A nurse is assisting in the care of a client who has bipolar disorder and is experiencing mania. Which of the following actions should the nurse take to promote a therapeutic environment?

Encourage the client to spend time with others in the dayroom.

Allow the client to choose activities for the day

Be specific when explaining care to the client.

Redirect client behavior by initiating physical exercise.

Answer and Explanation

The Correct Answer is C

Choice A: Encourage the client to spend time with others in the dayroom.
Encouraging a client experiencing mania to spend time with others in the dayroom might not be the best approach. Clients with mania often have heightened energy levels and may exhibit impulsive or disruptive behavior. This can lead to conflicts or overstimulation, which can exacerbate their condition. Instead, a more controlled and calm environment is usually recommended to help manage their symptoms effectively.

Choice B: Allow the client to choose activities for the day.
While allowing clients to have some autonomy can be beneficial, clients experiencing mania may have difficulty making appropriate decisions due to their heightened state. They might choose activities that are overly stimulating or unsafe. Structured and guided activities are generally more appropriate to ensure the client's safety and well-being during manic episodes.

Choice C: Be specific when explaining care to the client.
Being specific when explaining care to a client with mania is crucial. Clear and concise instructions help reduce confusion and anxiety, providing a sense of structure and predictability. This approach can help the client understand what to expect, which can be calming and help manage their symptoms more effectively. Specific instructions also ensure that the client follows the care plan accurately, which is essential for their treatment and safety.

Choice D: Redirect client behavior by initiating physical exercise.
Redirecting client behavior by initiating physical exercise can be beneficial, as it helps channel the client's excess energy in a positive way. However, it should be done in a controlled manner to prevent overstimulation or exhaustion. Physical exercise can be a part of the therapeutic plan, but it should be balanced with other interventions to ensure the client's overall well-being.

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Correct Answer is A

Explanation

Choice A reason:
Re-engaging a child in an appropriate activity is a common redirection technique. It helps to distract the child from inappropriate behavior and guides them towards a more suitable action. This method can be very effective in managing conduct disorders as it not only stops the unwanted behavior but also promotes the learning of new, more appropriate behaviors.

Choice B reason:
Moving closer to a child when they are agitated can sometimes help to calm them down. However, this is not specifically a redirection technique. It's more related to providing comfort and reassurance.

Choice C reason:
Role-playing can indeed enhance new behavioral skills. It allows the child to practice and understand the consequences of different behaviors in a safe and controlled environment. However, it's more of a teaching method than a redirection technique.

Choice D reason:
Ignoring attention-seeking behaviors is a technique often used in behavior management. The idea is to avoid reinforcing negative behavior with attention. However, it's important to note that this technique should be used with caution, as it's crucial to distinguish between attention-seeking behavior and a genuine cry for help.

A. Sodium level B. Liver enzymes C. Uric acid D. Erythrocyte sedimentation rate

Correct Answer is C

Explanation

Choice A: Sodium Level
Lithium can affect sodium levels in the body, but monitoring sodium levels is not the primary focus when assessing for lithium toxicity or adverse effects. Lithium can cause hyponatremia (low sodium levels) due to its effects on the kidneys and its ability to interfere with sodium reabsorption. However, sodium levels are not the most critical laboratory value to monitor for lithium therapy. Instead, healthcare providers focus on lithium levels in the blood to ensure they are within the therapeutic range, which is typically 0.6 to 1.2 mEq/L.

Choice B: Liver Enzymes
Monitoring liver enzymes is essential for medications that are metabolized by the liver and can cause hepatotoxicity. Lithium is not primarily metabolized by the liver; it is excreted unchanged by the kidneys. Therefore, liver enzymes are not a primary concern when monitoring for lithium's adverse effects. However, it is still important to monitor kidney function, as lithium can cause nephrotoxicity.

Choice C: Uric Acid
Lithium can increase uric acid levels in the blood, leading to hyperuricemia and potentially causing gout. Monitoring uric acid levels is important to prevent and manage these potential adverse effects. Elevated uric acid levels can lead to the formation of urate crystals in the joints, causing pain and inflammation. Therefore, healthcare providers often monitor uric acid levels in patients taking lithium to prevent complications related to hyperuricemia.

Choice D: Erythrocyte Sedimentation Rate
The erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation and is not directly related to lithium therapy. While ESR can be elevated in various conditions, including infections, autoimmune diseases, and chronic inflammatory conditions, it is not a primary laboratory value to monitor for lithium's adverse effects. Monitoring ESR would not provide specific information about lithium toxicity or its impact on the body.

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A nurse is assisting in the care of a client who has bipolar disorder and is experiencing mania. Which of the following actions should the nurse take to promote a therapeutic environment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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