A nurse is collecting data from a client who has bipolar disorder. Which of the following findings should the nurse expect?

Flight of ideas

Ritualistic behaviour

Well-groomed appearance

Command hallucinations

Answer and Explanation

The Correct Answer is A

A. Flight of ideas: Flight of ideas is a classic finding in clients experiencing a manic episode of bipolar disorder. It is characterized by rapid, continuous shifts from one topic to another, often making it difficult for the listener to follow the conversation. This reflects the elevated mood and pressured speech typical of mania.

B. Ritualistic behavior: Ritualistic behaviors, such as repetitive actions or strict routines, are more commonly associated with obsessive-compulsive disorder (OCD) rather than bipolar disorder. While clients with bipolar disorder may show disorganized behavior during mania, ritualism is not a hallmark feature.

C. Well-groomed appearance: During manic or depressive episodes of bipolar disorder, clients often experience a decline in self-care and grooming. A consistently well-groomed appearance would be more typical of a stable, euthymic phase rather than during an active mood episode.

D. Command hallucinations: Command hallucinations are typically linked to psychotic disorders such as schizophrenia. Although severe mania can include psychotic features, hallucinations are not a primary or consistent symptom in bipolar disorder unless it becomes a psychotic manic or depressive episode.

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Correct Answer is B

Explanation

A. Use humor to decrease tension: Humor may not translate well across cultures and languages, and it can lead to miscommunication or offend the client unintentionally. It is better to maintain a respectful, clear, and professional communication style when using an interpreter.

B. Speak in short sentences: Using short, clear sentences helps the interpreter accurately convey the nurse’s message to the client. It allows for better understanding and avoids overwhelming the interpreter with complex information that could get misinterpreted.

C. Speak in third person: Speaking in third person can cause confusion and distance the nurse from the client. It is best to speak directly to the client using first and second person ("I" and "you") so the interaction feels more personal and respectful.

D. Talk directly to the interpreter: The nurse should always speak directly to the client, maintaining eye contact and body language with the client. The interpreter is there to facilitate communication, not to replace the direct interaction between the nurse and the client.

A. "Your baby needs to suck on a pacifier." B. "Breastfed babies are usually fussy from swallowing too much air during feedings." C. "Swaddling your baby snugly in a blanket might help soothe her." D. "Breastfed babies often need to be supplemented with formula.”

Correct Answer is C

Explanation

A. "Your baby needs to suck on a pacifier.": While non-nutritive sucking on a pacifier can sometimes soothe a fussy baby, it is not the first recommendation, especially for a newborn who is establishing breastfeeding. Early introduction of pacifiers can interfere with successful breastfeeding due to nipple confusion.

B. "Breastfed babies are usually fussy from swallowing too much air during feedings.": Although some air swallowing can occur, especially if the latch is poor, this is not typically the primary reason for persistent crying. Addressing crying with soothing techniques like swaddling is a more immediate and supportive intervention for the parent.

C. "Swaddling your baby snugly in a blanket might help soothe her.": Swaddling provides warmth, security, and a sense of being back in the womb, which can calm a newborn effectively. It reduces the startle reflex and helps regulate the baby's nervous system, often resulting in decreased crying and improved comfort.

D. "Breastfed babies often need to be supplemented with formula.": Routine supplementation with formula is not recommended for healthy breastfed newborns unless there are clear medical indications. Promoting exclusive breastfeeding supports optimal nutrition, bonding, and gut health in the early postpartum period.

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A nurse is collecting data from a client who has bipolar disorder. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is using the assistance of an interpreter to reinforce discharge teaching to a client who does not speak the same language as the nurse. Which of the following actions should the nurse plan to take when working with an interpreter?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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