A nurse is caring for a patient diagnosed with bipolar disorder during the manic phase. The patient is exhibiting rapid speech, impulsivity, and racing thoughts. What is the priority nursing intervention?

Correct Answer: A

Rationale: The correct answer is A: Provide a quiet and low-stimulation environment. During the manic phase of bipolar disorder, patients often experience heightened agitation and sensory overload. Creating a calm and low-stimulation environment can help reduce the intensity of their symptoms and promote relaxation. This intervention is crucial to prevent exacerbation of manic behaviors and potential harm to the patient or others. Summary: - Choice B: Encouraging social activities may further stimulate the patient, worsening manic symptoms. - Choice C: While medication is important, creating a calming environment is the immediate priority. - Choice D: Firm limits may provoke resistance and escalate the situation, rather than de-escalate it.

Correct Answer: B

Rationale: The correct answer is B because only advanced practice nurses, such as psychiatric nurse practitioners, have the authority to prescribe psychotropic medications. This action falls under their scope of practice and requires advanced education and training in pharmacology and mental health. Asking an advanced practice nurse to prescribe psychotropic medication ensures that patients receive appropriate and safe pharmacological interventions. A: Mental health assessment interviews can be performed by staff nurses, not limited to advanced practice nurses. C: Establishing therapeutic relationships is a fundamental nursing skill that all nurses, including staff nurses, should possess. D: Individualizing nursing care plans is a responsibility of all nurses and does not specifically require involvement of advanced practice nurses.

Correct Answer: A

Rationale: The correct answer is A: giving advice is rarely helpful. Providing unsolicited advice can undermine the patient's autonomy and decision-making process. It is important for the nurse to support the patient in exploring their options and making their own informed decisions. Choices B, C, and D are incorrect because giving advice does not necessarily foster independence, lift the burden of personal decision-making, or help the patient develop feelings of personal adequacy. Rather, it can limit the patient's ability to think critically and make their own choices.

Correct Answer: B

Rationale: The correct answer is B: Somatic complaints. In many Latin American cultures, individuals may express emotional distress through physical symptoms due to cultural beliefs and practices. This phenomenon is known as somatization. The patient from Honduras is likely to present with physical complaints as a way of expressing their emotional stress, as discussing mental health openly may be stigmatized in their culture. In contrast, options A, C, and D are less likely as they do not align as closely with cultural patterns of stress expression in this context. Motor restlessness, memory deficiencies, and sensory perceptual alterations are not typically associated with stress expression in this cultural background.

Correct Answer: B

Rationale: The correct answer is B. Going to bed a half-hour earlier would work better than sleeping later because it can help the patient establish a more consistent sleep schedule and potentially improve the quality of their sleep. By going to bed earlier, the patient may be able to address their chronic fatigue and feel more refreshed in the morning. Choice A is incorrect as suggesting sedatives may not address the underlying issue of poor sleep quality. Choice C is incorrect as alcohol consumption before bedtime can disrupt sleep patterns. Choice D is incorrect as exercising before bedtime may actually stimulate the body and make it harder to fall asleep.