# 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?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=505790&lang=en  
> language: en  
> subject: Psychosocial Integrity  
> category: PSI

## 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?

## Option

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."

**Correct answer: 3**

## 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.

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