Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?
The policies do not absolve an individual nurse of the responsibility to practice according to professional standards of nursing care
In an institution with substandard policies, the nurse has a responsibility to inform the supervisor and leave the premises
Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care
Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted
The Correct Answer is A
Choice A reason: Nurses must adhere to professional standards, ensuring safe care despite substandard policies. Restraint use, for example, must minimize harm and respect patient dignity, regardless of policy. This aligns with ethical principles and evidence-based practices for managing agitation linked to neurotransmitter imbalances, upholding nurse accountability.
Choice B reason: Leaving the premises after informing a supervisor abandons patients, violating ethical duties. Professional standards require nurses to advocate for safe practices, like appropriate restraint use for dopamine-driven agitation, within the system. This option is impractical and neglects patient care responsibilities, making it incorrect.
Choice C reason: Agency policies do not override professional standards. Nurses are accountable to evidence-based practices, ensuring interventions like restraints for severe agitation are safe and ethical. Policies may guide but cannot excuse deviations from standards addressing neurobiological safety needs, making this option scientifically and ethically incorrect.
Choice D reason: Judicial interpretation varies, but nursing practice is guided by professional standards, not unpredictable legal outcomes. Standards ensure safe, ethical care, like minimizing restraint use for serotonin-related agitation, regardless of policy or judicial variability. This option is irrelevant to guiding daily nursing practice.
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Related Questions
Correct Answer is A
Explanation
Choice A reason: Muscarinic receptor blockers inhibit parasympathetic activity, reducing salivary gland secretion via acetylcholine pathways. This causes dry mouth, as muscarinic receptors in salivary glands are blocked, decreasing saliva production. This anticholinergic effect is common in drugs like benztropine, requiring assessment to manage discomfort and prevent oral health issues.
Choice B reason: Orthostatic hypotension is linked to alpha-1 adrenergic blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic pathways, not vascular tone regulated by norepinephrine. While autonomic effects occur, hypotension is not a primary consequence, making this side effect unrelated to muscarinic receptor antagonism.
Choice C reason: Pseudoparkinsonism results from dopamine receptor blockade, common in antipsychotics, not muscarinic blockers. Muscarinic receptors regulate parasympathetic functions like salivation, not motor control. Blocking muscarinic receptors may alleviate parkinsonism by balancing cholinergic-dopaminergic activity, making this an incorrect side effect for assessment.
Choice D reason: Gynecomastia is associated with hormonal imbalances or dopamine blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic systems, not prolactin or estrogen pathways. This side effect is unrelated to muscarinic antagonism, which primarily causes anticholinergic effects like dry mouth, not endocrine changes.
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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