A nurse is caring for a client diagnosed with bipolar II disorder. The client is experiencing a hypomanic episode. Which of the following symptoms is most consistent with this phase of bipolar disorder?

Choice A reason: Encouraging discussion about the purpose of rituals may help the client gain insight into their OCD but can increase anxiety if they feel pressured to explain compulsive behaviors. This approach is less effective for immediate security compared to allowing rituals, which reduces distress.

Choice B reason: Distracting the client from rituals with activities may disrupt their compulsive behaviors, increasing anxiety and reducing their sense of control. This can exacerbate OCD symptoms, as rituals are a coping mechanism, making this approach less effective for promoting immediate security.

Choice C reason: Asking the client to stop performing rituals can significantly increase anxiety, as these behaviors are driven by intrusive thoughts and provide temporary relief. Forcing cessation without therapeutic support can destabilize the client, reducing their sense of security and worsening OCD symptoms.

Choice D reason: Allowing the client to perform rituals reduces immediate anxiety by permitting their coping mechanism, which is central to OCD. This fosters a sense of security, as the client feels understood and less threatened, creating a stable environment for building trust and initiating therapy.

Choice A reason: Assessing family health history may provide context for genetic predispositions to mental health disorders. However, it is not the priority upon admission, as it does not address immediate physiological risks like malnutrition or cardiac instability, which are critical in anorexia nervosa due to severe weight loss.

Choice B reason: Assessing the client’s knowledge of treatment options is important for engaging them in their care plan. However, this is secondary to addressing immediate physical health risks, such as electrolyte imbalances or cardiac complications, which are life-threatening in anorexia nervosa and require urgent attention.

Choice C reason: Assessing early disturbances in family interactions may help identify triggers for anorexia nervosa, such as emotional stress. However, this is not the priority upon admission, as it does not address the immediate physiological dangers of malnutrition, dehydration, or organ dysfunction, which take precedence.

Choice D reason: Anorexia nervosa can cause severe physiological complications, including bradycardia, hypotension, and electrolyte imbalances, due to malnutrition. Assessing and monitoring vital signs and lab values is critical to identify life-threatening conditions like hypokalemia or cardiac arrhythmias, ensuring immediate stabilization and guiding treatment, making it the priority intervention.