A nurse is assessing a client with bipolar disorder during a manic episode. Which of the following findings should the nurse expect?

Choice A reason: Avoidance is a maladaptive coping strategy in generalized anxiety disorder, as it reinforces fear and hyperarousal. Anxiety involves excessive amygdala activity, and avoidance prevents desensitization, worsening symptoms by limiting exposure to anxiety-provoking stimuli, making this ineffective.

Choice B reason: Deep breathing reduces anxiety by activating the parasympathetic nervous system, counteracting amygdala-driven hyperarousal. This evidence-based technique lowers heart rate and cortisol levels, promoting self-regulation in generalized anxiety disorder, making it an effective coping strategy for managing acute anxiety episodes.

Choice C reason: Taking extra medication without guidance is dangerous, risking overdose or dependence. Anxiety disorders require structured treatment with SSRIs or therapy, not self-adjusted doses, as this bypasses the neurochemical balance needed for long-term symptom management, making it ineffective.

Choice D reason: Excessive TV watching is avoidance, not coping, as it distracts without addressing anxiety’s root causes. Generalized anxiety disorder involves chronic worry, and passive distraction fails to engage cognitive or physiological regulation, reinforcing maladaptive patterns rather than promoting effective coping.

Choice A reason: Interpersonal therapy focuses on relationships, not the cognitive distortions driving gambling disorder. Gambling involves dopamine-driven reward seeking, and while relationships may influence stress, addressing core beliefs about gambling is more effective for managing the addiction’s neurobiological basis.

Choice B reason: Cognitive behavioral therapy (CBT) targets distorted beliefs in gambling disorder, such as illusions of control, addressing dopamine-driven reward seeking. By restructuring thoughts, CBT reduces compulsive behaviors, making it a primary, evidence-based intervention for addressing the psychological and neurological aspects of gambling addiction.

Choice C reason: Gamblers Anonymous promotes abstinence, not controlled gambling, which is unrealistic for a behavioral addiction. Controlled gambling contradicts recovery principles, as the disorder’s reward pathway dysregulation drives compulsive behavior, making this statement incorrect and misleading for treatment goals.

Choice D reason: Systematic desensitization is used for phobias, not gambling disorder. It involves gradual exposure to feared stimuli, irrelevant to gambling’s reward-driven compulsions. CBT is more appropriate, targeting cognitive distortions and behaviors, not anxiety-based avoidance seen in phobic disorders.