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?

A. The child has a history of jaw fractures: This finding suggests physical abuse rather than neglect. Jaw fractures are not typically associated with neglect unless they result from untreated medical conditions or lack of appropriate supervision.

B. The child seems frightened of their parent: This finding may indicate emotional abuse or exposure to domestic violence rather than neglect. While fearfulness can be a sign of maltreatment, it does not specifically indicate neglect unless it is related to the failure of the parent to provide adequate care.

C. The child has had no immunizations since birth: This finding is indicative of medical neglect, which is a form of child neglect. Failure to provide necessary medical care, such as immunizations, can put the child at risk of preventable diseases and is considered a form of neglect.

D. The child rocks back and forth continually: This finding may suggest developmental delays or emotional distress but is not necessarily indicative of neglect on its own. However, if the rocking behavior is related to inadequate stimulation, supervision, or care from the caregiver, it could be considered a sign of neglect.

A. Encourage the client to attend group therapy sessions: While group therapy can be beneficial for some individuals with panic disorder by providing support and opportunities for learning coping strategies, it may not be appropriate for all clients. Some clients may feel overwhelmed or anxious in group settings, especially during panic attacks. The nurse should assess the client's readiness and comfort level with group therapy and individualize the treatment plan accordingly.

B. Allow the client to choose scheduled daily activities: Providing the client with a sense of control and autonomy over their daily activities can be helpful in managing anxiety and panic symptoms. However, this intervention alone may not address the specific cognitive and behavioral aspects of panic disorder. It is important to incorporate other evidence-based interventions, such as cognitive-behavioral therapy (CBT) techniques, into the treatment plan to address the underlying causes of panic attacks.

C. Use simple words to describe procedures to the client: Individuals with panic disorder may experience difficulty processing information and focusing during panic attacks or periods of heightened anxiety. Using simple and clear language to describe procedures can help reduce confusion and alleviate anxiety in these situations. It is important to provide information in a calm and reassuring manner to facilitate understanding and cooperation.

D. Avoid discussing topics that can trigger a panic attack: While it is important to be mindful of potential triggers for panic attacks, avoiding all discussion of triggering topics may not be practical or helpful in the long term. Instead, the nurse should work collaboratively with the client to identify triggers and develop coping strategies to manage them effectively. Avoidance alone may reinforce avoidance behaviors and perpetuate anxiety.