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 B
Explanation
Choice A reason: This statement may seem supportive, but it does not address the immediate safety concerns for a client with suicidal ideations and a verbalized plan. Submitting a request for privacy does not mitigate the risk of harm the client may pose to themselves.
Choice B reason: This is the most appropriate response because it directly addresses the safety of the client, which is the primary concern in this situation. It communicates care and concern while also reinforcing the need for observation due to the risk of suicide.
Choice C reason: While safety contracts can be a part of a comprehensive treatment plan, they are not foolproof and should not replace close observation for a client who has expressed suicidal ideations and has a plan. Relying solely on a contract in this situation could be dangerous.
Choice D reason: This statement is factual in that medication levels need to be therapeutic; however, it does not directly address the immediate risk of suicide. Constant observation is required regardless of medication levels if a client has verbalized a plan for suicide.
Correct Answer is A
Explanation
Choice A reason: Chlordiazepoxide is a benzodiazepine that is commonly used to treat the symptoms of acute alcohol withdrawal. It works by enhancing the effect of the neurotransmitter GABA, which has an overall calming effect on the nervous system. This helps to reduce the severity of withdrawal symptoms such as anxiety, agitation, and the risk of seizures.
Choice B reason: Buprenorphine is an opioid partial agonist-antagonist used primarily to treat opioid addiction and is not typically used for alcohol withdrawal. While it can help with some withdrawal symptoms, it does not address the full spectrum of alcohol withdrawal symptoms and is not the standard treatment for this condition.
Choice C reason: Bupropion is an antidepressant and smoking cessation aid. It affects neurotransmitters in the brain but is not indicated for the treatment of alcohol withdrawal. Therefore, it would not be the expected medication for managing acute alcohol withdrawal symptoms.
Choice D reason: Disulfiram is used as a deterrent agent in the management of chronic alcoholism. It causes unpleasant effects when even small amounts of alcohol are consumed, which helps to maintain abstinence but is not used for treating acute withdrawal symptoms.
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