A nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?

Remain silent and add the suggested outcome to the plan

Formulate a more appropriate outcome without the patient’s input

Explore with the patient possible consequences of the outcome

Educate the patient that the outcome is not realistic

Answer and Explanation

The Correct Answer is C

Choice A reason: Silently adding an inappropriate outcome disregards patient safety and autonomy. Outcomes must align with neurobiological needs, like serotonin modulation for depression. This approach fails to engage the patient in decision-making, risking ineffective treatment and neglecting evidence-based collaborative care principles.

Choice B reason: Formulating outcomes without patient input violates autonomy. Collaborative goal-setting, considering neurobiological factors like dopamine imbalances, ensures patient engagement and effective treatment. Excluding the patient disregards their perspective, reducing adherence and therapeutic alliance, making this approach contrary to evidence-based psychiatric nursing.

Choice C reason: Exploring consequences respects autonomy while guiding patients toward safe outcomes. Discussing implications, like medication non-adherence worsening dopamine-driven symptoms, fosters informed decisions. This collaborative approach aligns with cognitive-behavioral principles and neurobiological treatment needs, ensuring effective, patient-centered care in psychiatric practice.

Choice D reason: Educating that an outcome is unrealistic may dismiss patient autonomy. While addressing neurobiological realities, like serotonin deficits, is important, unilateral education risks disengagement. Collaborative exploration of consequences is more effective, promoting informed choices and adherence, making this option less suitable than discussion.

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Correct Answer is C

Explanation

Choice A reason: Claiming all mental illnesses can be cured oversimplifies disorders like schizophrenia, which often involve chronic dopamine dysregulation in the prefrontal cortex and limbic system, requiring lifelong management. This approach ignores genetic predispositions and neurobiological complexities, potentially fostering false hope and stigma by implying recovery is universal, disregarding evidence of persistent symptoms in many cases.

Choice B reason: Highlighting creativity and freedom romanticizes mental illnesses, ignoring their debilitating effects. Disorders like bipolar disorder may show creativity in manic phases, but hypomania often impairs judgment and stability. Neuroimaging shows altered amygdala activity in such conditions, causing emotional dysregulation. This portrayal minimizes suffering and misrepresents the neurobiological basis, perpetuating misunderstanding and stigma.

Choice C reason: Correcting misperceptions educates about the neurobiological underpinnings of mental illnesses, such as serotonin imbalances in depression or GABA deficits in anxiety. By addressing myths, nurses promote understanding that these are medical conditions involving brain dysfunction, not personal failings. This fosters empathy, reduces stigma, and aligns with evidence-based approaches to mental health advocacy.

Choice D reason: Attributing most mental illnesses to substance use disorders is inaccurate. While substances can exacerbate symptoms, primary disorders like major depression involve genetic factors and altered neurotransmitter activity, such as reduced serotonin uptake. This oversimplification ignores distinct etiologies, risks misdiagnosis, and perpetuates stigma by blaming patients for their conditions, contrary to scientific evidence.

A. To contact the psychiatrist for an order to cancel the impending discharge B. To notify hospital security to handle a potential disturbance and escort the family off the unit C. To ask the case manager to arrange a transfer to a long-term care facility D. To explain that the patient will continue to improve if the medication is taken regularly

Correct Answer is D

Explanation

Choice A reason: Canceling discharge overrides patient autonomy and recovery progress. Stabilized schizophrenia, managed with antipsychotics targeting dopamine, supports discharge with adherence. This action disregards the patient’s rights and neurobiological stabilization, making it an inappropriate advocacy response.

Choice B reason: Notifying security dismisses family concerns and escalates unnecessarily. Schizophrenia management relies on medication adherence, not coercion. This approach ignores patient rights and family education needs, failing to address neurobiological treatment principles, making it incorrect for advocacy.

Choice C reason: Transferring to long-term care assumes ongoing instability, ignoring current stabilization. Antipsychotics correct dopamine imbalances, supporting outpatient management. This undermines patient autonomy and recovery potential, making it an inappropriate advocacy action for a stabilized patient.

Choice D reason: Explaining medication adherence promotes patient autonomy and recovery. Antipsychotics reduce dopamine-driven hallucinations, ensuring symptom control. Educating the family empowers support for adherence, aligning with patient rights and neurobiological treatment principles, making this the correct advocacy response.

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A nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

How can the mental health nurse best advocate for individuals with mental illness and prevent stigmatization?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

A patient with paranoia states, “The state is monitoring us through the listening devices hidden in this room. Be careful what you say.” Which response by the nurse would be most therapeutic?

Which of the following speech patterns is an example of tangential thinking?

What best explains the importance of epidemiology in understanding the impact of mental disorders?

After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?

A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.” The spouse reports that the patient smokes, coughs daily, has recently lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?

A client experiences panic attacks when confronted with riding in elevators. The nurse is teaching the client to use relaxation techniques while gradually exposing the client to getting on an elevator. Which technique is the nurse using?

After assessing the patient and formulating the nursing diagnoses for a plan of care, what is the next action a nurse should take?

The spouse of a patient who experiences delusions asks the nurse, “Are there any circumstances under which the treatment team is justified in violating the patient’s right to confidentiality?” What is the nurse’s best response?