In which situations would a nurse have the duty to intervene and report? (Select all that apply)

Choice A reason: Using coercive language, like stating attendance is mandatory for progress, undermines patient autonomy and may increase resistance, especially in a manic phase where defiance is common. This non-therapeutic approach hinders trust, making it incorrect for promoting engagement.

Choice B reason: Reporting refusal to the doctor without exploring the patient’s reasons dismisses their feelings and escalates authority rather than fostering collaboration. Therapeutic engagement requires understanding the patient’s perspective, making this response non-therapeutic and incorrect.

Choice C reason: Asking about the patient’s hesitation uses open-ended questioning, a therapeutic communication technique that encourages expression of feelings and builds trust. This aligns with psychiatric nursing principles to engage patients respectfully, especially during mania, making this the correct choice.

Choice D reason: Warning about missing treatment is mildly coercive and does not explore the patient’s reasons for refusal. It fails to address underlying concerns, such as anxiety or grandiosity, which are critical in mania, making this less therapeutic than exploring hesitancy.

Choice A reason: Mood stabilizers, like lithium, are used for bipolar disorder to regulate mood swings, not for acute anxiety. They target long-term mood stabilization, not immediate symptom relief, which is critical for post-traumatic anxiety, making this category inappropriate for the patient’s condition.

Choice B reason: Antidepressants, such as SSRIs, treat depression and chronic anxiety over weeks, not acute anxiety. Their delayed onset makes them unsuitable for immediate relief following a traumatic event like a car accident, where rapid symptom management is needed, making this choice incorrect.

Choice C reason: Antipsychotics treat psychosis or severe agitation, not primary anxiety. Their use in anxiety is off-label and typically reserved for cases unresponsive to anxiolytics, with higher side effect risks. This makes them inappropriate for acute anxiety management, rendering this choice incorrect.

Choice D reason: Anxiolytics, like benzodiazepines, provide rapid relief for acute anxiety by enhancing GABA activity, calming the central nervous system. They are the primary choice for short-term management of anxiety post-trauma, aligning with clinical guidelines, making this the correct medication category for patient teaching.