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A 22-year-old patient with schizophrenia is refusing his antipsychotic medication. He states, 'I don?t like the dopey way it makes me feel. I feel like I?m walking under water when I take it.' The nurse explains to him, 'Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better.' This conversation reflects a conflict between which two types of ethical principles?
- A. Autonomy and justice
- B. Paternalism and veracity
- C. Justice and nonmaleficence
- D. Autonomy and beneficence
Correct Answer: D
Rationale: The patient?s refusal of medication reflects autonomy (self-determination), while the nurse?s insistence on medication to improve symptoms reflects beneficence (acting for the patient?s benefit). This creates an ethical conflict, as the nurse?s approach prioritizes the patient?s well-being over their right to choose. The other options do not accurately capture this dynamic: justice involves fairness, paternalism involves overriding autonomy, veracity involves truthfulness, and nonmaleficence involves avoiding harm.
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A nurse is engaged in exercises to develop self-awareness. The nurse is using which tool?
- A. Interdisciplinary care
- B. Reflection
- C. Plan of care
- D. Clinical reasoning
Correct Answer: B
Rationale: Reflection is the process of introspection and self-examination, which is essential for developing self-awareness in nursing. Interdisciplinary care involves collaboration, a plan of care is a structured approach to patient care, and clinical reasoning is a cognitive process for decision-making, none of which directly target self-awareness.
A group of students is reviewing the functions of psychiatric nurses. The students demonstrate understanding of the information when they identify which of the following as an advanced practice level function?
- A. Milieu therapy
- B. Promotion of self-care
- C. Psychopharmacology interventions
- D. Health promotion activities
Correct Answer: C
Rationale: Advanced practice psychiatric nurses have specialized training, often including prescriptive authority and expertise in managing medications. Psychopharmacology interventions, which involve prescribing and managing psychotropic medications, are specific to advanced practice roles. Milieu therapy, self-care promotion, and health promotion activities are typically within the scope of basic-level psychiatric nursing.
A nurse is working on developing ways to meet the challenge of knowledge development. Which of the following would be most appropriate?
- A. Access new information through continuing education programs.
- B. Improve access to community psychiatric care for all populations.
- C. Reduce the burden of mental illness by fighting stigma.
- D. Provide culturally competent, high-quality nursing care.
Correct Answer: A
Rationale: Knowledge development in nursing involves staying updated with current evidence and practices. Continuing education programs directly address this by providing access to new research and clinical advancements. The other options focus on improving access, reducing stigma, or providing care, which are important but not directly tied to knowledge development.
A nursing instructor is describing the impact of technology and electronic health records on psychiatric-mental health care. Which of the following would the instructor identify as a major challenge associated with it?
- A. Maintaining confidentiality
- B. Establishing educational models
- C. Decreasing fragmented care
- D. Defining professional standards more clearly
Correct Answer: A
Rationale: Electronic health records (EHRs) improve access to patient data but pose significant challenges in maintaining confidentiality due to risks of unauthorized access, data breaches, or improper sharing. This is a well-documented concern in psychiatric care, where sensitive mental health information requires stringent protection. The other options are less directly related to EHR challenges: educational models and professional standards are broader issues, and EHRs typically reduce fragmented care.
The plan of care for a patient with schizophrenia identifies the following outcomes. Which of the following would the nurse identify as addressing the biologic domain? Select all that apply.
- A. Improving problem-solving skills
- B. Promoting economic stability
- C. Minimizing adverse effects of drug therapy
- D. Improving nutritional status
- E. Providing family education
Correct Answer: C,D
Rationale: The biologic domain focuses on physical health and bodily functions. Minimizing adverse effects of drug therapy (C) addresses medication-related physical outcomes, and improving nutritional status (D) focuses on physical health through diet. Improving problem-solving skills is psychological, promoting economic stability is social, and providing family education is social.