A nurse is collecting data from a client who has bipolar disorder with mania.
Which finding is the nurse’s priority?

The client gives personal items and money away to other clients.

The client is hostile and sarcastic towards the staff.

The client paces in the hallway during the day and most of the night.

The client demonstrates flight of ideas.

Answer and Explanation

The Correct Answer is C

The correct answer is choice c. The client paces in the hallway during the day and most of the night.

Choice A rationale: Giving away personal items and money can indicate impulsivity and poor judgment, which are common in manic episodes. However, this behavior does not pose an immediate physical risk to the client or others.

Choice B rationale: Hostility and sarcasm towards staff can indicate irritability and agitation, which are also common in mania. While this behavior can disrupt the therapeutic environment, it is not the highest priority unless it escalates to physical aggression.

Choice C rationale: Pacing in the hallway during the day and most of the night indicates severe hyperactivity and potential exhaustion. This behavior poses a significant risk to the client’s physical health due to the possibility of dehydration, exhaustion, and other complications from lack of rest.

Choice D rationale: Demonstrating flight of ideas is a cognitive symptom of mania where the client rapidly shifts from one idea to another. While this can affect communication and thought processes, it does not pose an immediate physical risk.

In summary, the priority is to address behaviors that pose the greatest immediate risk to the client’s physical health and safety.

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Correct Answer is A

Explanation

The correct answer is Choice A.

Choice A rationale:

Having consistent unit routines can provide a sense of stability and predictability, which can be beneficial for a client in the manic phase of bipolar disorder.

Choice B rationale:

Providing a stimulating environment can potentially exacerbate symptoms of mania, making it an inappropriate intervention.

Choice C rationale:

Scheduling daily seclusion times is not typically recommended as it can lead to feelings of isolation.

Choice D rationale:

Discouraging daytime napping can potentially lead to fatigue and worsen symptoms, so it’s not typically recommended.

A. “You really should work hard to stay on the schedule we establish here.” B. “I wouldn’t worry about what you’ve done in the past. C. You’ll do just fine this time.” D. “Why do you find it difficult to take your medications if they improve your condition?”

Correct Answer is D

Explanation

The correct answer is Choice D.

Choice A rationale: Telling the client to work hard to stay on the schedule does not address the underlying reasons for the client's difficulty in following a medication regimen and may come off as dismissive.

Choice B rationale: Saying not to worry about the past does not acknowledge the client's concerns and may not provide practical assistance for future adherence.

Choice C rationale: Offering reassurance without addressing the client's past challenges does not provide a concrete plan for improving adherence.

Choice D rationale: Asking the client why they find it difficult to take medications opens a dialogue that allows the nurse to understand the client's specific barriers and to provide tailored strategies to improve adherence. This response is empathetic and solution-focused.

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A nurse is collecting data from a client who has bipolar disorder with mania. Which finding is the nurse’s priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is in the manic phase of bipolar disorder. Which of the following interventions should the nurse include in the client's plan of care?.

Correct Answer is A

Explanation

A nurse is reinforcing discharge teaching with a client who has several new prescriptions for psychotropic medications. The client tells the nurse that she has always had trouble following a medication regimen. What should the nurse respond?

Correct Answer is D

Explanation

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A nurse is collecting data from a client who has bipolar disorder with mania.
Which finding is the nurse’s priority?