A nurse in an inpatient mental health facility is assisting with the care of a client who has bipolar disorder and is experiencing an acute manic episode. Which of the following actions should the nurse take?

Have the client participate in a group therapy session.

Recommend the client participate in a basketball game with other clients.

Encourage the client to ambulate around the unit.

Instruct the client to avoid napping during the day.

Answer and Explanation

The Correct Answer is C

A. Have the client participate in a group therapy session: Group therapy may be overwhelming and overstimulating for a client in an acute manic episode. Rapid speech, distractibility, and hyperactivity can make it difficult to engage appropriately, potentially increasing agitation rather than providing therapeutic benefit.

B. Recommend the client participate in a basketball game with other clients: High-intensity, competitive activities like basketball can increase stimulation and risk of injury for a client experiencing mania. Physical exertion in a structured, low-stimulation environment is safer than group sports.

C. Encourage the client to ambulate around the unit: Walking or ambulating provides a safe outlet for excess energy while maintaining supervision. Structured, low-stimulation physical activity helps reduce agitation, promotes safety, and supports self-regulation during manic episodes.

D. Instruct the client to avoid napping during the day: Sleep deprivation can exacerbate manic symptoms. Encouraging rest and allowing the client to nap when fatigued is safer and helps stabilize mood. Preventing sleep would be counterproductive in managing mania.

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Correct Answer is B

Explanation

A. Consumes foods with purines: Dietary habits may be relevant for certain conditions, such as gout, but consumption of purine-rich foods is not part of the client’s medical history. It is considered current lifestyle information rather than past or ongoing medical diagnoses.

B. Hospitalized for bipolar disorder 2 years ago: Previous hospitalizations for psychiatric conditions are a key component of the client’s medical history. This information provides context for current mental health status, risk assessment, and planning of care, and helps identify patterns in symptom management and treatment response.

C. Step-sister has major depressive disorder: Family history is important and documented separately under genetic or familial risk factors. While it informs potential predisposition, it does not constitute the client’s personal medical history.

D. Plans to start group therapy sessions once per week: Future intentions or planned interventions reflect care planning and goals rather than historical medical data. This information is documented in the plan of care rather than the medical history section.

A. Rotavirus (RV) B. Measles, mumps, and rubella (MMR) C. Varicella (VAR) D. Influenza (IV)

Correct Answer is A

Explanation

A. Rotavirus (RV): The first dose of the rotavirus vaccine is recommended at 2 months of age as part of the routine immunization schedule. Rotavirus vaccination protects infants from severe gastroenteritis caused by rotavirus, which can lead to dehydration and hospitalization. Administration at this age supports early immunity before peak exposure to the virus.

B. Measles, mumps, and rubella (MMR): The MMR vaccine is typically administered starting at 12 months of age, with a second dose at 4–6 years. Giving it at 2 months is not appropriate because maternal antibodies can interfere with vaccine efficacy, and the infant’s immune system is not sufficiently mature to mount an adequate response.

C. Varicella (VAR): Varicella vaccination is also recommended at 12 months of age, with a second dose at 4–6 years. Administering it at 2 months would be ineffective due to interference from maternal antibodies and the immature immune system.

D. Influenza (IV): Routine influenza vaccination is recommended starting at 6 months of age. Infants younger than 6 months are !not eligible for the vaccine, so it is not appropriate to administer during a 2-month well-child visit.

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A nurse in an inpatient mental health facility is assisting with the care of a client who has bipolar disorder and is experiencing an acute manic episode. Which of the following actions should the nurse take?

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