phase in bipolar disorder but less likely in unipolar depression?
- A Feeling sad most of the day nearly every day
- B Hypersomnia and increased appetite (atypical features)
- C Severe mood elevation and excessive spending
- D Having a prior history of elevated mood episodes
Correct answer: Having a prior history of elevated mood episodes
A history of elevated mood (mania or hypomania) distinguishes bipolar depression from unipolar depression.
Which medication class is considered a mood stabilizer commonly used in bipolar disorder?
- A Selective serotonin reuptake inhibitors (SSRIs) only
- B Lithium and certain anticonvulsants (e.g., valproate)
- C Benzodiazepines exclusively
- D Antihistamines
Correct answer: Lithium and certain anticonvulsants (e.g., valproate)
Lithium and anticonvulsants like valproate are standard mood stabilizers in bipolar disorder to manage both manic and depressive phases.
If a client is experiencing elevated mood, decreased need for sleep, pressured speech, and distractibility for 5 days, this meets criteria for which episode?
- A Major depressive episode
- B Hypomanic episode
- C Manic episode
- D Mixed episode
Correct answer: Hypomanic episode
A hypomanic episode requires at least 4 consecutive days of elevated or irritable mood with increased energy and other symptoms.
In bipolar disorder, rapid cycling refers to:
- A At least four mood episodes (manic, hypomanic, or depressive) within 12 months
- B Switching between mania and depression several times within a single day
- C Experiencing only a single mood episode across the entire lifetime
- D Mood episodes that occur exclusively during the winter months each year
Correct answer: At least four mood episodes (manic, hypomanic, or depressive) within 12 months
Rapid cycling is defined as four or more distinct mood episodes within 12 months, and is associated with a worse prognosis.
During the manic phase, a client may show “flight of ideas.” This refers to:
- A Persistent difficulty staying awake throughout the day
- B Physical attempts to flee or run away from a situation
- C Racing thoughts that jump rapidly between many topics
- D Sudden, complete loss of recent and remote memory
Correct answer: Racing thoughts that jump rapidly between many topics
Flight of ideas refers to a rapid sequence of loosely connected thoughts seen in mania, leading to pressured speech and distractibility.
In the depressive phase of bipolar disorder, one might see “psychomotor retardation.” This means:
- A Excessive energy and constant motion
- B Slowed speech, thinking, movements
- C Inability to sleep for days
- D Sudden start of hyperactivity
Correct answer: Slowed speech, thinking, movements
Psychomotor retardation involves generalized slowing of physical and cognitive activity, commonly seen in major depressive episodes.
Which statement is true regarding suicide risk in bipolar disorder?
- A Bipolar disorder carries a lower suicide risk than the general population
- B Suicide risk in bipolar disorder is elevated only during manic phases
- C Suicide risk is substantially higher than in the general population
- D Depressive phases in bipolar disorder never involve any suicidal ideation
Correct answer: Suicide risk is substantially higher than in the general population
Bipolar disorder has a higher risk of suicide compared to the general population, particularly during depressive or mixed states.
Which of these is a specifier for bipolar disorder describing a pattern of frequent mood shifts?
- A Seasonal pattern
- B Single episode
- C Rapid cycling
- D Postpartum only
Correct answer: Rapid cycling
Rapid cycling indicates frequent mood shifts, with four or more episodes in 12 months, commonly found in bipolar disorder.
A client in a manic phase may exhibit significantly reduced need for sleep, meaning:
- A They sleep 10 hours but still feel tired
- B They feel rested after only 3 hours of sleep
- C They must nap every hour
- D They have insomnia due to depression
Correct answer: They feel rested after only 3 hours of sleep
A reduced need for sleep in mania is characterized by feeling rested after only a few hours of sleep.
When comparing bipolar I and bipolar II disorders, which statement is accurate?
- A Bipolar I requires at least one hypomanic episode but no depressive episodes
- B Bipolar II involves full manic episodes and never any depressive episodes
- C Bipolar I requires at least one manic episode; bipolar II has hypomania and depression
- D Bipolar I and bipolar II are identical in presentation, course, and treatment
Correct answer: Bipolar I requires at least one manic episode; bipolar II has hypomania and depression
Bipolar I requires at least one manic episode, whereas bipolar II involves hypomania and depression but no full mania.
In group therapy for clients with bipolar disorder, teaching the group to recognize early warning signs might include:
- A Consistently sleeping more than 10 hours every night without difficulty
- B Sudden decreased need for sleep, increased talkativeness, and racing thoughts
- C Feeling mildly sad or low for only a few hours during the day
- D Minor changes in appetite without any other mood or energy shift
Correct answer: Sudden decreased need for sleep, increased talkativeness, and racing thoughts
Recognizing early signs like decreased need for sleep, talkativeness, and racing thoughts helps in the prevention of full episodes.
In the depressive phase of bipolar disorder, the nurse should prioritize assessment of which of the following?
- A Presence of auditory hallucinations and their content only
- B Suicidal thoughts or intent, loss of interest, and psychomotor changes
- C The client's overall energy and activity level only
- D Whether the client is likely to engage in impulsive spending sprees
Correct answer: Suicidal thoughts or intent, loss of interest, and psychomotor changes
Assessment should focus on suicidal ideation, loss of interest, and psychomotor changes during depressive episodes.