A client in a manic episode is having difficulty concentrating and frequently changes topics during conversation. Which nursing response is appropriate in this situation?
"You're not making any sense right now. Can you focus?”
"I'm here to listen. Let's try to stick to one topic at a time.”
"Please stop interrupting and let others speak as well.”
"I don't understand what you're trying to say.”
The Correct Answer is B
Choice A rationale:
This response is not appropriate as it may come across as confrontational and dismissive of the client's current state. The client's difficulty in concentrating is a symptom of their manic episode, and using such phrasing might increase their agitation and escalate the situation.
Choice B rationale:
"I'm here to listen. Let's try to stick to one topic at a time." This response acknowledges the client's difficulty while providing support and a gentle redirection to stay focused on one topic. It maintains a therapeutic and non-confrontational approach, promoting effective communication with the client.
Choice C rationale:
While it's important to ensure fair participation in group conversations, this response may not address the immediate need of the client in a manic episode. It could potentially trigger further irritability or resistance from the client.
Choice D rationale:
This response may be interpreted as the nurse not making an effort to understand the client's thoughts, which could exacerbate the client's frustration and hinder therapeutic communication. It lacks empathy and a collaborative approach.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Increased sleep duration is not a characteristic of manic episodes in bipolar disorder. In fact, decreased need for sleep is a common symptom of manic episodes. Individuals experiencing a manic episode often report feeling restless and having a decreased need for sleep.
Choice B rationale:
Reduced goal-directed activity is not typical of manic episodes. During manic episodes, individuals often exhibit heightened goal-directed activity, excessive energy, and increased involvement in various activities. This can lead to a decreased ability to focus on one task at a time.
Choice C rationale:
Correct Choice In a manic episode, individuals may display a decreased need for social interaction. They might engage in excessive socializing, seek out new social interactions, and exhibit a heightened level of confidence in their ability to engage with others. This increased sociability can sometimes be characterized by rapid speech and impulsiveness in social situations.
Choice D rationale:
Feelings of sadness and hopelessness are not indicative of manic episodes. These emotions are more aligned with depressive episodes in bipolar disorder rather than manic ones. Manic episodes are characterized by elevated mood, increased energy, and a sense of euphoria or grandiosity.
Correct Answer is D
Explanation
Choice A rationale:
Benzodiazepines can cause weight gain and increased appetite. Rationale: This statement is incorrect. Benzodiazepines are not typically associated with weight gain and increased appetite. Weight gain is more commonly associated with certain other psychotropic medications like some antipsychotics and mood stabilizers. Benzodiazepines primarily affect the central nervous system and are known for their sedative and anxiolytic properties rather than influencing appetite.
Choice B rationale:
Benzodiazepines are used to enhance the effects of dopamine in the brain. Rationale: This statement is incorrect. Benzodiazepines do not enhance the effects of dopamine in the brain. They work by enhancing the inhibitory effects of the neurotransmitter gamma-aminobutyric acid (GABA), which leads to sedative and calming effects. Dopamine is a separate neurotransmitter associated with reward, motivation, and movement control, and benzodiazepines do not directly influence its effects.
Choice C rationale:
Benzodiazepines are commonly prescribed as mood stabilizers. Rationale: This statement is incorrect. Benzodiazepines are not commonly prescribed as mood stabilizers. Mood stabilizers are a class of medications used to manage mood disorders like bipolar disorder. While benzodiazepines might be used in certain cases to manage anxiety or agitation associated with bipolar disorder, they are not considered primary mood stabilizers. Mood stabilizers like lithium, anticonvulsants (e.g., valproate, carbamazepine), and certain atypical antipsychotics are more commonly used for this purpose.
Choice D rationale:
Benzodiazepines may lead to cognitive impairment and dependence. Rationale: This statement is correct. Benzodiazepines are associated with potential cognitive impairment and the risk of dependence. These medications have sedative effects that can impact cognitive function, including memory and attention. Prolonged use of benzodiazepines can lead to physical and psychological dependence, making it important for healthcare providers to carefully assess and monitor their use in patients, particularly those with bipolar disorder.
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