A patient diagnosed with schizophrenia had an exacerbation of hallucinations and delusions related to medication non-adherence and was hospitalized for 10 days. The patient is stabilized and discharge is planned. The patient’s family is concerned that the patient’s symptoms will return after discharge. Acting as an advocate for the patient’s rights, the nurse’s best response is:
To contact the psychiatrist for an order to cancel the impending discharge
To notify hospital security to handle a potential disturbance and escort the family off the unit
To ask the case manager to arrange a transfer to a long-term care facility
To explain that the patient will continue to improve if the medication is taken regularly
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Flooding involves intense, immediate exposure to the feared stimulus, like elevators, overwhelming amygdala-driven fear responses. This contrasts with gradual exposure, which calms norepinephrine surges incrementally. Flooding is less controlled and riskier, making it incorrect for the described gradual relaxation technique.
Choice B reason: Systematic desensitization pairs gradual exposure to a fear, like elevators, with relaxation to reduce amygdala hyperactivity and norepinephrine-driven panic. This counterconditions fear responses, promoting calm neural pathways, aligning with the described technique and making it the correct choice for this therapeutic approach.
Choice C reason: Combination therapy involves multiple modalities, like medication and psychotherapy, not specifically gradual exposure with relaxation. The described technique targets phobia-specific amygdala responses, not a broad approach, making combination therapy too vague and incorrect for this targeted intervention.
Choice D reason: Cognitive restructuring modifies thought patterns, not exposure-based fear responses. While it addresses distorted beliefs, the described technique uses relaxation with gradual exposure to reduce norepinephrine-driven panic, not cognitive reframing, making this incorrect for the specific therapeutic method described.
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.
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