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:

The correct answer is A, "Orientation, memory, and attention." Impaired judgment and poor insight can be indicative of cognitive dysfunction in bipolar disorder. Assessing orientation (awareness of time, place, and person), memory (short-term and long-term memory abilities), and attention (ability to focus and concentrate) can provide insights into cognitive deficits that may be contributing to impaired judgment.

Choice B rationale:

"Physical vital signs and laboratory tests" are essential assessments, but they are not directly related to the cognitive abilities of the client. They focus on physiological aspects rather than cognitive functioning.

Choice C rationale:

"Coherence, logic, and continuity of thought" are aspects of thought processes, not cognitive abilities like memory and attention. These are more relevant to assessing thought disorders or psychosis.

Choice D rationale:

"Signs of confusion, disorientation, and amnesia" are relevant to cognitive assessment, but this choice does not cover the breadth of cognitive abilities encompassed by choice A.