A patient diagnosed with bipolar disorder becomes hyperactive after discontinuing lithium. The patient threatens to hit another patient. Which comment by the nurse is appropriate?
"You know we will not let you hit anyone. Why do you continue this behavior?"
"Do not hit anyone. If you are unable to control yourself, we will help you."
"Stop that! No one did anything to provoke an attack by you."
"If you do that one more time, you will be secluded immediately."
The Correct Answer is B
Rationale:
A. This approach is confrontational and accusatory, which may escalate agitation in a hyperactive or manic patient.
B. This response sets clear limits in a calm, supportive, and non-threatening manner, while also offering assistance with impulse control.
C. This statement is shaming and could escalate aggression rather than de-escalate the situation.
D. This is a threat rather than a therapeutic intervention, and it may increase the patient's agitation or resistance.
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Related Questions
Correct Answer is C
Explanation
Rationale:
A. Suggesting it is unusual for the provider to continue lithium could undermine trust in the treatment plan and is inaccurate.
B. Lithium is typically continued long-term or indefinitely to prevent relapse, not just for 6 months.
C. Continuing daily lithium helps maintain mood stability and significantly reduces the risk of relapse in bipolar disorder, even when the patient feels well.
D. Stopping lithium after only 1 month of stability greatly increases the likelihood of recurrence of manic or depressive episodes.
Correct Answer is B
Explanation
Rationale:
A. This approach is confrontational and accusatory, which may escalate agitation in a hyperactive or manic patient.
B. This response sets clear limits in a calm, supportive, and non-threatening manner, while also offering assistance with impulse control.
C. This statement is shaming and could escalate aggression rather than de-escalate the situation.
D. This is a threat rather than a therapeutic intervention, and it may increase the patient's agitation or resistance.
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