A nurse is caring for a client who is involuntarily admitted for major depressive disorder and refuses to take a prescribed oral antianxiety medication. Which of the following actions should the nurse take?

Implement consequences until the client takes the medication.

Inform the client that he does not have the right to refuse the medication.

Offer the client the medication at the next scheduled dose time.

Administer the medication to the client via IM injection.

Answer and Explanation

The Correct Answer is C

A. Implement consequences until the client takes the medication:
Punitive measures should never be used in healthcare, especially in the context of mental health treatment. Coercion and punitive consequences can lead to mistrust and hinder the therapeutic relationship, which is crucial in mental health care.

B. Inform the client that he does not have the right to refuse the medication:
While it's important for the client to understand the potential consequences of refusing medication, it's also crucial to respect the client's autonomy and right to make decisions about their own treatment. Involuntary admission doesn't negate the individual's right to be informed and involved in their care decisions to the extent they are able.

C. Offer the client the medication at the next scheduled dose time:
Respecting the client's autonomy is a fundamental ethical principle in nursing care. The nurse should continue to offer the medication to the client at the scheduled times. It's essential to maintain open communication with the client, addressing concerns and attempting to build trust, which can sometimes lead to the client accepting the medication voluntarily.

D. Administer the medication to the client via IM injection:
Administering medication against a patient's will is ethically and legally questionable without proper authorization, especially if the patient is not an immediate danger to themselves or others. This approach should be avoided whenever possible.

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Correct Answer is D

Explanation

A. Increased time sleeping:
Increased time sleeping alone is not a specific or direct indicator of PTSD. However, changes in sleep patterns are common in individuals with PTSD, with symptoms like nightmares, insomnia, and disturbances in sleep. These disturbances can lead to increased time in bed, but this alone is not a definitive sign of PTSD.

B. Inability to express empathy:
Inability to express empathy is a complex issue and could be related to various emotional or psychological factors. While people with PTSD can experience difficulties in interpersonal relationships, including issues with empathy, this alone is not a specific indicator of the disorder. PTSD primarily involves symptoms related to re-experiencing trauma, avoidance, negative mood changes, and arousal symptoms.
C. Auditory hallucinations:
Auditory hallucinations, which involve hearing voices or sounds that others do not, are not typically associated with PTSD. This symptom is more commonly linked to conditions like schizophrenia or other psychotic disorders, but it is not specific to PTSD.

D. Difficulty concentrating:
Difficulty concentrating is a common and well-recognized symptom of PTSD. Individuals with PTSD often struggle with focus, memory, and attention due to the intrusion of traumatic thoughts and memories. This symptom can significantly impact their daily functioning and is one of the hallmark features of the disorder.

A. Buprenorphine B. Naltrexone C. Disulfiram D. Bupropion

Correct Answer is B

Explanation

A. Buprenorphine:
Buprenorphine is a medication used in the treatment of opioid dependence. It acts on the same receptors in the brain as opioids, helping to reduce cravings and withdrawal symptoms in individuals recovering from opioid addiction. It is not typically used for alcohol withdrawal.

B. Naltrexone:
Naltrexone is an opioid receptor antagonist used in the treatment of alcohol dependence. It works by blocking the effects of endorphins, the body's natural opioids. In the context of alcohol dependence, it reduces the rewarding effects of alcohol and decreases the craving for alcohol. Naltrexone can be prescribed for individuals experiencing acute manifestations of alcohol withdrawal as part of a comprehensive treatment plan.

C. Disulfiram:
Disulfiram is a medication that causes unpleasant symptoms (such as nausea, vomiting, and flushing) when alcohol is consumed. It works as a deterrent, discouraging individuals from drinking alcohol by creating a negative reaction. Disulfiram is used as a part of comprehensive alcohol treatment programs to help maintain abstinence. It is not typically used for acute alcohol withdrawal symptoms.

D. Bupropion:
Bupropion is an antidepressant medication that is also used to aid smoking cessation. It helps reduce withdrawal symptoms and the urge to smoke. While it is not used specifically for alcohol withdrawal, individuals with alcohol dependence often have higher rates of tobacco use. Bupropion might be prescribed to address both smoking cessation and depressive symptoms in individuals with alcohol dependence, but it does not directly address alcohol withdrawal.

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