A nurse is caring for a client who has bipolar disorder. The client says to the nurse, “Give me your pen to cut the pain out of my chest.” The nurse should identify that the client is at risk for which of the following?

Choice A reason:
Feelings are a key component of the psychological domain in the biopsychosocial model. This domain focuses on the client’s emotions, thoughts, and behaviors, which are crucial in understanding and treating mental health problems. Addressing feelings helps the nurse develop a comprehensive care plan that considers the client’s emotional well-being.

Choice B reason:
Cultural groups fall under the social domain of the biopsychosocial model. This domain includes factors such as family, community, and cultural influences on the client’s health. While cultural considerations are important, they are not part of the psychological domain.

Choice C reason:
Family functioning is also part of the social domain. It involves the dynamics and interactions within the client’s family that can impact their mental health. Understanding family functioning is essential, but it is not categorized under the psychological domain.

Choice D reason:
Sleep patterns can be influenced by both psychological and biological factors. However, in the context of the biopsychosocial model, sleep patterns are typically considered part of the biological domain. The psychological domain specifically addresses the client’s emotions and mental processes.

Choice A reason:
An illusion is a misinterpretation of a real external stimulus. For example, seeing a shadow and thinking it is a person. The client’s statement does not indicate a misinterpretation of reality but rather a desire to inflict harm on themselves.
Choice B reason:
A hallucination is a false sensory perception without any real external stimulus, such as hearing voices or seeing things that are not there. The client’s statement does not suggest they are experiencing a hallucination but rather expressing a desire to self-harm.
Choice C reason:
Attention-seeking behavior involves actions taken to gain attention from others. While the client’s statement could be seen as a cry for help, it is more accurately identified as a risk for self-mutilation due to the explicit mention of wanting to cut themselves.
Choice D reason:
Self-mutilation refers to deliberate self-inflicted harm, often as a way to cope with emotional pain. The client’s statement, “Give me your pen to cut the pain out of my chest,” clearly indicates a risk for self-mutilation, as they are expressing a desire to harm themselves to alleviate emotional distress.