A nurse is assessing a patient with bipolar disorder. Which of the following aspects of the assessment should the nurse consider as part of the physical assessment? Select all that apply:

Choice C rationale:

The primary goal of establishing a therapeutic nurse-patient relationship in the context of caring for a patient with MDD is to promote trust, rapport, empathy, and communication. This relationship provides a safe and supportive environment for the patient to express their thoughts and feelings, which is essential for effective treatment and recovery.

Choice A rationale:

Providing constant reassurance to the patient oversimplifies the therapeutic relationship. While offering reassurance is part of the nurse's role, the relationship is multidimensional and involves active listening, understanding, and collaborative problem-solving beyond just providing reassurance.

Choice B rationale:

Offering advice and solutions to the patient's problems might be part of the therapeutic process, but it's not the primary goal of the nurse-patient relationship. The relationship focuses on fostering open communication and empowering the patient to explore their feelings and thoughts.

Choice D rationale:

Encouraging the patient to rely solely on the nurse for support is not the goal of the therapeutic relationship. Instead, the nurse aims to empower the patient to develop a network of support and coping strategies, both within and outside the healthcare setting. This approach enhances the patient's long-term resilience.

Choice A rationale:

Cognitive abilities, memory, and attention are important cognitive functions to assess in patients with bipolar disorder. However, when addressing aggressive behavior and impulsivity, the focus should be on observing and documenting behavioral aspects rather than cognitive functions. These cognitive functions might be affected, but they are not the primary aspects of interest in this context.

Choice B rationale:

The patient's mood state and affect are indeed important considerations, especially in the context of bipolar disorder. However, the question specifically asks about aggressive behavior and impulsivity. While mood and affect might influence behavior, they are not the same as behavior. Choice D directly addresses the aspects of behavior relevant to the situation.

Choice C rationale:

Physical height and weight are not directly relevant to the assessment of aggressive behavior and impulsivity in a client with bipolar disorder. These measurements are more related to physical health rather than the behavioral or psychosocial aspects of the patient's presentation.

Choice D rationale:

This is the correct choice. Aggressive behavior and impulsivity are behavioral manifestations that can provide important insights into the patient's mental state and psychosocial functioning. Observing and documenting activity level, speech pattern, and self-care behaviors can help understand the extent and nature of these behaviors, which are relevant to the client's bipolar disorder diagnosis.