A client with bipolar disorder is admitted to the psychiatric unit. The client is talking loudly, walking back and forth rapidly, and exhibiting a short attention span. Which nursing intervention should occur first?

Choice A reason: The first priority is to reduce environmental stimuli. Clients in manic states are highly sensitive to stimulation, which can worsen agitation and distractibility. A calm, low-stimulation environment helps stabilize behavior. Choice B reason: Feedback about behavior may be helpful later, but in acute mania, the client’s ability to process feedback is impaired. Immediate environmental control is more effective. Choice C reason: Explaining rules and policies is important, but during acute mania, the client cannot focus or retain complex information. This intervention is not appropriate as the first step. Choice D reason: Introducing the client to staff increases stimulation and may worsen agitation. This should be delayed until the client is calmer.