A client with bipolar disorder tells the nurse about the need to make some deals to improve a retirement savings. Based on this information, which client outcome should the nurse include in the care?

Choice A reason: A mental status examination (MSE) assesses cognition, mood, and thought processes, providing critical data on distractibility and concentration in a short timeframe. This guides the treatment plan for a client with these symptoms, aligning with psychiatric assessment protocols, making it the most important initial assessment.

Choice B reason: Substance use history is relevant but less urgent than an MSE, which directly evaluates current cognitive and emotional state. In 15 minutes, MSE provides immediate data for treatment planning, making substance history secondary and incorrect for the most critical initial assessment.

Choice C reason: Medication compliance informs treatment but does not address the client’s current distractibility and concentration issues as directly as an MSE. The MSE offers real-time insight into symptoms, guiding the plan, making compliance less urgent and incorrect for the primary assessment in this timeframe.

Choice D reason: Motivation for treatment is important but secondary to understanding the client’s current mental state via MSE, which informs immediate interventions for distractibility. Limited time prioritizes objective assessment, making motivation less critical and incorrect for the most important initial treatment planning step.

Choice A reason: In bipolar disorder, manic episodes impair judgment, leading to impulsive financial decisions. Delaying business deals until mania subsides ensures sound decision-making, protecting the client’s financial stability. This outcome aligns with psychiatric care goals for mania, making it the most appropriate care plan inclusion.

Choice B reason: Identifying feelings behind behavior is therapeutic but does not address the immediate risk of poor financial decisions during mania. Delaying decisions prevents harm, making this less critical and incorrect compared to prioritizing judgment stabilization in the client’s manic state.

Choice C reason: Seeking legal counsel is practical but secondary to delaying decisions until mania resolves, as manic impulsivity drives risky behavior. Ensuring decisions are made in a stable state is the priority, making this incorrect for the primary outcome in managing bipolar financial impulsivity.

Choice D reason: Describing financial fears may explore emotions but does not mitigate the risk of impulsive deals during mania. Delaying decisions addresses the immediate danger of poor judgment, making this less relevant and incorrect for the primary outcome in the client’s care plan.