Nokea
A student nurse prepares to administer oral medication to a patient diagnosed with major depressive disorder. What should the student nurse do when the patient refuses the medication?
- A. Share with the patient, 'I'll get an unsatisfactory grade if I don't give you the medication.'
- B. Tell the patient, 'Refusing your medication is not permitted. You are required to take it.'
- C. Attempt to discuss the patient's concerns about the medication, and report to the staff nurse.
- D. Document the patient's refusal of the medication without further comment.
Correct Answer: C
Rationale: The patient has the right to refuse medication in most cases. The patient's reason for refusing should be ascertained, and the refusal should be reported to a unit nurse. Sometimes refusals are based on unpleasant side effects that can be ameliorated. Threats and manipulation are inappropriate. Medication refusal should be reported to permit appropriate intervention.
You may also like to solve these questions
A community psychiatric nurse assesses that a patient diagnosed with a mood disorder is more depressed than on the previous visit a month ago; however, the patient says, 'I feel the same.' Which intervention supports the nurse's assessment while preserving the patient's autonomy?
- A. Arrange for a short hospitalization.
- B. Schedule weekly clinic appointments.
- C. Refer the patient to the crisis intervention clinic.
- D. Call the family and ask them to observe the patient closely.
Correct Answer: B
Rationale: Scheduling clinic appointments at shorter intervals will give the opportunity for more frequent assessment of symptoms and allow the nurse to use early intervention. If the patient does not admit to having a crisis or problem, a referral would be useless. The remaining options may produce unreliable information, violate the patient's privacy, and waste scarce resources.
A nurse surveys the medical records for violations of patients' rights. Which finding signals a violation?
- A. No treatment plan is present in record.
- B. Patient belongings were searched at admission.
- C. Physical restraints were used to prevent harm to self.
- D. Patient is placed on one-to-one continuous observation.
Correct Answer: A
Rationale: The patient has the right to have a treatment plan. Inspecting a patient's belongings is a safety measure. Patients have the right to a safe environment, including the right to be protected against impulses to harm self that occur as a result of a mental disorder.
The relapse of a patient diagnosed with schizophrenia is related to medication nonadherence. The patient is hospitalized for 5 days, medication is restarted, and the patient's thoughts are now more organized. The patient's family members are upset and say, 'It's too soon for discharge. Hospitalization is needed for at least a month.' The nurse should implement what intervention?
- A. Call the psychiatrist to come explain the discharge rationale.
- B. Explain that health insurance will not pay for a longer stay for the patient.
- C. Notify security to handle the disturbance and escort the family off the unit.
- D. Explain that the patient will continue to improve if medication is taken regularly.
Correct Answer: D
Rationale: Patients no longer stay in a hospital until all evidence of a symptom disappears. The nurse must assume responsibility to advocate for the patient's 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. Calling security is unnecessary. The nurse can handle this matter.
A nurse can best address factors of critical importance to successful community treatment for persons with mental illness by including assessments related to which of the following?
- A. Housing adequacy and stability
- B. Income adequacy and stability
- C. Family and other support systems
- D. Early psychosocial development
- E. Substance abuse history and current use
Correct Answer: A,B,C,E
Rationale: Early psychosocial developmental history is less relevant to successful outcomes in the community than the assessments listed in the other options. If a patient is homeless or fears homelessness, focusing on other treatment issues is impossible. Sufficient income for basic needs and medication is necessary. Adequate support is a requisite to community placement. Substance abuse undermines medication effectiveness and interferes with community adjustment.
Which assessment finding for a patient living in the community requires priority intervention by the nurse?
- A. Receives Social Security disability income plus a small check from a trust fund.
- B. Lives in an apartment with two patients who attend day hospital programs.
- C. Has a sibling who is interested and active in care planning.
- D. Purchases and uses marijuana on a frequent basis.
Correct Answer: D
Rationale: Patients who regularly buy illegal substances often become medication noncompliant. Medication noncompliance, along with the disorganizing influence of illegal drugs on cellular brain function, promotes relapse. The remaining options do not suggest problems.