A nurse is caring for a hospitalized client with bipolar I d… | MyMerci
Psychosocial IntegrityPSI
Question
A nurse is caring for a hospitalized client with bipolar I disorder who is in an acute manic episode. The client is pacing rapidly, speaking loudly, and demanding to use the phone to call a business partner at 2 a.m. Which response by the nurse is most appropriate?
1"Let's discuss your business ideas in the morning group session."
2"You cannot use the phone now; it is against unit rules."
3"It is nighttime now. Let's walk to the quiet room and talk."✓ Correct answer
4"If you calm down, I will let you use the phone."
Explanation
The correct response uses a brief, clear, calm statement that sets a consistent limit ("It is nighttime now") and redirects the client to a less stimulating environment ("Let's walk to the quiet room and talk"). This approach reduces stimulation and avoids arguing or lengthy discussion. Suggesting a group session is inappropriate because group activities can be overstimulating for a client in acute mania. Stating a rule without redirection may escalate the client's agitation. Bargaining with the client ("If you calm down, I will let you use the phone") is inconsistent and may reinforce manipulative behavior.