A nurse is interviewing the partner of a client who was admitted in the manic phase of bipolar disorder. The partner states, "I don't know what to do. Everything has been happening so quickly." Which of the following responses by the nurse is therapeutic?

• Lack of sleep: Decreased need for sleep is a core feature of mania, where individuals may go days with minimal rest and still appear energetic or overly active. It is not a defining feature of psychosis, though it may occur secondarily.
• Pressured speech: Pressured, rapid, and difficult-to-interrupt speech is strongly associated with mania, reflecting accelerated thought processes and elevated mood. It is uncommon in psychosis unless mania and psychotic features coexist.
• Disorganized thought process: This is a hallmark of psychosis, often seen in disorders like schizophrenia. It includes loose associations, tangentiality, and difficulty organizing ideas, and can impair communication significantly.
• Excessive spending habits: Engaging in impulsive or risky financial behaviors is a classic symptom of mania, often driven by grandiosity or impaired judgment. This behavior is not typical of psychosis unless mania is also present.
• Hallucinations: Perceptual disturbances such as seeing or hearing things that are not present are definitive features of psychosis. While they can occur in severe mania with psychotic features, they are primarily linked to psychotic disorders.

A. "Take your temperature every night before going to bed." Basal body temperature (BBT) must be measured after a full night’s sleep, not at bedtime, to accurately detect ovulatory shifts in temperature.
B. "Take your temperature 1 hour after getting out of bed." Delaying the measurement even by an hour can alter the results, as physical activity and environmental exposure can cause inaccurate readings.
C. "Take your temperature immediately after waking and before getting out of bed." This is the correct instruction. BBT should be taken at the same time each morning, right after waking, before any activity, to detect the slight rise in temperature (0.3–0.6°C or 0.5–1.0°F) that typically follows ovulation.
D. "Take your temperature within 30 minutes after your first morning void." Waiting until after voiding can also affect the reading. The temperature should be taken prior to any physical movement, including going to the bathroom, for best accuracy.