Which tasks are safe and appropriate to be performed by a basic-level nurse for a patient suffering from mental illness?
Teaching coping skills to the patient and family members
Treating major depressive disorder
Prescribing antidepressants
Assessing suicide risk
The Correct Answer is A
Choice A reason: Basic-level nurses, such as LPNs or RNs, can teach coping skills, a standard intervention within their scope. This involves education on stress management, aligning with psychiatric nursing roles to support patient and family well-being, making this the correct choice.
Choice B reason: Treating major depressive disorder requires advanced skills, like prescribing or managing complex therapies, which is beyond a basic-level nurse’s scope. This is typically reserved for advanced practice nurses or physicians, making this choice incorrect.
Choice C reason: Prescribing antidepressants is restricted to advanced practice nurses or physicians, not basic-level nurses. This task involves medical decision-making outside the scope of RNs or LPNs, making it unsafe and inappropriate, thus incorrect.
Choice D reason: Assessing suicide risk requires advanced clinical judgment, often reserved for advanced practice nurses or psychiatrists. While basic-level nurses can observe and report, formal assessment exceeds their scope, making this choice incorrect for their role.
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Correct Answer is B
Explanation
Choice A reason: Electroconvulsive therapy (ECT) is reserved for severe, treatment-resistant depression or acute suicidal ideation, not general hopelessness. It involves significant risks and requires specialist oversight, making it inappropriate as a first-line intervention for this symptom, which can be addressed with less invasive methods.
Choice B reason: Cognitive behavioral therapy (CBT) targets negative thought patterns, such as hopelessness, by restructuring cognitions, a core feature of depression. Evidence-based for mood disorders, CBT reduces symptoms through structured interventions, making it the most appropriate choice for addressing hopelessness in a mental health assessment.
Choice C reason: High-dose benzodiazepines treat acute anxiety or agitation, not hopelessness, which is a depressive symptom. They risk sedation and dependence without addressing cognitive distortions, making them inappropriate for this symptom and contrary to evidence-based psychiatric nursing practice.
Choice D reason: Avoiding social interactions may worsen hopelessness by increasing isolation, a risk factor for depression. Evidence-based practice encourages social engagement to improve mood and support networks, making this intervention counterproductive and incorrect for addressing the patient’s reported symptom.
Correct Answer is A
Explanation
Choice A reason: A 16-year-old voluntarily admitted for mental health treatment has the legal right to refuse treatment, as voluntary admission implies consent and autonomy. Minors may have limited rights, but voluntary status allows refusal unless overridden by guardianship or legal statutes, making this the correct choice.
Choice B reason: A 20-year-old with court-ordered treatment lacks the legal right to refuse, as a court mandate overrides autonomy due to assessed risk or incapacity. Legal frameworks prioritize compliance in such cases to ensure safety and treatment efficacy, making this choice incorrect.
Choice C reason: A 35-year-old involuntarily admitted client cannot refuse treatment, as involuntary admission indicates a legal determination of danger or incapacity. Mental health laws prioritize intervention over autonomy in these cases to protect the client or others, making this choice incorrect.
Choice D reason: An adult refusing life-threatening treatment may face legal restrictions, as mental health laws can override refusal if the client poses a danger or lacks capacity. This scenario does not clearly grant a legal right to refuse, unlike voluntary admission, making this choice incorrect.
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