A nurse is caring for patients receiving clozapine, lithium, fluoxetine, and venlafaxine. Which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance?

Choice A reason: Basic-level nurses, such as LPNs or RNs, can teach coping skills, a standard intervention within their scope. This involves education on stress management, aligning with psychiatric nursing roles to support patient and family well-being, making this the correct choice.

Choice B reason: Treating major depressive disorder requires advanced skills, like prescribing or managing complex therapies, which is beyond a basic-level nurse’s scope. This is typically reserved for advanced practice nurses or physicians, making this choice incorrect.

Choice C reason: Prescribing antidepressants is restricted to advanced practice nurses or physicians, not basic-level nurses. This task involves medical decision-making outside the scope of RNs or LPNs, making it unsafe and inappropriate, thus incorrect.

Choice D reason: Assessing suicide risk requires advanced clinical judgment, often reserved for advanced practice nurses or psychiatrists. While basic-level nurses can observe and report, formal assessment exceeds their scope, making this choice incorrect for their role.

Choice A reason: Autonomy involves respecting a patient’s right to make decisions. While relevant in mental health, the scenario focuses on differing treatments for similar conditions, not patient choice, making autonomy less directly applicable than the principle of fair treatment across patients.

Choice B reason: Beneficence emphasizes promoting patient well-being. Both restraints and supervision aim to prevent harm, fulfilling beneficence, but the concern is about unequal treatment, not the intent to benefit, making this principle less relevant than justice.

Choice C reason: Justice involves fair and equitable treatment for all patients. Using restraints for one self-mutilating patient and supervision for another raises concerns about consistency and fairness in care, directly aligning with the ethical principle of justice, making this the correct choice.

Choice D reason: Nonmaleficence focuses on avoiding harm. Both interventions aim to prevent self-mutilation, fulfilling this principle, but the ethical issue is about equitable application, not harm avoidance, making justice the more relevant principle in this scenario.