A nurse is preparing to administer diphenhydramine 50 mg PO every 6 hr to a client who has acute dystonia. The available medication is diphenhydramine 25 mg tablets.

How many tablets should the nurse administer per dose?

Choice A rationale: Refusal of medication due to paranoia is not typically associated with conversion disorder. Paranoia is more commonly seen in disorders such as schizophrenia or paranoid personality disorder.

Choice B rationale: Preoccupation with manifestations of various illnesses is a characteristic of somatic symptom disorder, not conversion disorder. In somatic symptom disorder, individuals are excessively worried about having a serious illness, despite having no or only mild symptoms.

Choice C rationale: Frequent manic episodes are a hallmark of bipolar disorder, not conversion disorder. Manic episodes involve periods of extreme high energy or mood.

Choice D rationale: Conversion disorder, also known as functional neurological symptom disorder, is characterized by the presence of neurological symptoms, such as the loss of a sensory or motor function, that cannot be explained by medical evaluation. Symptoms can include seizures, weakness or paralysis, or reduced input from one or more senses. Therefore, an involuntary loss of a sensory function or a motor function with no underlying neurologic pathology is an expected finding in a client diagnosed with conversion disorder.

Choice A rationale: Clients who are admitted involuntarily cannot be hospitalized for as long as the provider deems necessary. There are legal and ethical guidelines that dictate the length and conditions of involuntary hospitalization. These guidelines vary by jurisdiction, but they generally require periodic review and reevaluation of the client’s condition and the necessity of continued hospitalization.

Choice B rationale: Clients cannot be given medications against their will under normal circumstances. Informed consent is a fundamental right in healthcare, including mental health care. This means that clients have the right to be fully informed about the potential benefits, risks, and alternatives of a proposed treatment, and to make an informed decision about whether to accept or refuse the treatment. There are exceptions in emergency situations where the client poses an immediate danger to self or others, but these are governed by strict legal and ethical guidelines.

Choice C rationale: Clients who are involuntarily admitted do have the right to informed consent. This means that even if a client is admitted to a mental health facility against their will, they still have the right to be informed about their treatment and to make decisions about their care. This includes the right to be informed about the potential benefits, risks, and alternatives of proposed treatments, and the right to refuse treatment.

Choice D rationale: The laws regarding restraints are not different for clients who are admitted involuntarily. Restraints can only be used as a last resort when less restrictive interventions have failed and the client poses an immediate danger to self or others. The use of restraints is governed by strict legal and ethical guidelines, and these apply to all clients, regardless of whether they were admitted voluntarily or involuntarily.