A nurse is collecting data from a client who has bipolar disorder. Which of the following findings is the nurse's priority?

The client talks excessively.

The client dresses in vivid, bright colors.

The client refuses to eat.

The client sleeps 6 hr at night.

Answer and Explanation

The Correct Answer is C

A. The client talks excessively: Pressured speech is a common manifestation of mania in bipolar disorder. While it requires monitoring, it does not pose an immediate threat to the client’s health.

B. The client dresses in vivid, bright colors: Wearing bright or unusual clothing reflects the euphoric or expansive mood seen in mania. This behavior is not immediately harmful and does not take priority over basic physiological needs.

C. The client refuses to eat: Refusal to eat can lead to malnutrition, dehydration, and electrolyte imbalances, which are life-threatening if not addressed promptly. Maintaining adequate nutrition and hydration is a priority over behavioral or mood-related symptoms.

D. The client sleeps 6 hr at night: Reduced sleep is common during manic episodes but is not immediately life-threatening. Sleep deprivation should be monitored, but the client’s refusal to eat requires more urgent intervention.

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Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

Rationale for correct choices

• Methadone: Methadone is a long-acting opioid agonist used to manage withdrawal symptoms in clients dependent on opioids such as heroin. It reduces cravings and prevents severe withdrawal manifestations, allowing the client to stabilize while engaging in therapy. Methadone therapy is a cornerstone of medication-assisted treatment for opioid use disorder.

• Group therapy: Group therapy provides peer support, helps the client share experiences, and reinforces coping strategies for substance use disorder. It complements individual therapy and helps reduce feelings of isolation and anxiety during withdrawal. Participation in group therapy is associated with improved treatment adherence and long-term recovery outcomes.

Rationale for incorrect choices

• Varenicline: Varenicline is used to aid smoking cessation and is not indicated for opioid or methamphetamine withdrawal. It does not address cravings or withdrawal symptoms from the substances the client is using.

• Naloxone: Naloxone is an opioid antagonist used to reverse opioid overdose, not to manage withdrawal. Administering naloxone during opioid dependence can precipitate acute withdrawal and is therefore contraindicated in this setting.

• Meditation therapy: While meditation can support stress reduction and relaxation, it is not a primary intervention for managing withdrawal or substance use disorder. It may be used adjunctively but is not prescribed as a structured therapy for withdrawal management.

• Aroma therapy: Aromatherapy may provide calming effects but does not address the physiological or psychological needs of clients experiencing opioid and stimulant withdrawal. It is non-essential and not a standard part of withdrawal management protocols.

A. The client's friend who visits daily B. The client C. The client's appointed guardian D. The client's psychiatrist

Correct Answer is C

Explanation

A. The client's friend who visits daily: A friend, regardless of the frequency of visits or closeness, does not have legal authority to provide informed consent for medical procedures. Consent must come from someone legally recognized to make healthcare decisions.

B. The client: Since the client has been legally declared incompetent, they are unable to provide informed consent. Their decision-making capacity is impaired, and legal authority shifts to a designated surrogate or guardian.

C. The client's appointed guardian: The appointed guardian has the legal authority to make healthcare decisions on behalf of a client who is deemed incompetent. The guardian can provide informed consent for surgery while considering the client’s best interests and previously expressed wishes.

D. The client's psychiatrist: While the psychiatrist can provide recommendations, evaluate capacity, and assist in decision-making, they do not have the legal authority to give consent for surgery unless specifically appointed as the client’s legal guardian.

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A nurse is collecting data from a client who has bipolar disorder. Which of the following findings is the nurse's priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

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Explanation

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