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While transfer timing is operationally relevant, it does not address clinical urgency. Psychiatric units must first prepare for the client’s behavioral presentation and safety needs.

Police presence may be necessary depending on legal status, but asking this first overlooks clinical priorities. Risk assessment should precede logistical or custodial concerns.

The client’s physical injuries are minor and medically cleared, making psychiatric admission appropriate. Questioning trauma unit placement diverts focus from psychiatric stabilization.

Joining the milieu may increase attention to the behavior and inadvertently reinforce it. It does not address the need for behavioral redirection or environmental control.

Discussing dress privately may be appropriate later, but it does not address the immediate behavioral disruption. Priority lies in managing group dynamics and preventing escalation.

Administering PRN medication without first attempting behavioral interventions bypasses least-restrictive strategies. Medication is reserved for when redirection fails or risk escalates.

Preventing injury is a safety goal, not a cognitive one. While important, it does not specifically target the disturbed thought process or reflect progress in reality testing.

Appropriate interaction is a behavioral goal that may improve with cognitive clarity, but it does not directly measure resolution of delusional thinking or thought disturbance.

Medication compliance supports treatment but is a behavioral outcome. It does not confirm cognitive improvement or resolution of disturbed thought processes.

Although hallucinations may occur in manic episodes, they are not the most immediate threat unless they directly provoke harmful behavior. The priority is safety, not perceptual disturbances.

Manic clients are typically hyper-social and intrusive, not withdrawn. Isolation is more characteristic of depressive phases, making this diagnosis less relevant during acute mania.

Feelings of guilt and low self-esteem are more prominent in depressive episodes. During mania, clients often display inflated self-worth and lack insight into inappropriate behaviors.

Sitting with Beldine may not be effective due to her restlessness. She may resist structured meal times or leave the table prematurely, making this approach impractical during a manic phase.

While familiar foods may be comforting, relying on a family member to bring meals does not address the need for accessibility and caloric density. It also lacks consistency and clinical oversight.

Room restriction is punitive and may escalate agitation or noncompliance. It does not address the underlying issue of poor intake and may worsen behavioral symptoms during mania.

While Margaret’s poor intake is concerning, nutrition is not the most immediate threat. The physical consequences of hyperactivity, such as collapse or injury, take precedence in acute care.

Sleep disturbance is a hallmark of mania, but agitation and hyperactivity pose more immediate safety risks. Sleep can be addressed once Margaret is stabilized and safe.

Denial of illness is common in bipolar disorder, but coping strategies are not the priority during acute manic episodes. Immediate physiological safety concerns override psychosocial considerations.

Sedation is not the therapeutic goal of aripiprazole. While some calming may occur, excessive sedation suggests overmedication or use of a different pharmacologic class like benzodiazepines.

Although aripiprazole can reduce psychotic symptoms over time, its immediate IM use in acute mania targets agitation and excitability first. Psychotic symptom relief is not the primary indicator of short-term effectiveness.

Mood stabilization is a long-term goal in bipolar management. Acute IM administration does not equalize mood swings immediately; it primarily addresses behavioral dysregulation.