Substance Abuse and Abuse Q 14
The nurse assesses a client with the admitting diagnosis of bipolar affective disorder, mania. The symptom presented by the client that requires the nurse’s immediate intervention is the client’s:
A. Outlandish behaviors and inappropriate dress.
B. Grandiose delusions of being a royal descendant of King Arthur.
C. Nonstop physical activity and poor nutritional intake.
D. Constant, incessant talking that includes sexual innuendos and teasing the staff.
Correct Answer: C. Nonstop physical activity and poor nutritional intake.
Mania is a mood characterized by excitement, euphoria, hyperactivity, excessive energy, decreased need for sleep, and impaired ability to concentrate or complete a single train of thought. Mania is a period when the mood is predominately elevated, expansive, or irritable. All options reflect a client’s possible symptomatology. Option C, however, clearly presents a problem that compromises one’s physiological integrity and needs to be addressed immediately.
Option A: One of the criteria for diagnosing a manic or hypomanic episode of bipolar disorder is what we call an expansive mood. Individuals with an expansive mood may behave rashly or lavishly, assume a superior or grandiose attitude, or dress and act flamboyantly. They exhibit larger-than-life behaviors that can often be accompanied by (or result in) extreme bursts of irritability.
Option B: A delusion of grandeur is the false belief in one’s own superiority, greatness, or intelligence. People experiencing delusions of grandeur do not just have high self-esteem; instead, they believe in their own greatness and importance even in the face of overwhelming evidence to the contrary. Someone might, for example, believe they are destined to be the leader of the world, despite having no leadership experience and difficulties in interpersonal relationships. Delusions of grandeur are characterized by their persistence. They are not just moments of fantasy or hopes for the future.
Option D: The defining characteristics of mania are increased talkativeness, rapid speech, decreased the need for sleep (unlike depression or anxiety in which the need for sleep exists, but there is an inability to sleep), racing thoughts, distractibility, increase in goal-directed activity, and psychomotor agitation. Some other hallmarks of mania are an elevated or expansive mood, mood lability, impulsivity, irritability, and grandiosity.