A nurse is conducting an admission assessment for a client who is experiencing a manic episode of bipolar disorder. Which of the following behaviors should the nurse expect? (Select all that apply.)

A. Grandiosity: Individuals experiencing a manic episode may exhibit grandiosity, such as an inflated sense of self-importance, superiority, or power.

B. Flight of ideas: Flight of ideas refers to rapid, continuous speech that jumps from one topic to another, often with loose associations. It is a common manifestation of a manic episode.

C. Splitting: Splitting is a defense mechanism commonly associated with certain personality disorders, such as borderline personality disorder, but it is not typically observed during a manic episode of bipolar disorder.

D. Hyperactivity: Hyperactivity, or increased physical activity, is characteristic of a manic episode. Clients may engage in excessive goal-directed activities or restlessness.

E. Withdrawal: Withdrawal, or social withdrawal, is not a typical behavior during a manic episode. Instead, individuals with mania tend to exhibit increased sociability and extroversion.

A. “I can hear him crying in the middle of the night.”: While this statement indicates distress, it does not necessarily indicate an immediate risk of suicide. Crying can be a symptom of various emotional or psychological issues, but it does not provide direct evidence of suicidal intent.

B. "He spends most of his time locked in his room.”: Social withdrawal or isolating oneself from others can be a warning sign of depression or other mental health issues, including suicidal ideation. However, it alone may not indicate imminent risk of suicide.

C. “He refuses to go to the movies with his friends.”: Social withdrawal or a decline in interest in previously enjoyed activities can also be indicators of depression or other mental health concerns. However, like spending time alone, it does not provide direct evidence of suicidal intent.

D. “I noticed several cutting marks on both of his arms.”: This statement is the most concerning and indicates a potential self-harm behavior. Self-harm, such as cutting, can be a significant risk factor for suicide, especially if the behavior escalates or if the individual expresses suicidal thoughts or intentions.