An 11-year-old diagnosed with ODD becomes angry over the rules at a residential treatment program and begins shouting at the nurse. What is the nurse's initial action to defuse the situation?

Correct Answer: B

Rationale: The correct initial action for the nurse to defuse the situation with the 11-year-old diagnosed with ODD is to take the child swimming at the facility's pool (Choice B). This action can help the child release pent-up emotions through physical activity, providing a positive outlet for their anger. Swimming can also have a calming effect on the child's nervous system, promoting relaxation and reducing stress levels. By engaging in a fun and physical activity, the child may be able to regulate their emotions and behavior more effectively than discussing feelings or establishing a behavioral contract in the heat of the moment. Administering an anxiolytic medication (Choice D) should not be the initial response as it does not address the root cause of the behavior, and it is important to try non-pharmacological interventions first. Choices A and C may be helpful in the long term but are not as immediate or appropriate in this situation.

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: D

Rationale: The correct answer is D: Zyprexa calms hyperactivity until the Eskalith takes effect. Olanzapine (Zyprexa) is an atypical antipsychotic that helps control manic symptoms quickly, providing immediate relief from hyperactivity while waiting for lithium carbonate (Eskalith) to reach therapeutic levels. It is essential to address the severe manic behaviors promptly to prevent potential harm to the client or others. Choices A, B, and C are incorrect. A: Zyprexa does not cure manic symptoms; it helps manage symptoms. B: Zyprexa is not primarily used to prevent extrapyramidal side effects; it is more for managing acute manic episodes. C: Zyprexa may or may not directly ensure a good night's sleep; its primary purpose is to manage manic symptoms.

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.