1. A 25-year-old woman is admitted to the psychiatric unit with a diagnosis

of bipolar disorder, manic episode. She is restless, talkative, and has

grandiose ideas. She tells the nurse that she is a famous singer and she has a

concert tonight. The nurse should:

a) Agree with her and ask her to sing a song

b) Confront her with reality and tell her that she is not a singer

c) Ignore her statements and redirect her to another topic

d) Acknowledge her feelings and set limits on her behavior*

Rationale: The nurse should acknowledge the patient's feelings and set

limits on her behavior to prevent further escalation of mania and ensure

safety. Agreeing with her delusions or confronting her with reality may

increase her agitation and anxiety. Ignoring her statements may make her

feel rejected and isolated.

2. A 45-year-old man is brought to the emergency department by his wife,

who says he has been depressed and suicidal for the past two weeks. He

tells the nurse that he has a plan to kill himself by overdosing on his

antidepressants. He says he has no hope for the future and he feels

worthless and guilty. The nurse should:

a) Explore his suicidal plan and assess his level of risk*

b) Reassure him that everything will be okay and he has a lot to live for

c) Leave him alone in a quiet room to calm down

d) Give him a list of crisis hotline numbers and community resources

Rationale: The nurse should explore his suicidal plan and assess his level of

risk to determine the urgency of the situation and intervene accordingly.

Reassuring him or giving him a list of resources may not be helpful if he is

not ready to accept help or change his mind. Leaving him alone may

increase his chance of harming himself.

3. A 35-year-old woman is diagnosed with post-traumatic stress disorder

(PTSD) after being sexually assaulted by a stranger. She has nightmares,