A client with schizophrenia has had 2 hospitalizations within the past 9 months due to non-adherence to medications and their counseling plan. What measures should the nurse and the mental health treatment team recommend for tertiary prevention? (Select All That Apply)
Recommend the client distance themselves from people who knew them before their diagnosis.
Provide the client with a multi-step written plan to follow if auditory hallucinations occur.
Risperidone as a depot formulation every 2 weeks.
Increase white bread and bananas to help with anticholinergic symptoms.
Assist the client to enroll in a program of assertive community treatment.
Correct Answer : B,C,E
Choice A Reason:
Recommending the client distance themselves from people who knew them before their diagnosis is not a suitable measure for tertiary prevention. Tertiary prevention aims to reduce the impact of an ongoing illness by helping patients manage long-term, complex health problems and injuries. It focuses on improving quality of life and reducing symptoms. Distancing from familiar people could lead to social isolation, which might worsen the client’s condition.
Choice B Reason:
Providing the client with a multi-step written plan to follow if auditory hallucinations occur is a practical measure for tertiary prevention. This plan can help the client manage symptoms effectively and reduce the likelihood of hospitalization. It empowers the client to take control of their symptoms and provides clear steps to follow during a crisis, which can be crucial for maintaining stability.
Choice C Reason:
Risperidone as a depot formulation every 2 weeks is an effective measure for ensuring medication adherence in clients with schizophrenia. Depot formulations are long-acting injections that help maintain consistent medication levels in the body, reducing the risk of relapse due to missed doses. This approach is particularly beneficial for clients who have difficulty adhering to daily oral medication regimens.
Choice D Reason:
Increasing white bread and bananas to help with anticholinergic symptoms is not a recommended measure for managing schizophrenia. While diet can play a role in overall health, there is no evidence to suggest that these specific foods help with anticholinergic symptoms. Anticholinergic symptoms are typically managed with medications and other medical interventions.
Choice E Reason:
Assisting the client to enroll in a program of assertive community treatment (ACT) is a highly effective measure for tertiary prevention. ACT provides comprehensive, community-based psychiatric treatment, rehabilitation, and support to individuals with serious and persistent mental illnesses. This approach helps clients manage their symptoms, adhere to treatment plans, and reduce the risk of hospitalization by providing continuous, personalized care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
The statement “Autonomy” is correct. Autonomy is the ethical principle that respects an individual’s right to make their own decisions and act on their own values. By allowing clients to choose whether or not to attend group therapy, the unit manager is preserving the clients’ autonomy. This approach acknowledges the clients’ ability to make informed decisions about their own treatment and respects their personal preferences and values1. Autonomy is a fundamental principle in healthcare, emphasizing the importance of respecting patients’ rights to self-determination.
Choice B Reason:
The statement “Justice” is incorrect. Justice refers to the ethical principle of treating individuals fairly and equitably. While justice is an important consideration in healthcare, the policy of allowing clients to choose whether or not to attend group therapy is more directly related to respecting their autonomy rather than ensuring equitable treatment. Justice would be more relevant in ensuring that all clients have equal access to group therapy sessions and resources.
Choice C Reason:
The statement “Beneficence” is incorrect. Beneficence is the ethical principle that involves acting in the best interest of the client and promoting their well-being. While encouraging group therapy can be seen as an act of beneficence, the specific policy of allowing clients to choose whether or not to attend is more aligned with respecting their autonomy. Beneficence focuses on doing good for the client, whereas autonomy emphasizes the client’s right to make their own choices.
Choice D Reason:
The statement “Veracity” is incorrect. Veracity refers to the ethical principle of truthfulness and honesty in interactions with clients. While veracity is crucial in maintaining trust and transparency in the therapeutic relationship, the policy of allowing clients to choose whether or not to attend group therapy is primarily about respecting their autonomy. Veracity would be more relevant in ensuring that clients are fully informed about the benefits and potential risks of group therapy.
Correct Answer is C
Explanation
Choice A Reason: Assess regularly for self-harm during treatment
Regular assessment for self-harm is crucial in any psychiatric care plan, especially for clients with conversion disorder who may experience significant distress. However, this action alone does not address the underlying issues or provide the client with tools to manage their symptoms. Continuous monitoring is important, but it should be part of a broader, more comprehensive care plan.
Choice B Reason: Allow for unlimited discussion on physical symptoms
While it is important to validate the client’s experiences and provide a space for them to discuss their symptoms, allowing unlimited discussion can sometimes reinforce the symptoms and lead to increased focus on physical complaints. This approach may not be beneficial in the long term and can detract from addressing the psychological aspects of the disorder.
Choice C Reason: Discuss alternative coping strategies with the client
This is the correct answer. Discussing alternative coping strategies helps the client develop skills to manage their symptoms more effectively. Techniques such as cognitive-behavioral therapy (CBT), relaxation exercises, and stress management can be very beneficial. These strategies empower the client to handle stress and reduce the impact of their symptoms. Providing education on coping mechanisms is a proactive approach that can lead to better outcomes.
Choice D Reason: Encourage alone time for the client in seclusion
Encouraging alone time in seclusion is generally not recommended for clients with conversion disorder. Seclusion can increase feelings of isolation and distress, potentially exacerbating symptoms. Instead, supportive and interactive interventions are preferred to help the client feel connected and understood.
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