A nurse is working with a patient diagnosed with schizophrenia who is experiencing auditory hallucinations. Which intervention best supports the patient in managing these symptoms?
Encourage the patient to argue with the voices to challenge their validity
Teach the patient distraction techniques, such as listening to music
Administer an additional dose of antipsychotic medication without consulting the prescriber
Advise the patient to ignore the hallucinations and focus on daily tasks
The Correct Answer is B
Choice A reason: Encouraging the patient to argue with auditory hallucinations can escalate distress and reinforce engagement with the voices, which is non-therapeutic in schizophrenia management. Evidence-based practice emphasizes reducing focus on hallucinations through coping strategies, not confrontation, making this choice incorrect.
Choice B reason: Teaching distraction techniques, like listening to music, is an evidence-based non-pharmacological intervention for managing auditory hallucinations. It helps shift attention away from the voices, reducing their intensity and promoting coping, aligning with psychiatric nursing principles, making this the correct choice.
Choice C reason: Administering an additional dose of antipsychotic medication without prescriber consultation violates nursing scope of practice and safety protocols. It risks toxicity and side effects, such as extrapyramidal symptoms, making this choice unsafe and incorrect for managing hallucinations.
Choice D reason: Advising the patient to ignore hallucinations is oversimplified and often ineffective, as it dismisses the distress caused by symptoms. This approach lacks therapeutic support and does not provide practical coping strategies, making it less appropriate than teaching distraction techniques.
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Related Questions
Correct Answer is C
Explanation
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.
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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