A nurse is conducting a mental health assessment for a patient reporting persistent feelings of hopelessness. Which intervention best aligns with evidence-based practice for addressing this symptom?
Recommend immediate electroconvulsive therapy
Initiate cognitive behavioral therapy techniques
Administer a high-dose benzodiazepine
Encourage the patient to avoid social interactions
The Correct Answer is B
Choice A reason: Electroconvulsive therapy (ECT) is reserved for severe, treatment-resistant depression or acute suicidal ideation, not general hopelessness. It involves significant risks and requires specialist oversight, making it inappropriate as a first-line intervention for this symptom, which can be addressed with less invasive methods.
Choice B reason: Cognitive behavioral therapy (CBT) targets negative thought patterns, such as hopelessness, by restructuring cognitions, a core feature of depression. Evidence-based for mood disorders, CBT reduces symptoms through structured interventions, making it the most appropriate choice for addressing hopelessness in a mental health assessment.
Choice C reason: High-dose benzodiazepines treat acute anxiety or agitation, not hopelessness, which is a depressive symptom. They risk sedation and dependence without addressing cognitive distortions, making them inappropriate for this symptom and contrary to evidence-based psychiatric nursing practice.
Choice D reason: Avoiding social interactions may worsen hopelessness by increasing isolation, a risk factor for depression. Evidence-based practice encourages social engagement to improve mood and support networks, making this intervention counterproductive and incorrect for addressing the patient’s reported symptom.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A 16-year-old voluntarily admitted for mental health treatment has the legal right to refuse treatment, as voluntary admission implies consent and autonomy. Minors may have limited rights, but voluntary status allows refusal unless overridden by guardianship or legal statutes, making this the correct choice.
Choice B reason: A 20-year-old with court-ordered treatment lacks the legal right to refuse, as a court mandate overrides autonomy due to assessed risk or incapacity. Legal frameworks prioritize compliance in such cases to ensure safety and treatment efficacy, making this choice incorrect.
Choice C reason: A 35-year-old involuntarily admitted client cannot refuse treatment, as involuntary admission indicates a legal determination of danger or incapacity. Mental health laws prioritize intervention over autonomy in these cases to protect the client or others, making this choice incorrect.
Choice D reason: An adult refusing life-threatening treatment may face legal restrictions, as mental health laws can override refusal if the client poses a danger or lacks capacity. This scenario does not clearly grant a legal right to refuse, unlike voluntary admission, making this choice incorrect.
Correct Answer is C
Explanation
Choice A reason: Discussing patient history with staff during care planning is permissible under HIPAA for treatment purposes. It ensures coordinated care within the healthcare team, not violating privacy, as it is limited to professional need-to-know, making this choice incorrect.
Choice B reason: Documenting daily behavior is standard practice in medical records for treatment continuity and legal documentation. It is protected under confidentiality laws and does not breach privacy when restricted to authorized personnel, making this choice incorrect for a privacy violation.
Choice C reason: Releasing information to an employer without consent violates HIPAA, which mandates patient authorization for disclosures outside treatment, payment, or operations. This breaches confidentiality, compromising the patient’s right to privacy, making this the correct choice for a privacy violation.
Choice D reason: Asking family for pre-hospitalization information is appropriate if done with patient consent or legal justification, such as assessing history for treatment. Without evidence of unauthorized disclosure, this does not inherently breach privacy, making this choice incorrect.
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