A client, brought to the mental health unit by police, had been ...

[leilurhhh]

A client, brought to the mental health unit by police, had been directing traffic and shouting rhymes
  on a busy city street. Her husband reported that she had stopped taking her lithium 3 weeks ago and
  had not slept or eaten for 3 days.
 
  She was dressed in a red leotard, an exercise bra, and an assortment
  of chains and brightly colored scarves on her head, waist, wrists, and ankles. Her first words to the
  nurse were I'll punch you, munch you, crunch you, as she danced into the room, shadow boxing.
  Then she shook the nurse's hand and said gaily, We need to become better acquainted. I have the
  world's greatest intellect and you are probably an intellectual midget.. The nurse should assess the
  client's mood as
  a. irritable and belligerent.
  b. excessively happy and confident.
  c. unstable and unpredictable.
  d. highly suspicious and haughty.

Question 2

A newly admitted client diagnosed with paranoid schizophrenia is hypervigilant and constantly
  scans the environment. He states that he saw two doctors talking in the hall and knows they were
  plotting to kill him.
 
  The nurse may correctly assess this behavior as
  a. an idea of reference.
  b. a delusion of infidelity.
  c. an auditory hallucination.
  d. echolalia.

[mmj22343]

Answer to Question 1

C
The client has demonstrated angry behavior and pleasant, happy behavior within seconds of each
other. Mood swings are often rapid and seemingly without understandable reason in manic clients.
Options A and B are not entirely correct. Option D is not described in the scenario.

Answer to Question 2

A
Ideas of reference are misinterpretations of the verbalizations or actions of others that give special
personal meanings to these behaviors; for example, seeing two people talking, the individual
assumes they are talking about him or her. The other behaviors do not correspond with the scenario.