The nurse continues to care for the client.

Select 1 condition and 1 client finding to fill in each blank in the following sentence.

The client is most likely experiencing
_
as evidenced by the client's
_
.

Answer and Explanation

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

Rationale for correct choices

• Mania: The client exhibits classic manic features, including decreased need for sleep, impulsivity, excessive energy, pressured speech, and distractibility. Elevated self-confidence, grandiose behavior, and excessive goal-directed activity (obsession with cleaning and hosting parties) support the diagnosis. These symptoms distinguish mania from psychotic disorders.

• Euphoric mood: The client demonstrates an abnormally elevated, joyful, and expansive mood, which is characteristic of mania. Euphoric mood manifests in overconfidence, heightened social engagement, and intense goal-directed activity. This contrasts with depressive or anxious affect and provides a key behavioral indicator supporting the manic episode diagnosis.

Rationale for incorrect choices

• Panic disorder: The client does not exhibit acute episodes of intense fear, autonomic hyperarousal, or situational triggers typical of panic disorder. Hypervigilance alone is insufficient to diagnose panic disorder, as the primary symptoms here relate to elevated mood, impulsivity, and goal-directed activity rather than recurrent panic attacks.

• Delirium: Although the client shows some disorientation to place, there is no acute onset or fluctuating level of consciousness, which are hallmark features of delirium. Attention and awareness are largely intact aside from distractibility, making delirium unlikely.

• Catatonia: Catatonia involves motor immobility, mutism, stupor, or excessive purposeless movement, which are not present here. The client is highly active, speaking rapidly, and interacting, which is opposite of catatonic presentation.

• Major depressive disorder: The client does not exhibit depressed mood, anhedonia, fatigue, or psychomotor retardation, which are essential features of major depressive disorder. Instead, the mood is elevated and goal-directed activity is increased, ruling out depressive disorder.

• Hypervigilance: While the client may show some alertness to environmental stimuli, hypervigilance is more aligned with anxiety or trauma-related disorders. It does not explain the overall euphoric mood, increased energy, or impulsive behaviors indicative of mania.

• Magical thinking: The client reports hallucinations, but there is no evidence of believing in unrealistic causal powers or delusional ideation unrelated to psychotic features. Magical thinking is not a primary symptom of mania and does not account for the elevated mood and activity.

• Anhedonia: Anhedonia refers to loss of interest or pleasure, which contradicts the client’s excessive engagement in cleaning, hosting, and social activities. The client demonstrates heightened interest and motivation rather than diminished pleasure.

• Alogia: Alogia is characterized by poverty of speech or reduced content, which is opposite of the client’s pressured, verbose, and disorganized speech. This symptom does not fit the current presentation of mania.

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Correct Answer is C

Explanation

A. Avoid eye contact with the client: Avoiding eye contact can convey disinterest or disengagement, which may increase the client’s sense of isolation. Therapeutic engagement requires maintaining appropriate eye contact to promote trust and effective communication.

B. Encourage the client to lie down in a quiet room: Isolating the client in a quiet room may intensify auditory hallucinations, as there are fewer environmental stimuli to help the client reality-test. Structured interaction and distraction techniques are generally more effective.

C. Ask the client directly what they are hearing: Engaging the client in a nonjudgmental discussion about their hallucinations helps the nurse understand the content, assess risk, and provide support. This approach promotes reality orientation, therapeutic rapport, and early identification of command hallucinations that may pose safety risks.

D. Refer to the hallucinations as if they are real: Validating hallucinations as real can reinforce psychotic thinking and perpetuate the hallucinations. The nurse should acknowledge the client’s experience without confirming the reality of the voices.

A. Chlordiazepoxide B. Naltrexone C. Bupropion D. Clonidine

Correct Answer is C

Explanation

A. Chlordiazepoxide: Chlordiazepoxide is a benzodiazepine primarily used to manage anxiety and alcohol withdrawal. It does not have any pharmacologic effect on nicotine cravings or withdrawal symptoms and is not indicated for smoking cessation.

B. Naltrexone: Naltrexone is an opioid receptor antagonist used mainly for alcohol and opioid dependence. It does not target the neurochemical pathways involved in nicotine addiction and is therefore not prescribed for smoking cessation.

C. Bupropion: Bupropion is an atypical antidepressant that also functions as a smoking cessation aid by reducing nicotine cravings and withdrawal symptoms. It acts on dopaminergic and noradrenergic pathways, making it an effective first-line pharmacologic option for clients seeking to quit smoking.

D. Clonidine: Clonidine is an antihypertensive medication that can be used off-label to reduce withdrawal symptoms in opioid or nicotine dependence. However, it is not a first-line therapy for smoking cessation and is generally reserved for clients who cannot tolerate other medications.

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The nurse continues to care for the client. Select 1 condition and 1 client finding to fill in each blank in the following sentence. The client is most likely experiencing _____ as evidenced by the client's _____ .

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The nurse continues to care for the client.

Select 1 condition and 1 client finding to fill in each blank in the following sentence.

The client is most likely experiencing
_
as evidenced by the client's
_
.