The nurse is taking the history of a patient found in the street trying to stop traffic. The patient admits to multiple recent long episodes of severe depression. Then, 12 days ago, the patient described feeling elated and “on top of the world.” He recounts many days planning far-reaching projects that would “change the world,” and required only an hour of sleep once or twice. Patient is talking continuously in a rapid, rushed manner and cannot seem to complete a thought without jumping to the next. He sometimes sees things that others do not see. The nurse anticipates which diagnosis?

The patient reports being hungry prior to the breakfast tray delivery. When the nurse checks on the patient an hour after the tray was delivered, the nurse notes the patient has not eaten any of the food. Which initial nursing action is most appropriate? 

The nurse notes the patient’s nails appear to curl upwards like spoons. Which statement by the nurse is most appropriate?