A nurse is caring for a client who has right-sided hemiplegia following a recent stroke. Which of the following questions should the nurse ask to determine the client's ability to cope?

Choice A reason:
Writing a detailed daily activity schedule is not typically indicative of acute mania. Individuals with acute mania often have difficulty focusing and may start many projects but struggle to follow through. A detailed schedule suggests organization, which is not characteristic of mania.

Choice B reason:
Refusing to engage in conversation is not a common sign of acute mania. On the contrary, individuals experiencing mania are more likely to exhibit pressured speech, which is fast, excessive, and difficult to interrupt.

Choice C reason:
Isolating oneself from others is not a typical behavior observed in acute mania. Individuals with mania are more likely to seek out social interactions, although these may be inappropriate or excessive.

Choice D reason:
A lack of sleep is a common symptom of acute mania. Individuals experiencing mania may feel a decreased need for sleep, stay up for long periods, and still not feel tired. This can exacerbate other manic symptoms and is a key indicator of mania.

Choice A reason:
Providing teaching on the use of coping skills is an important part of helping a client manage a situational crisis. Coping skills can include stress management techniques, relaxation methods, and problem-solving strategies. These skills are vital for the client to regain a sense of control and begin the healing process. However, this is not the immediate action to take when a client is experiencing a crisis following a significant loss.

Choice B reason:
Assisting the client to identify a friend or a support system is beneficial for providing emotional support and reducing feelings of isolation. Social support is a key factor in improving outcomes for individuals in crisis. However, this step comes after ensuring the client's immediate safety and addressing any potential risks.

Choice C reason:
Planning regular follow-up visits is crucial for ongoing support and monitoring the client's progress. Follow-up visits provide opportunities for the nurse to reassess the client's condition, adjust the care plan as needed, and continue providing education and support. Nevertheless, this is a subsequent step after initial safety concerns are addressed.

Choice D reason:
The first and most critical action for a nurse caring for a client in a situational crisis, especially after the sudden loss of a child, is to determine if the client has thoughts of self-harm. A situational crisis can lead to overwhelming emotions, which may result in suicidal ideation or attempts. Ensuring the client's safety is the top priority, and immediate intervention is required if there is any indication of self-harm thoughts.