By discharge, which outcome is appropriate for a patient who hears voices telling them they are evil?

Correct Answer: C

Rationale: In the context of pharmacology and psychiatry, the correct answer to the question is option C) Identify events that increase anxiety and promote hallucinations. This answer is appropriate because it focuses on addressing the underlying factors contributing to the patient's hallucinations, which is crucial in managing psychotic symptoms in psychiatric patients. Option A) Respond verbally to the voices may not be the best course of action as it does not address the root cause of the hallucinations and may even reinforce the patient's belief in the voices. Option B) Verbalize the reason the voices say they are evil does not address the need to manage the anxiety and hallucinations that the patient is experiencing. Understanding the reason behind the voices may not necessarily lead to effective symptom management. Option D) Integrate the voices into their personality structure in a positive manner can be a risky approach as it may lead to further entrenchment of the hallucinations and could potentially worsen the patient's condition. In an educational context, it is essential for healthcare providers to understand the importance of addressing underlying factors contributing to psychiatric symptoms, such as hallucinations. By identifying and addressing triggers for hallucinations, healthcare providers can help patients better manage their symptoms and improve overall outcomes. This rationale highlights the significance of a holistic approach to psychiatric care that goes beyond just symptom management.

Correct Answer: C

Rationale: In the context of a patient diagnosed with residual schizophrenia exhibiting ambivalence, choosing between two outfits to wear each morning (Option C) would be the most appropriate short-term outcome. This choice provides the patient with a manageable decision-making task that can help them practice making choices and regain a sense of control over their daily routine. Option A, deciding their own daily schedule, might be overwhelming for a patient struggling with ambivalence due to the high level of complexity involved. Option B, deciding which unit groups to attend, may also be challenging as it requires more cognitive load and decision-making capacity. Option D, choosing which clinic staff member to work with, may not directly address the ambivalence issue and may not be as relevant to daily functioning as choosing an outfit. In the educational context, it is important to understand that individuals with schizophrenia often struggle with decision-making and may benefit from structured tasks that gradually build their confidence in making choices. Providing opportunities for small, manageable decisions like choosing an outfit can be a valuable therapeutic intervention in addressing ambivalence in schizophrenia.

Correct Answer: A

Rationale: In the context of post-electroconvulsive therapy (ECT), it is crucial for the nurse to place the client on his or her side (Option A) to prevent aspiration. As ECT can induce confusion, disorientation, and muscle weakness immediately after the procedure, there is a risk of regurgitation and aspiration if the client is lying flat on their back. Placing the client on their side helps to ensure that any vomitus or secretions can easily drain out of the mouth, reducing the risk of aspiration pneumonia and other respiratory complications. Option B, placing the client in semi-Fowler's position to promote oxygenation, is incorrect in this scenario because the priority post-ECT is to prevent aspiration rather than focusing solely on oxygenation. Placing the client in Trendelenburg's position (Option C) could actually be harmful as it may increase intracranial pressure and is not indicated for this situation. Option D, placing the client in a prone position to prevent airway blockage, is also incorrect as lying prone could further increase the risk of aspiration. In an educational context, understanding the rationale behind positioning post-ECT is essential for nurses working in psychiatric settings. It not only ensures the safety and well-being of the client but also demonstrates the nurse's knowledge of proper post-procedural care. By prioritizing the prevention of aspiration in this scenario, nurses can provide effective and evidence-based care to clients undergoing ECT.

Correct Answer: A

Rationale: In the context of adolescent suicide risk assessment, option A, being sexually abused, is considered a high-risk factor for several reasons. Adolescents who have experienced sexual abuse may suffer from various psychological traumas, such as depression, anxiety, and post-traumatic stress disorder, which significantly increase their vulnerability to suicidal ideation and behavior. Options B, having experienced panic attacks, and C, being mildly cognitively impaired, while important factors to consider in a comprehensive psychiatric assessment, do not directly correlate with as high a risk of suicide in adolescents as a history of sexual abuse does. Panic attacks and cognitive impairments can contribute to mental health challenges but do not carry the same level of immediate risk as a history of sexual abuse. Option D, having a diagnosis of type 1 diabetes, is also a relevant factor to consider in the overall assessment of an adolescent's mental health and well-being. However, it is not typically considered as high a risk factor for suicide as a history of sexual abuse, which is more directly linked to mental health issues and suicidal behavior in adolescents. In an educational context, it is crucial for healthcare providers, particularly those in psychiatry or mental health fields, to be able to recognize and prioritize risk factors for adolescent suicide accurately. Understanding the significance of different risk factors can help in conducting thorough assessments, developing appropriate interventions, and implementing preventive strategies to support at-risk adolescents effectively.

Correct Answer: D

Rationale: In this scenario, option D, "The gun I got for my birthday is my most prized possession," is the most concerning statement made by the teenage male hospitalized after a failed suicide attempt. This statement raises red flags because it indicates that the individual may still have access to a potentially lethal means of self-harm, which increases the risk of a repeated suicide attempt. Option A is incorrect because it repeats the same statement as option D. Option B, "I don’t know why I get so depressed and want to die," while concerning, reflects a sense of confusion rather than immediate danger. Option C, "I don’t feel like I can talk to anyone about my feelings," is also worrying but does not pose an immediate threat to the individual's safety. Educationally, this question highlights the importance of assessing suicide risk factors, such as access to lethal means, in individuals who have attempted suicide. It emphasizes the critical role nurses play in identifying and addressing potential risks to ensure the safety and well-being of patients experiencing psychiatric crises. By understanding the significance of statements like the one in option D, healthcare providers can intervene effectively to prevent further harm and provide appropriate support and interventions.