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This statement is coercive and violates the patient’s rights. Voluntary admission does not equate to forced compliance with treatment. Threatening the patient with discharge or implying conditional care based on medication compliance undermines trust and autonomy.

This is misleading and potentially inaccurate. Refusing medication alone does not automatically lead to involuntary commitment. Involuntary commitment requires a legal process and evidence that the patient poses a danger to self or others or is gravely disabled. This response may escalate the situation and damage rapport.

This response is inappropriate and unethical. Forcing medication through security without legal authorization constitutes assault and violates the patient’s rights. It is only permissible to administer medication involuntarily under specific legal circumstances, such as a court order or emergency situations involving imminent harm.

While an increase above 1.0 mEq/L may indicate a higher therapeutic range, it does not necessarily indicate toxicity. Toxicity is more likely when levels exceed 1.5 mEq/L. This choice underestimates the severity of the fluid loss and its impact on lithium clearance.

This is incorrect. Dehydration and sodium loss from excessive sweating reduce renal clearance of lithium, leading to accumulation and increased serum levels, not a decrease. Lithium is excreted by the kidneys, and any condition that reduces renal perfusion or sodium levels can precipitate toxicity.

This is incorrect. Significant fluid loss and electrolyte imbalance are expected to affect lithium levels. Assuming no change disregards the pharmacokinetics of lithium and the impact of hydration status on renal excretion.

While olanzapine may have sedative properties, its primary indication in this context is not to promote sleep but to manage acute manic symptoms. This response minimizes the therapeutic rationale and may mislead the family about the medication’s purpose.

This is incorrect. There is no cure for bipolar disorder. Treatment focuses on symptom management and relapse prevention. Suggesting a cure is misleading and may create unrealistic expectations.

This is incorrect. While second-generation antipsychotics have a lower risk of extrapyramidal symptoms compared to first-generation agents, their use is not primarily to prevent these side effects. The rationale for olanzapine in this case is to manage acute mania.

Agranulocytosis is a rare but serious side effect associated primarily with clozapine, characterized by a dangerously low white blood cell count. It presents with signs of infection such as fever and sore throat, not involuntary oral-facial movements. This diagnosis does not match the described symptoms.

Neuroleptic malignant syndrome is a life-threatening reaction to antipsychotics, presenting with hyperthermia, muscle rigidity, altered mental status, and autonomic instability. It is an acute medical emergency, unlike the chronic, progressive nature of tardive dyskinesia.

Acute dystonia involves sudden, sustained muscle contractions, often affecting the neck, face, or eyes, and typically occurs within hours to days of starting or increasing antipsychotic medication. The chronic, repetitive oral movements described are more consistent with tardive dyskinesia.

Somatic delusions involve false beliefs about bodily functions or sensations, such as believing one’s organs are rotting or infested. They do not pertain to thought control or external manipulation of cognition.

Ideas of reference involve misinterpreting external events as having personal significance, such as believing a news anchor is speaking directly to them. This does not involve the belief that others are inserting thoughts.

Nihilistic delusions involve beliefs that one is dead, does not exist, or that the world is ending. These are typically seen in severe depression or psychotic states and are unrelated to thought control.

While patients generally have the right to refuse treatment, this right is not absolute. In cases where the patient poses a danger to themselves or others, legal and ethical frameworks allow for treatment over objection under emergency or court-ordered conditions.

This is incorrect. Patients can refuse both pharmacological and psychological treatments unless they are deemed incompetent or dangerous. Treatment refusal is not limited to medication.

This is incorrect. ECT requires informed consent, but it is not the only treatment that can be refused. Patients may refuse any treatment unless overridden by legal or clinical necessity.

This is appropriate. Recognizing early signs of anxiety allows the client to implement coping strategies before symptoms escalate. It promotes self-awareness and proactive management.

This is appropriate. Relaxation techniques such as deep breathing, progressive muscle relaxation, and mindfulness help reduce physiological arousal and promote calmness.

This is appropriate. Cognitive restructuring helps the client challenge and modify distorted thoughts that contribute to anxiety. It is a core component of cognitive-behavioral therapy.

Benzodiazepines are primarily used for anxiety and agitation. They do not treat core psychotic symptoms such as delusions or hallucinations and carry a risk of dependence.

SSRIs are used to treat depression and anxiety disorders. They do not address psychotic symptoms and may exacerbate mania in bipolar disorder if used without mood stabilizers.

Anticonvulsant mood stabilizers are used in bipolar disorder to manage mood swings but are not first-line treatments for psychosis. They may be used adjunctively but not as primary therapy for schizophrenia.