A nurse is caring for a client who is experiencing a manic episode. Which of the following actions should the nurse take first?

Provide supervised physical activities.

Maintain a calm attitude with the client.

Decrease environmental stimuli.

Encourage the client to rest each hour.

Answer and Explanation

The Correct Answer is C

Choice A reason:
Supervised physical activity may be beneficial later to channel excess energy, but it does not address the immediate need to reduce overstimulation, which can worsen manic symptoms.

Choice B reason:
Maintaining a calm attitude is essential for therapeutic communication; however, it is not the highest-priority initial intervention when managing acute mania.

Choice C reason:
Decreasing environmental stimuli is the priority intervention because excessive noise, light, and activity can intensify manic behaviors. A low-stimulus environment promotes safety, reduces agitation, and helps prevent escalation.

Choice D reason:
Encouraging rest is important, but manic clients often cannot rest until environmental stimuli are controlled. Rest becomes more achievable after stimulation is reduced.

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Correct Answer is D

Explanation

Choice A reason: Sleeping only 4 hours is common during mania and contributes to exhaustion, but it is not immediately life-threatening.

Choice B reason: Refusing to shower reflects poor self-care, which is expected in mania, but it does not pose an acute medical risk.

Choice C reason: Eating half a snack shows reduced intake but is not as urgent as fluid refusal.

Choice D reason: Refusing fluids is the priority because dehydration can quickly lead to severe complications such as electrolyte imbalance, cardiac dysrhythmias, and renal impairment. This requires immediate intervention.

A. Sit with the client during mealtimes. B. Turn on the television for the client to watch. C. Remove sharp objects from the client’s room. D. Observe the client every 15 min. E. Provide the client with a low-protein diet. F. Offer the client physical activities. G. Offer the client physical activities.

Correct Answer is ["A","C","D","F"]

Explanation

Choice A reason: Sitting with the client during mealtimes is an essential intervention because clients with bipolar disorder, especially during manic episodes, often have poor appetite and difficulty focusing long enough to eat. Direct support ensures nutritional intake, prevents further weight loss, and provides structure. It also reduces the risk of malnutrition and dehydration, which are common complications in manic states.

Choice B reason: Turning on the television for the client is not therapeutic. Clients in manic episodes are easily overstimulated, and television can increase agitation, distractibility, and hyperactivity. Instead of calming the client, it may worsen confusion and disorientation. Therefore, this intervention is inappropriate.

Choice C reason: Removing sharp objects from the client’s room is a critical safety measure. Clients with bipolar disorder experiencing mania may act impulsively, and the risk of self-harm or accidental injury is high. Ensuring the environment is free of dangerous objects reduces the likelihood of harm and supports safe management of the client’s agitation.

Choice D reason: Observing the client every 15 minutes is necessary for safety monitoring. The client is hyperactive, confused, and disoriented, which increases the risk of injury, aggression, or unpredictable behavior. Frequent observation allows early detection of escalating agitation and ensures timely intervention. This is a standard safety protocol in acute psychiatric care.

Choice E reason: Providing a low-protein diet is not indicated. Clients with bipolar disorder do not require protein restriction; in fact, adequate protein intake is important for maintaining energy and nutritional balance. Restricting protein could worsen malnutrition and weight loss. This intervention is inappropriate.

Choice F reason: Offering the client physical activities is beneficial because it provides a safe outlet for excess energy during manic episodes. Structured physical activity helps reduce agitation, channel hyperactivity, and promote better sleep. It also decreases restlessness and supports overall emotional regulation. Activities should be simple, noncompetitive, and safe to avoid overstimulation.

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A nurse is caring for a client who is experiencing a manic episode. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has bipolar disorder and is experiencing mania. Which of the following findings is the priority for the nurse to report to the provider?

Correct Answer is D

Explanation

A nurse is caring for a client who has bipolar disorder. The nurse is planning care for the client. Select the 4 interventions the nurse should include in the client’s care.

Correct Answer is ["A","C","D","F"]

Explanation

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