A nurse is assessing a client during a follow-up visit at a behavioral health clinic. The client reports that they have not been taking the prescribed antipsychotic medication on a regular basis. Which of the following actions should the nurse take to improve medication adherence?

Discuss the provider's goals for the client's care.

Ask the client if the medication is causing adverse effects.

Tell the client they will be admitted to an inpatient care facility if they do not take the medication.

Request the provider prescribe a second antipsychotic medication to the client.

Answer and Explanation

The Correct Answer is B

A. Discuss the provider's goals for the client's care:
Discussing the provider's goals is essential, but it may not directly address the client's concerns about medication adherence. While these goals are important for the overall care plan, it's crucial to first engage in a conversation with the client about their specific issues and challenges related to taking the prescribed medication. The client's perspective and concerns should be a priority.

B. Ask the client if the medication is causing adverse effects:
This is the recommended choice. Inquiring about adverse effects is important to understand the client's experience with the medication. Some clients may discontinue their medication due to intolerable side effects. By addressing this concern, the nurse can provide education, seek potential solutions, and collaborate with the healthcare team to adjust the medication or dosage. Open communication helps to identify and mitigate barriers to medication adherence.

C. Tell the client they will be admitted to an inpatient care facility if they do not take the medication:
This choice involves a coercive and threatening approach. It's not an ethical or therapeutic method to promote medication adherence. Threatening involuntary hospitalization can create fear and mistrust, potentially leading to further non-compliance and damaging the therapeutic relationship. It should be avoided.

D. Request the provider prescribe a second antipsychotic medication to the client:
This option is not appropriate at this stage. Adding another medication without addressing the underlying issue of non-adherence and without assessing the client's response to the current medication is not advisable. It can complicate the medication regimen, potentially worsen side effects, and doesn't address the primary concern, which is the client's non-adherence to their current medication. It's important to understand the reasons for non-adherence before considering additional medications.

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Correct Answer is C

Explanation

A. Long-term isolation: Long-term isolation, or social isolation, can lead to feelings of loneliness and depression. While prolonged isolation can contribute to mental health issues, it is not a direct risk factor for violent behavior. People who are socially isolated might suffer from emotional distress, but it doesn't necessarily make them violent.

B. Dysthymic disorder: Dysthymic disorder, also known as persistent depressive disorder, is a type of chronic depression. While individuals with dysthymic disorder may experience low moods and a lack of interest in activities, it doesn't inherently make them prone to violence. Depression is more likely to cause self-directed harm (such as self-harm or suicide) rather than violent behavior towards others.

C. Alcohol intoxication: Alcohol is a substance that impairs judgment and reduces inhibitions. When a person is intoxicated, they may act aggressively or violently, even in situations where they wouldn't normally do so. Alcohol intoxication can lead to a loss of control, impaired decision-making, and aggressive behavior, making it a significant risk factor for violent actions.

D. Schizoid personality disorder: Schizoid personality disorder is characterized by a lack of interest in social relationships, emotional coldness, and detachment. While individuals with this disorder may prefer to be alone and avoid social interactions, they are not necessarily prone to violent behavior. Schizoid personality disorder primarily affects social functioning rather than predisposing someone to violence.

A. Prepare the client for electroconvulsive therapy. B. Weigh the client twice per day. C. Encourage the client to participate in family therapy. D. Set a weight gain goal of 2.2 kg (4.9 lb) per week.

Correct Answer is C

Explanation

A. Prepare the client for electroconvulsive therapy:
Electroconvulsive therapy (ECT) is not a standard or appropriate treatment for anorexia nervosa. ECT is primarily used for severe depression, bipolar disorder, and certain other mental health conditions. Anorexia nervosa is typically managed through psychotherapy, nutritional counseling, and medical monitoring, often in an outpatient or inpatient setting, depending on the severity of the disorder.

B. Weigh the client twice per day:
Frequent weighing is generally discouraged in the treatment of anorexia nervosa. Individuals with this disorder often have an unhealthy fixation on their weight. Frequent weigh-ins can exacerbate anxiety, foster an unhealthy relationship with food and body image, and reinforce obsessive thoughts about weight and appearance. Healthcare providers should monitor weight and nutritional status regularly, but the frequency should be determined based on the individual's specific needs and in a manner that does not worsen their anxiety.

C. Encourage the client to participate in family therapy:
This is the appropriate choice. Family therapy is often a crucial component of the treatment plan for anorexia nervosa. It helps address family dynamics, communication patterns, and any dysfunctional relationships that might contribute to the eating disorder. Family therapy provides a supportive environment for both the individual with anorexia and their family members, aiding in understanding, coping, and healing.

D. Set a weight gain goal of 2.2 kg (4.9 lb) per week:
Setting specific weight gain goals can be counterproductive and potentially harmful for individuals with anorexia nervosa. Rapid or arbitrary weight gain goals may lead to unhealthy eating behaviors, excessive exercise, or other dangerous practices in an attempt to meet the goal quickly. Instead, healthcare providers focus on a more individualized and gradual approach to weight restoration, ensuring that it is safe, sustainable, and in line with the client's overall health and well-being.

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A nurse is assessing a client during a follow-up visit at a behavioral health clinic. The client reports that they have not been taking the prescribed antipsychotic medication on a regular basis. Which of the following actions should the nurse take to improve medication adherence?

Nursing Test Bank

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