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 D
Explanation
Choice A reason: Trust versus mistrust, Erikson's first psychosocial stage (0–1 year), focuses on developing trust in caregivers for basic needs. Failure leads to fear and suspicion, not feelings of worthlessness or insignificance. These symptoms do not align with the adult’s statements about opinions not counting, making this choice scientifically inaccurate for the described crisis.
Choice B reason: Autonomy versus shame and doubt, Erikson’s second stage (1–3 years), involves gaining independence in actions like self-care. Failure results in shame and self-doubt about autonomy, not a broader sense of worthlessness or lack of influence. This stage is unrelated to the adult’s expressed feelings, rendering this choice incorrect.
Choice C reason: Initiative versus guilt, the third stage (3–6 years), centers on initiating activities and asserting control. Failure leads to guilt over actions, not a diminished sense of self-worth or influence. The adult’s statements reflect identity struggles, not guilt from initiative, so this choice does not fit the psychosocial crisis described.
Choice D reason: Identity versus role confusion, Erikson’s fifth stage (12–18 years), involves forming a cohesive self-identity. Failure leads to role confusion, low self-esteem, and feelings of insignificance, directly aligning with the adult’s statements about having no answers and opinions not counting. This unresolved crisis persists into adulthood, making this the correct choice.
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