A nurse is assessing a patient with bipolar disorder. Which aspect of the patient's psychosocial status should the nurse evaluate during the assessment?

Choice A rationale:

Physical vital signs and body mass index (BMI) are important indicators of the patient's physical health. However, when assessing a patient with bipolar disorder, the focus should be on their psychosocial status rather than their physical health. Bipolar disorder primarily affects mood and emotions, so evaluating physical vital signs and BMI might not provide relevant information about the patient's psychosocial well-being.

Choice B rationale:

The patient's medication history and laboratory tests are crucial for understanding their medical treatment and potential physiological factors contributing to their bipolar disorder. However, this choice emphasizes the medical aspect rather than the psychosocial aspect of the patient's condition. While medication history and lab tests are important, they do not directly address the psychosocial evaluation that is required for understanding emotional expression in bipolar disorder.

Choice C rationale:

This is the correct choice. Bipolar disorder involves significant mood swings, from manic to depressive episodes. Assessing the quality, intensity, and range of emotional expression is essential to understand the patient's current emotional state, which is a fundamental aspect of their psychosocial well-being. It provides insight into potential mood fluctuations, which are characteristic of bipolar disorder.

Choice D rationale:

Social and emotional well-being is indeed crucial for individuals with bipolar disorder. However, this choice is too broad and general. The question specifically asks for an aspect related to psychosocial status that should be evaluated during the assessment. Choice C provides a more specific and relevant focus on emotional expression, which is directly tied to bipolar disorder symptoms.

Choice A rationale:

Correct Choice Responding with empathy and reflecting the client's feelings is important in therapeutic communication. In this scenario, the client is exhibiting grandiose beliefs and a heightened sense of self-importance. The response acknowledges the client's feelings without necessarily agreeing or disagreeing, maintaining a nonjudgmental stance.

Choice B rationale:

While offering to listen and talk more is a good approach, the phrasing of this option, "I'm sorry you're feeling this way," could be perceived as dismissive or patronizing. It's important to provide a more empathetic and open response to the client's feelings.

Choice C rationale:

Responding with a contradictory statement might escalate the situation and potentially lead to a power struggle with the client. Challenging the client's beliefs directly could be counterproductive to building a therapeutic relationship.

Choice D rationale:

This response could be interpreted as confrontational and potentially distressing to the client. It's important to maintain a supportive and nonjudgmental stance when communicating with individuals experiencing manic or hypomanic episodes.