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A patient diagnosed with schizophrenia had an exacerbation related to medication noncompliance and was hospitalized for 5 days. The patients thoughts are now more organized, and discharge is planned. The patients family says, Its too soon for discharge. We will just go through all this again. The nurse should:
- A. ask the case manager to arrange a transfer to a long-term care facility.
- B. notify hospital security to handle the disturbance and escort the family off the unit.
- C. explain that the patient will continue to improve if the medication is taken regularly.
- D. contact the health care provider to meet with the family and explain the discharge rationale.
Correct Answer: C
Rationale: Patients do not stay in a hospital until every symptom disappears. The nurse must assume responsibility to advocate for the patients right to the least restrictive setting as soon as the symptoms are under control and for the right of citizens to control health care costs. The health care provider will use the same rationale. Shifting blame will not change the discharge. Security is unnecessary. The nurse can handle this matter.
You may also like to solve these questions
Which technique will best communicate to a patient that the nurse is interested in listening?
- A. Restating a feeling or thought the patient has expressed.
- B. Asking a direct question, such as 'Did you feel angry?'
- C. Making a judgment about the patient's problem.
- D. Saying, 'I understand what you're saying.'
Correct Answer: A
Rationale: Restating allows the patient to validate the nurse's understanding of what has been communicated. Restating is an active listening technique. Judgments should be suspended in a nurse-patient relationship. Close-ended questions such as 'Did you feel angry?' ask for specific information rather than showing understanding. When the nurse simply states that he or she understands the patient's words, the patient has no way of measuring the understanding.
A patient with fears of serious heart disease was referred to the mental health center by a cardiologist. Extensive diagnostic evaluation showed no physical illness. The patient says, "My chest is tight, and my heart misses beats. I'm often absent from work. I don't go out much because I need to rest." Which health problem is most likely?
- A. Dysthymic disorder
- B. Somatic symptom disorder
- C. Antisocial personality disorder
- D. Illness anxiety disorder (hypochondriasis)
Correct Answer: D
Rationale: Illness anxiety disorder (hypochondriasis) involves preoccupation with fears of having a serious disease even when evidence to the contrary is available. The preoccupation causes impairment in social or occupational functioning. Somatic symptom disorder involves fewer symptoms. Dysthymic disorder is a disorder of lowered mood. Antisocial disorder applies to a personality disorder in which the individual has little regard for the rights of others. See relationship to audience response question.
The nurse asks the patient, 'What was it like for you when you first knew you had no place to go?' The patient looks down and pauses for quite some time. Which action by the nurse is most therapeutic?
- A. Change the subject to something the patient will discuss
- B. Encourage the patient to express any unpleasant feelings
- C. Apologize for asking such a personal question
- D. Sit quietly until the patient responds
Correct Answer: D
Rationale: Silence allows the patient time to process and respond, respecting their pace. A avoids the issue, B pressures, and C retracts the therapeutic intent.
A patient diagnosed with major depression has lost pounds in one month, has chronic low self-esteem, and a plan for suicide The patient has taken an antidepressant medication for week Which nursing intervention has the highest priority?
- A. Implement suicide precautions
- B. Offer high-calorie snacks and fluids frequently
- C. Assist the patient to identify three personal strengths
- D. Observe patient for therapeutic effects of antidepressant medication
Correct Answer: A
Rationale: Suicide precautions (A) address the urgent safety risk B, C, and D are secondary to preventing harm
Which behavior shows that a nurse values autonomy? The nurse
- A. suggests one-on-one supervision for a patient who has suicidal thoughts.
- B. informs a patient that the spouse will not be in during visiting hours.
- C. discusses options and helps the patient weigh the consequences.
- D. sets limits on a patient's romantic overtures toward the nurse.
Correct Answer: C
Rationale: A high level of valuing is acting on one's belief. Autonomy is supported when the nurse helps a patient weigh alternatives and their consequences before the patient makes a decision.