Psychiatric care technicians (PCTs) are unlicensed assistive personnel that are an integral part of the acute care mental healthcare team. Which of the following choices would be an example(s) of overdelegation by the nurse to a PCT? The nurse directs the PCT to (Select All that Apply):
Perform a neurological assessment on a patient in seclusion to compare the nurse’s findings.
Play cards with 3 patients during unstructured time.
Review follow-up care with a patient about to be discharged.
Set a goal for the day for a patient with a borderline personality disorder.
Obtain a weight on a patient with bipolar disorder in a hypomanic state.
Correct Answer : A,C,D
Choice A Reason: Perform a neurological assessment on a patient in seclusion to compare the nurse’s findings
This task is an example of overdelegation. Performing a neurological assessment requires specialized knowledge and skills that are beyond the scope of practice for unlicensed assistive personnel. Such assessments should be conducted by a licensed nurse or healthcare provider to ensure accuracy and appropriate clinical judgment.
Choice B Reason: Play cards with 3 patients during unstructured time
This task is appropriate for a PCT. Engaging patients in recreational activities like playing cards does not require specialized clinical skills and falls within the scope of practice for unlicensed assistive personnel. It helps in providing social interaction and can be beneficial for the patients’ mental health.
Choice C Reason: Review follow-up care with a patient about to be discharged
This task is an example of overdelegation. Reviewing follow-up care involves providing important information about the patient’s ongoing treatment and care plan, which requires clinical knowledge and the ability to answer any questions the patient may have. This responsibility should be handled by a licensed nurse or healthcare provider.
Choice D Reason: Set a goal for the day for a patient with a borderline personality disorder
This task is also an example of overdelegation. Setting therapeutic goals for patients, especially those with complex mental health conditions like borderline personality disorder, requires clinical expertise and an understanding of the patient’s treatment plan. This should be done by a licensed nurse or mental health professional.
Choice E Reason: Obtain a weight on a patient with bipolar disorder in a hypomanic state
This task is appropriate for a PCT. Obtaining a patient’s weight is a routine task that does not require specialized clinical skills and falls within the scope of practice for unlicensed assistive personnel. It is a straightforward task that can be safely delegated.
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Correct Answer is D
Explanation
Choice A Reason: Notify all members of the treatment team and place the client on suicide precautions
While notifying the treatment team and placing the client on suicide precautions is crucial, it is not the immediate priority. The first step is to assess the immediacy and severity of the risk by determining if the client has a specific plan. This assessment helps in understanding the level of danger and urgency required in the intervention.
Choice B Reason: Assess for past history of suicide attempts
Assessing for a past history of suicide attempts is important for understanding the client’s risk factors and potential for future attempts. However, it is not the immediate priority when a client expresses current suicidal ideation. The immediate concern is to assess the current risk and plan, which directly impacts the urgency of the intervention.
Choice C Reason: Identify coping mechanisms
Identifying coping mechanisms is a valuable part of the overall treatment plan and can help in long-term management. However, in the context of immediate suicidal ideation, the priority is to assess the current risk and plan. Once the immediate risk is managed, coping mechanisms can be explored to support the client’s ongoing mental health.
Choice D Reason: Determine whether the client has a specific plan to commit suicide
This is the correct answer. Determining whether the client has a specific plan to commit suicide is the highest priority because it directly assesses the immediacy and severity of the risk. If the client has a specific plan, it indicates a higher level of danger and necessitates immediate intervention to ensure the client’s safety.
Correct Answer is B
Explanation
The correct answer is b. It’s not my fault.
Choice A Reason: I just don’t remember doing it
This statement might be used by someone trying to avoid responsibility, but it is not as characteristic of antisocial personality disorder (ASPD) as outright denial of fault. Individuals with ASPD often exhibit a lack of accountability and may lie or manipulate to avoid consequences. However, claiming memory loss is less direct than denying responsibility altogether.
Choice B Reason: It’s not my fault
This statement is highly characteristic of antisocial personality disorder. Individuals with ASPD often refuse to take responsibility for their actions and may blame others or external circumstances. This lack of accountability and tendency to deflect blame is a core feature of the disorder, making this the most expected comment.
Choice C Reason: I’m really sorry about all the people I’ve hurt
This statement is unlikely for someone with antisocial personality disorder. People with ASPD typically lack empathy and remorse for their actions. Expressing genuine sorrow and concern for others is not consistent with the typical behavior of someone with this disorder.
Choice D Reason: I’m too ashamed to talk about it
This statement suggests a level of self-awareness and guilt that is not typical of antisocial personality disorder. Individuals with ASPD generally do not experience shame or guilt in the same way as others. They are more likely to be indifferent or dismissive about the consequences of their actions.
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