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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C"]
Explanation
Choice A reason: Bupropion is not primarily a sedative; it is an atypical antidepressant that stimulates norepinephrine and dopamine. It may cause insomnia, not promote sleep, making this statement incorrect. Sedative medications like zolpidem are used for sleep, not bupropion, which has activating properties.
Choice B reason: Bupropion has a lower risk of sexual dysfunction compared to SSRIs, making it a suitable alternative for depression treatment in patients experiencing this side effect. Its mechanism avoids serotonin-related sexual issues, supporting its use in such cases, making this a correct choice.
Choice C reason: Bupropion is FDA-approved for major depressive disorder, acting on norepinephrine and dopamine to alleviate depressive symptoms. It is commonly prescribed for depression, making this statement true and a correct choice, as it aligns with its primary clinical use.
Choice D reason: Bupropion, under the brand Zyban, is approved for smoking cessation, as it reduces nicotine cravings and withdrawal symptoms by modulating dopamine pathways. This evidence-based use makes the statement true, correctly identifying bupropion’s role in smoking cessation programs.
Correct Answer is B
Explanation
Choice A reason: Weight gain and metabolic changes are side effects of clozapine, primarily due to its antihistaminic and serotonergic effects, not its dopaminergic action. Dopamine blockade is more associated with movement disorders, making this choice incorrect for teaching related to dopaminergic effects.
Choice B reason: Clozapine’s strong dopaminergic effect, particularly D2 receptor blockade, can cause extrapyramidal symptoms like tardive dyskinesia, a movement disorder. Patient education must emphasize monitoring for abnormal movements, as these are significant risks in antipsychotic therapy, making this the correct choice.
Choice C reason: Infection risk, particularly agranulocytosis, is a serious clozapine side effect but is unrelated to its dopaminergic action. It stems from bone marrow suppression, requiring blood monitoring, not dopamine-related teaching, making this choice incorrect for the question’s focus.
Choice D reason: Improved mood is not a direct result of clozapine’s dopaminergic effect, which primarily addresses psychotic symptoms. Mood changes occur over weeks and involve multiple receptors, not just dopamine, making this choice incorrect for dopaminergic-focused teaching.
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