A client diagnosed with bipolar I disorder is distraught over insomnia experienced over the past 3 nights and a 12-lb weight loss over the past 2 weeks. Which should be this client's priority nursing diagnosis?

Correct Answer: B

Rationale: The correct answer is B: Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss. The client's weight loss and hyperactivity indicate a potential imbalance between energy intake and expenditure, leading to altered nutrition. This should be the priority nursing diagnosis as it directly addresses the client's physical health and well-being. Choice A is incorrect because the client's primary concern is not knowledge deficit but rather the physical symptoms of weight loss and insomnia. Choice C is incorrect as the client's distress over insomnia and weight loss does not directly indicate immediate risk for suicide. Choice D is incorrect as altered sleep patterns related to mania may be a contributing factor to the insomnia, but the weight loss is a more critical issue that needs immediate attention.

Correct Answer: A

Rationale: The correct answer is A (ADHD) because research shows a strong link between ADHD and bipolar disorder in youth. Both conditions share symptoms like impulsivity and mood instability. ADHD is often a precursor to developing bipolar disorder later in life. Choice B (Disruptive mood dysregulation disorder) is incorrect because it is a distinct disorder characterized by severe temper outbursts, not directly linked to bipolar disorder. Choice C (Nonepisodic irritability) is incorrect as it does not specify a specific mental health condition and lacks a direct connection to bipolar disorder. Choice D (Schizophrenia) is incorrect as it is a separate psychotic disorder with different symptoms and does not typically co-occur with bipolar disorder in youth.

Correct Answer: C

Rationale: The correct answer is C because ensuring the client's safety is the top priority in managing bipolar disorder. This includes preventing self-harm or harm to others. Without safety, other outcomes are not achievable. Choices A and B focus on therapeutic interventions but are not as critical as safety. Choice D addresses coping skills, which are important but secondary to ensuring immediate safety.

Correct Answer: D

Rationale: The correct answer is D because providing dialectical behavioral therapy (DBT) requires specialized training and expertise typically possessed by advanced practice nurses. DBT is a specific therapeutic approach designed for individuals with impulse control disorders, and it involves intensive training and ongoing supervision. Leading an activity group (A) and providing positive feedback (B) are within the scope of practice of both staff nurses and advanced practice nurses. Formulating nursing diagnoses (C) is also a skill that staff nurses can perform as part of the nursing process. In summary, the advanced practice nurse would be better equipped to provide DBT due to their advanced training and expertise in this specific therapeutic approach.

Correct Answer: A

Rationale: The correct answer is A: Parent-child interaction therapy (PCIT). PCIT focuses on improving parent-child relationships and teaching parents effective behavior management techniques. It helps parents develop positive communication skills and appropriate discipline strategies. This therapy is likely to be helpful for parents of an adolescent with CD as it addresses the specific challenges they are facing in managing their child's behavior. Summary: B: Behavior modification therapy focuses on changing specific behaviors through reinforcement and punishment, but may not address the underlying parent-child relationship issues. C: Multi-systemic therapy (MST) targets multiple systems involved in the adolescent's life, but may not provide the direct skills and support needed for parents in managing their child's behavior at home. D: Pharmacotherapy involves medication and is not designed to help parents develop effective parenting skills.