A nurse is teaching a client about the use of cognitive reframing for stress management. Which of the following statements by the client indicates an understanding of the teaching?

A. Encourage the client to join group activities:
Encouraging a client experiencing a manic episode to join group activities is not the best option. Manic episodes are characterized by heightened energy, impulsive behavior, and decreased attention span. Group activities may overstimulate the client, making it difficult for them to focus or participate appropriately. It's essential to minimize stimulation and provide a calm environment to help manage the symptoms of mania.

B. Administer methylphenidate to the client:
Methylphenidate is a stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD). Administering a stimulant like methylphenidate to a person in a manic state can exacerbate their symptoms. It would increase their already elevated energy levels, restlessness, and impulsivity, making the manic episode more intense and challenging to manage. Using stimulant medications in this context is contraindicated.

C. Dim the lights in the client's room:
Dimming the lights in the client's room is the appropriate choice. Bright lights can increase agitation and restlessness in individuals experiencing a manic episode. Dimming the lights creates a calming environment, reducing excessive stimulation and promoting relaxation. A calm atmosphere is crucial for someone going through a manic episode to help them manage their symptoms effectively.

D. Provide detailed explanations to the client:
During a manic episode, individuals often have racing thoughts and may have difficulty concentrating. Providing detailed explanations can overwhelm the client, as they might have trouble processing complex information in this state. Instead, simple and clear communication is more effective. It's important to provide straightforward instructions and information to prevent further agitation and confusion.

A. Initiates social interactions with caregivers:One of the key goals for adolescents with autism spectrum disorder (ASD) is to improve social skills and interactions. Encouraging the adolescent to initiate social interactions is a positive and realistic outcome that promotes social development and enhances communication skills.

B. Meets own needs without manipulating others:While fostering independence and self-advocacy is important, adolescents with ASD may struggle with understanding social cues and may not manipulate others in a typical sense. This outcome may not be as relevant or achievable for the individual with ASD.

C. Changes behavior as a result of peer pressure:Adolescents with ASD may have difficulty understanding and responding to peer pressure in the same way as their neurotypical peers. This outcome may not be appropriate or realistic for someone with ASD, as it can lead to increased anxiety or discomfort.

D. Acknowledges that his delusions are not real:This outcome is more relevant to conditions such as schizophrenia or severe psychotic disorders, rather than ASD. Adolescents with autism may experience different cognitive challenges but generally do not have delusions in the way that individuals with psychotic disorders do.