Silence can be a helpful therapeutic tool for group participants by giving each an opportunity to contemplate what has transpired, weigh alternatives, and formulate ideas. Which statement best supports this?

Choice A reason: Encouraging the patient to argue with auditory hallucinations can escalate distress and reinforce engagement with the voices, which is non-therapeutic in schizophrenia management. Evidence-based practice emphasizes reducing focus on hallucinations through coping strategies, not confrontation, making this choice incorrect.

Choice B reason: Teaching distraction techniques, like listening to music, is an evidence-based non-pharmacological intervention for managing auditory hallucinations. It helps shift attention away from the voices, reducing their intensity and promoting coping, aligning with psychiatric nursing principles, making this the correct choice.

Choice C reason: Administering an additional dose of antipsychotic medication without prescriber consultation violates nursing scope of practice and safety protocols. It risks toxicity and side effects, such as extrapyramidal symptoms, making this choice unsafe and incorrect for managing hallucinations.

Choice D reason: Advising the patient to ignore hallucinations is oversimplified and often ineffective, as it dismisses the distress caused by symptoms. This approach lacks therapeutic support and does not provide practical coping strategies, making it less appropriate than teaching distraction techniques.

Choice A reason: Autonomy involves respecting a patient’s right to make decisions. While relevant in mental health, the scenario focuses on differing treatments for similar conditions, not patient choice, making autonomy less directly applicable than the principle of fair treatment across patients.

Choice B reason: Beneficence emphasizes promoting patient well-being. Both restraints and supervision aim to prevent harm, fulfilling beneficence, but the concern is about unequal treatment, not the intent to benefit, making this principle less relevant than justice.

Choice C reason: Justice involves fair and equitable treatment for all patients. Using restraints for one self-mutilating patient and supervision for another raises concerns about consistency and fairness in care, directly aligning with the ethical principle of justice, making this the correct choice.

Choice D reason: Nonmaleficence focuses on avoiding harm. Both interventions aim to prevent self-mutilation, fulfilling this principle, but the ethical issue is about equitable application, not harm avoidance, making justice the more relevant principle in this scenario.