A client diagnosed with bipolar disorder is experiencing a severe depressive episode. Which client behavior would alert the nurse to the highest priority intervention? The client:

is not responding to other clients on the unit.

angrily argues with another client stating, "God is dead."

is refusing to take his prescribed mood stabilizer.

states, "There is no future when you feel so depressed."

Answer and Explanation

The Correct Answer is D

D. This behavior suggests the possibility of suicidal ideation, which is a medical emergency in mental health care. The nurse should assess the client for suicidal thoughts, intentions, and plans, and provide a safe environment to prevent self-harm. It's crucial to address this as a priority to ensure the safety and well- being of the client.
A. Withdrawing from social interactions can be a symptom of depression. However, it may not always be the highest priority intervention
B. This behavior suggests agitation and potential delusional thinking, which can be indicative of a severe depressive episode or a mixed state in bipolar disorder. This however, does not indicate the need for immediate intervention.
C. Non-adherence to prescribed medication, particularly mood stabilizers, can significantly impact the management of bipolar disorder and increase the risk of mood destabilization. However, addressing adherence is not the priority intervention.

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Correct Answer is C

Explanation

C. Sodium intake can influence lithium excretion and affect serum lithium levels. Maintaining a consistent and adequate sodium intake is important for stabilizing serum lithium levels and optimizing the medication's therapeutic effects.
A. Patients should have their serum lithium levels checked regularly, typically every 3 months, not just every 6 months as suggested.
B. Clients should never adjust their lithium dose without consulting their healthcare provider. Lithium dosage adjustments should be made only under the guidance and supervision of a healthcare professional based on the client's clinical response, serum lithium levels, and overall treatment plan.
D. Adequate hydration is essential for overall health and well-being, and dehydration can increase the risk of lithium toxicity.

A. Promoting activities that encourage self-reflection B. Identifying community resources C. Providing positive feedback D. Conveying an accepting attitude

Correct Answer is D

Explanation

D. Conveying an accepting attitude involves demonstrating empathy, respect, and non-judgmental acceptance of the client as they are. Clients with BPD often have a fear of rejection and abandonment, so feeling accepted and understood by the nurse is critical for building trust.
A. In the early stages of group intervention, clients may not yet feel comfortable engaging in deep self-reflection without first establishing trust in the nurse and the group.
B. Identifying community resources is important for comprehensive care, but it may not be the most essential aspect initially for establishing trust.
C. Providing positive feedback can help reinforce positive behaviors and build rapport with clients, but it may not be the most essential aspect initially for establishing trust.

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A client diagnosed with bipolar disorder is experiencing a severe depressive episode. Which client behavior would alert the nurse to the highest priority intervention? The client:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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Correct Answer is D

Explanation

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