A newly admitted client diagnosed with Bipolar I is experiencing an acute manic episode. Which nursing diagnosis is a priority?
Altered thought process related to hallucinations.
Risk for violence related to poor impulse control and judgement.
Altered thought process related to poor judgement.
Social isolation related to mania.
The Correct Answer is B
A. Altered thought process related to hallucinations: While altered thought processes are common in manic episodes, hallucinations are not typically associated with mania in Bipolar I disorder. Hallucinations are more commonly seen in psychotic disorders.
B. Risk for violence related to poor impulse control and judgment: This is the correct priority diagnosis. During a manic episode, individuals may have impaired impulse control and poor judgment, increasing the risk of impulsive and potentially violent behaviors. Ensuring the safety of the client and others is the priority.
C. Altered thought process related to poor judgment: While altered thought processes and poor judgment are characteristic of mania, the specific concern in this scenario is the potential for violence. The risk for violence takes precedence as a priority nursing diagnosis.
D. Social isolation related to mania: Social isolation may be a concern, but the immediate priority is addressing the risk for violence, as it poses a more significant threat to the client and others during a manic episode.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Having an advanced degree in engineering:
While pursuing an advanced degree can be challenging, it is not inherently a source of psychological distress. It may represent a personal and professional accomplishment.
B. Attending a community center daily:
Attending a community center daily is a regular activity and may not necessarily be a source of psychological distress. It could be a positive and fulfilling aspect of one's routine.
C. Belonging to the middle-class socioeconomic group:
Belonging to the middle-class socioeconomic group is not inherently a source of psychological distress. Socioeconomic status alone does not determine psychological well-being, and being in the middle class can provide stability and resources.
D. Being the only person of their ethnicity in a school setting:
This qualifies as a source of psychological distress. Being the only person of a particular ethnicity in a school setting may lead to feelings of isolation, cultural dissonance, and a sense of being different. Such situations can contribute to psychological distress and impact mental well-being.
Correct Answer is D
Explanation
A. Case Manager:
A case manager is typically responsible for coordinating and managing the overall care and services for a client. This role involves collaboration with various healthcare professionals and services outside the immediate treatment setting.
B. Educator:
An educator is involved in providing information, teaching, and promoting the understanding of health-related topics. While education is an essential component of nursing care, the described actions are more indicative of another role.
C. Counselor:
A counselor focuses on providing emotional support, guidance, and therapeutic communication to help clients explore and address personal issues. While nurses do engage in counseling, the described actions emphasize a broader role.
D. Milieu Manager:
The role of a milieu manager involves organizing and maintaining the therapeutic environment, including scheduling activities, managing interactions, and ensuring safety on a psychiatric unit. This role is crucial for creating a supportive and therapeutic atmosphere for clients.
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