Walking down the aisle of a local grocery store, a nurse encounters a client the nurse has recently cared for on an inpatient psychiatric setting. Which is the appropriate reaction by the nurse?

Correct Answer: D

Rationale: The correct answer is D because making eye contact and responding if the client engages maintains professionalism and acknowledges the client's presence without compromising confidentiality. It shows respect and empathy, which are important in nursing practice. A: Inquiring about the client's well-being can breach confidentiality and may not be appropriate in a public setting. B: Ignoring the client can be seen as rude and may harm the therapeutic relationship. C: Talking to the client without using names may still breach confidentiality and does not fully acknowledge the client's presence.

Correct Answer: D

Rationale: The correct answer is D because the phase of the nurse-client relationship involving reviewing the client's record is the orientation phase. In this phase, the nurse gathers information about the client's diagnosis, health history, and current care needs to understand the client's situation. This phase focuses on setting goals, exploring attitudes, and establishing a plan of care based on the client's needs. It is essential for the nurse to understand the client's diagnosis to provide effective care. Choice A (Getting to know each other and establishing trust) is typically associated with the initial phase of the relationship, not specifically related to reviewing records. Choice B (Implementing nursing interventions to achieve outcomes) is part of the working phase, where interventions are carried out. Choice C (Achievement of independence and maintenance of health without nursing care) is more aligned with the termination phase, where the client achieves independence.

Correct Answer: C

Rationale: The correct answer is C: Caregiver Role Strain related to social isolation. The priority nursing diagnosis addresses the wife's current state of distress due to social isolation, which can impact her ability to provide care for the client. This diagnosis directly addresses her feelings of being overwhelmed and unable to fulfill her caregiving role effectively. In contrast, option A focuses on family coping, which is secondary to the wife's immediate need for support. Option B is not as relevant since it does not address the wife's emotional and psychological stress. Option D refers to the client's emotional state rather than the wife's, making it less of a priority in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Lithium. Lithium is considered the gold standard for treating bipolar disorder due to its proven efficacy in reducing manic episodes and preventing relapse. It has been used for decades and has a well-established track record. Additionally, lithium has a unique mechanism of action in stabilizing mood by modulating neurotransmitters. Carbamazepine, valproate, and lamotrigine are also used in treating bipolar disorder, but they are not considered the gold standard like lithium. Carbamazepine and valproate are typically used as alternative options or in combination with other medications, while lamotrigine is often used for bipolar depression rather than mania.

Correct Answer: B

Rationale: The correct answer is B because the scenario indicates that time-out is no longer effective for April. The fact that April's mother puts her in time-out up to 20 times a day suggests overuse, leading to desensitization. This renders time-out ineffective as a therapeutic tool. April's increasing agitation and lack of self-control despite time-outs indicate the need for a different approach. Choices A and C are incorrect because they assume time-out is still effective, which contradicts the scenario. Choice D is incorrect as seclusion and restraint should only be considered as a last resort due to ethical and safety concerns.