A nurse is reinforcing teaching with a client who has a permanent pacemaker in place. Which of the following statements by the client indicates an understanding of the teaching?

A. The client spends most of their day sleeping: Excessive sleep is more characteristic of depressive episodes in bipolar disorder. While fatigue can contribute to risk in some contexts, it does not directly indicate increased injury risk from manic behaviors.

B. The client is easily distracted by external stimuli: Distractibility is a hallmark of mania and can lead to impulsive or unsafe actions, such as leaving dangerous objects within reach, wandering, or starting multiple activities at once. This significantly increases the client’s risk for injury.

C. The client withdraws from group activities: Social withdrawal is more associated with depressive states. While it may affect engagement or mood, it does not inherently increase risk for injury due to manic behavior.

D. The client will only eat finger foods: Preferring finger foods may indicate impulsivity or hyperactivity but does not directly correlate with a substantial risk for injury. Safety risks are more closely tied to distractibility, poor judgment, and impulsive actions during mania.

A. Encourage the parents to remain in the room: Adolescents benefit from privacy during a physical examination to promote trust, autonomy, and open communication about sensitive issues. Parents may be asked to step out during parts of the exam, so keeping them present at all times is not recommended.

B. Avoid using medical terminology during the examination: While explanations should be clear, avoiding all medical terminology can limit the adolescent’s understanding. Using age-appropriate language along with brief medical terms helps the adolescent learn about their health and fosters health literacy.

C. Allow the adolescent to handle the equipment: Allowing the adolescent to interact with examination tools (e.g., stethoscope, blood pressure cuff) reduces anxiety, promotes engagement, and increases cooperation. Hands-on involvement empowers the adolescent and helps them feel more comfortable during the assessment.

D. Limit the adolescent's choices throughout the examination: Providing choices whenever possible, such as the order of nonurgent assessments or clothing options, supports autonomy and collaboration. Restricting choices can increase resistance and reduce the adolescent’s comfort.