A nurse is collecting data from a client who has bipolar disorder. The nurse should identify that which of the following findings places the client at an increased risk for injury due to mania?

The client spends most of their day sleeping.

The client is easily distracted by external stimuli.

The client withdraws from group activities.

The client will only eat finger foods.

Answer and Explanation

The Correct Answer is B

A. The client spends most of their day sleeping: Excessive sleep is more characteristic of depressive episodes in bipolar disorder. While fatigue can contribute to risk in some contexts, it does not directly indicate increased injury risk from manic behaviors.

B. The client is easily distracted by external stimuli: Distractibility is a hallmark of mania and can lead to impulsive or unsafe actions, such as leaving dangerous objects within reach, wandering, or starting multiple activities at once. This significantly increases the client’s risk for injury.

C. The client withdraws from group activities: Social withdrawal is more associated with depressive states. While it may affect engagement or mood, it does not inherently increase risk for injury due to manic behavior.

D. The client will only eat finger foods: Preferring finger foods may indicate impulsivity or hyperactivity but does not directly correlate with a substantial risk for injury. Safety risks are more closely tied to distractibility, poor judgment, and impulsive actions during mania.

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Correct Answer is D

Explanation

A. Amniotic fluid color: Assessing amniotic fluid color is important to identify meconium-stained or bloody fluid, which can indicate fetal compromise or infection. While this provides valuable information, it does not provide immediate data about fetal well-being, making it secondary to continuous fetal monitoring.

B. The client's temperature: Maternal temperature is monitored to detect infection, especially after rupture of membranes. However, fever develops over time, so it is not the most immediate priority immediately following amniotomy. Early assessment focuses on detecting acute fetal compromise.

C. Frequency of contractions: Monitoring contraction frequency, duration, and intensity is essential for assessing labor progress. While contraction patterns guide labor management, fetal response to contractions is a higher priority after membrane rupture, as sudden changes can affect fetal oxygenation.

D. Fetal heart rate: Fetal heart rate assessment is the priority immediately after an amniotomy because sudden changes in amniotic fluid volume, umbilical cord prolapse, or cord compression can compromise fetal oxygenation. Early identification of decelerations or abnormal patterns allows rapid intervention to prevent fetal injury.

A. Administer bupropion 1 hr before meals. B. Allow the client access to food throughout the day. C. Weigh the client once weekly. D. Observe the client for 1 hr after meals.

Correct Answer is D

Explanation

A. Administer bupropion 1 hr before meals: Bupropion is contraindicated in clients with bulimia nervosa due to an increased risk of seizures. Antidepressants such as SSRIs, like fluoxetine, are preferred for managing bulimia and comorbid depression.

B. Allow the client access to food throughout the day: Unrestricted access to food can trigger binge-eating episodes in clients with bulimia nervosa. Structured meal planning with scheduled eating times is more effective in reducing binge-purge behaviors.

C. Weigh the client once weekly: Weekly weighing is insufficient for monitoring rapid weight fluctuations associated with bulimia. Daily or more frequent monitoring, combined with close observation, is recommended to identify sudden changes and ensure safety.

D. Observe the client for 1 hr after meals: Post-meal observation helps prevent purging behaviors, such as self-induced vomiting or misuse of laxatives. This intervention directly addresses the core pathology of bulimia nervosa and supports safety and behavioral modification strategies.

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A nurse is collecting data from a client who has bipolar disorder. The nurse should identify that which of the following findings places the client at an increased risk for injury due to mania?

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