An adolescent acts out in disruptive ways. When this adolescent threatens to throw a heavy pool ball at another adolescent, which comment by the nurse would set appropriate limits?

Correct Answer: C

Rationale: The correct answer is C because it directly addresses the behavior of the adolescent by instructing them not to throw the ball and to put it back on the pool table. This sets a clear limit on the inappropriate behavior and provides a specific directive for the adolescent to follow. Choice A does not address the behavior or set limits. Choice B mentions consequences but does not guide the adolescent on what to do instead. Choice D is too vague and does not provide a clear direction for the adolescent to follow. Therefore, choice C is the most appropriate response in this situation.

Correct Answer: C

Rationale: The correct answer is C, as medication is not typically the first line of treatment for Oppositional Defiant Disorder (ODD). The nurse should educate the parents on the importance of behavioral strategies as the primary intervention. Medications are usually reserved for cases where behavioral approaches have not been effective or for co-occurring conditions. Option A is too absolute and dismissive. Option B is a general statement and does not address the specific situation. Option D provides inaccurate information by suggesting that medications are the main solution without considering other interventions. By selecting option C, the nurse acknowledges the parents' concerns while redirecting the focus towards more appropriate strategies for managing ODD.

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.