In a team meeting, a nurse says, "I’m concerned about whether we are behaving ethically by using restraints to prevent one patient from self-mutilation, while the care plan for another self-mutilating patient requires one-on-one supervision." Which ethical principle most clearly applies to this situation?

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.

Choice A reason: Living in a shelter for 2 years indicates survival but not necessarily resilience, which involves active adaptation and recovery. Prolonged displacement may reflect limited coping, making this choice less indicative of high resilience compared to maintaining relationships.

Choice B reason: Maintaining relationships after significant loss demonstrates resilience, reflecting emotional strength and adaptive coping. Social connections buffer stress and promote recovery, aligning with psychological resilience models, making this the correct choice for the highest resilience level.

Choice C reason: Becoming depressed after a spouse’s death is a normal grief response but indicates lower resilience, as it suggests difficulty adapting. Resilience involves recovering from adversity, not succumbing to depression, making this choice incorrect.

Choice D reason: Taking a temporary job shows problem-solving but is less indicative of resilience than maintaining relationships, which reflects emotional and social adaptation. Financial stability is one aspect, but relational resilience is broader, making this choice less optimal.