A nurse in a rehabilitation center is caring for a client who has bipolar disorder. Which of the following actions by the client indicates mania?
The client is constantly talking.
The client displays memory loss.
The client is sleeping over 10 hours a day.
The client expresses feelings of inferiority.
The Correct Answer is A
Choice A reason: Constant talking is a common indicator of mania in individuals with bipolar disorder. During manic episodes, clients may experience pressured speech, which is fast, incessant, and difficult to interrupt. This symptom reflects the increased energy and reduced need for sleep that are characteristic of mania.
Choice B reason: While memory loss is not a definitive indicator of mania, it can occur in bipolar disorder. However, it is more commonly associated with either depressive episodes or the aftermath of a manic episode, rather than the manic phase itself.
Choice C reason: Excessive sleep is typically not associated with mania. In fact, a decreased need for sleep is one of the diagnostic criteria for a manic episode. Clients in a manic phase often feel rested after only a few hours of sleep.
Choice D reason: Expressing feelings of inferiority is not typically indicative of mania. Such feelings are more commonly associated with depressive episodes. Manic episodes often involve inflated self-esteem or grandiosity.
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Correct Answer is D
Explanation
Choice A reason: While discussing the client's diagnosis with their family could be part of the care process, it does not address the client's immediate concern about the quality of care they are receiving. This response does not validate the client's feelings or provide an opportunity for them to elaborate on their concerns.
Choice B reason: Telling the client that their feelings are part of anticipatory grieving may be true, but it can come across as dismissive and does not offer support for the specific issue the client has raised about the quality of care.
Choice C reason: Assuring the client that the nurses are trying to provide good care does not acknowledge the client's perception of inadequate care. It's important to validate the client's feelings and understand their perspective before offering reassurances.
Choice D reason: Asking the client to elaborate on their concerns shows empathy and a willingness to listen. It allows the nurse to gather more information about the client's experience and identify specific areas that may need improvement in the care provided.
Correct Answer is D
Explanation
Choice A reason: While ECT has been used to treat various mental health conditions, its effectiveness in treating borderline personality disorder is not well-established. Borderline personality disorder is typically managed with psychotherapy, and there is limited evidence to support the use of ECT for this condition.
Choice B reason: ECT is not typically used to treat phobias such as a fear of heights. Phobias are usually addressed with cognitive-behavioral therapy and sometimes medication, but not with ECT. Therefore, a decreased fear of heights would not be a typical indicator of ECT's effectiveness.
Choice C reason: ECT may be used in some cases of epilepsy to reduce the frequency of seizures, but it is not a common treatment for this condition. The primary use of ECT is for severe psychiatric conditions, particularly major depressive disorder, and not for neurological disorders like epilepsy.
Choice D reason: ECT is most commonly used to treat severe depression, especially when it is resistant to other treatments. It is known for its rapid and significant improvements in severe symptoms of depression. An improvement in the manifestations of depression, such as a better mood, increased appetite, and improved sleep, is a clear indication that ECT is effective.
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