A postpartum client with a history of bipolar disorder reports seeing things that aren't there and feeling extremely confused. What is the first step the nurse should take?

Encourage verbal expression of feelings to alleviate symptoms.

Provide literature about managing postpartum stress.

Schedule a routine follow-up appointment.

Contact the client's psychiatrist for an emergency consultation.

Answer and Explanation

The Correct Answer is D

A. Encouraging verbal expression of feelings can be helpful for clients experiencing anxiety or mild mood disturbances. However, hallucinations and severe confusion indicate a possible psychiatric emergency, not a situation that can be managed through supportive conversation alone. This intervention does not address the immediate safety risk.

B. Providing literature about managing postpartum stress is appropriate for clients experiencing mild postpartum adjustment difficulties. However, hallucinations and confusion are not typical stress reactions and suggest a severe mental health crisis. Education alone is insufficient and inappropriate as a first step.

C. Scheduling a routine follow-up appointment delays urgently needed care. Psychotic symptoms in the postpartum period, especially in a client with a history of bipolar disorder, may indicate postpartum psychosis, which is a psychiatric emergency requiring immediate evaluation and possible hospitalization.

D. Contacting the client's psychiatrist for an emergency consultation is the priority action. Hallucinations and severe confusion place the client and potentially the infant at risk for harm. Immediate psychiatric evaluation is necessary to ensure safety and initiate rapid treatment, which may include hospitalization and medication management.

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Correct Answer is D

Explanation

A. Being a parent can motivate some individuals to avoid harmful behaviors; however, it is not a consistent protective factor. Parents may still experience stress, social pressure, or mental health challenges that can increase the risk of substance use. Parenting alone does not guarantee prevention of addiction.

B. Passive personality is actually a potential risk factor for addiction rather than a protective factor. Individuals who are passive or dependent may struggle with assertiveness, have difficulty resisting peer pressure, and may rely on substances to cope with stress or social situations, increasing vulnerability to addiction.

C. Single status is also not a protective factor. Lack of stable relationships or social support can increase isolation, stress, and susceptibility to unhealthy coping mechanisms such as substance use. Protective effects are more associated with healthy, supportive relationships, not simply marital or relationship status.

D. Positive self-image is a strong protective factor. Adults with a healthy sense of self-esteem and self-worth are more likely to use adaptive coping strategies, set healthy boundaries, make responsible choices, and seek help when stressed. They are less likely to rely on substances as a means of coping with emotional or social challenges. Maintaining a positive self-image helps buffer against stressors that might otherwise contribute to addictive behaviors.

A. Client's ethnicity B. Housing transition C. Client's comorbidities D. Treatment of animals

Correct Answer is ["B","C","E"]

Explanation

A. Client's ethnicity is not a risk factor for oppositional defiant disorder (ODD). While cultural factors may influence behavior or presentation, ethnicity alone does not increase the likelihood of developing ODD.

B. Housing transition is a risk factor. Frequent moves, homelessness, or unstable living conditions create stress and instability in a child’s environment, which can contribute to the development of defiant and oppositional behaviors.

C. Client's comorbidities are risk factors. Conditions such as ADHD, depression, and anxiety increase the likelihood of ODD. ADHD, in particular, is strongly associated with impulsivity and defiant behavior.

D. Treatment of animals is not relevant to risk for ODD. The client’s reaction to giving up a family pet reflects stress or grief but is not a documented risk factor for developing ODD.

E. Family's socioeconomic status is a risk factor. Financial hardship and low socioeconomic status can increase environmental stress, reduce access to mental health resources, and exacerbate behavioral problems, all of which contribute to the risk for ODD.

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A postpartum client with a history of bipolar disorder reports seeing things that aren't there and feeling extremely confused. What is the first step the nurse should take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse should identify that which of the following factors is a protective factor that prevents adults from developing addictions?

Correct Answer is D

Explanation

Correct Answer is ["B","C","E"]

Explanation

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