Due to the need to self-medicate for anxiety, a patient diagnosed with schizophrenia smokes two packs of cigarettes a day. What unique risk does nicotine pose to this patient's health?

Correct Answer: C

Rationale: The correct answer is C: Impaired psychotropic medication therapy. Nicotine can interfere with the metabolism of certain psychotropic medications, potentially reducing their effectiveness. Smoking two packs of cigarettes a day can lead to increased levels of enzymes in the liver, which can accelerate the breakdown of medications, making them less potent. Lung cancer (A) and increased incidence of lung-related disorders (D) are potential risks of smoking but are not unique to this patient's situation. Cardiovascular constriction (B) is a general risk of smoking and not directly related to the patient's schizophrenia diagnosis.

Correct Answer: A

Rationale: The correct answer is A because four-point restraints are used for clients who pose an imminent danger to themselves or others due to violent behavior, such as being hostile and threatening. Restraints should only be utilized as a last resort to ensure safety. Choices B, C, and D do not warrant the use of restraints as they do not involve immediate physical harm or danger. De-escalation techniques and alternative interventions should be attempted before resorting to restraint use.

Correct Answer: B

Rationale: The correct answer is B: perform a client strengths assessment. This is essential to keep the plan client-centered by focusing on the individual's positive attributes and resources. By identifying the client's strengths, the nurse can tailor interventions that build on these assets to empower the client in managing the risk factors for substance misuse. A: Contacting a rehab center for an intake assessment is premature without fully assessing the client's strengths and individualized needs first. C: Asking the psychiatrist to screen for depression is important but does not directly address keeping the plan client-centered and focusing on strengths. D: Completing a health assessment is necessary but does not specifically address the client's strengths and may not fully support client-centered care.

Correct Answer: D

Rationale: The correct answer is D because clubhouse programs are known for being primarily run by psychiatric patients with minimal assistance from mental health staff. This model emphasizes empowerment, peer support, and self-help. It promotes a sense of community and belonging among members, allowing individuals to take an active role in their recovery. Choice A is incorrect because clubhouses are not typically open 24 hours a day. They usually operate during standard business hours. Choice B is incorrect because clubhouses are not run entirely by psychiatric mental health nurses. While mental health staff may be present, the focus is on peer support and collaboration among members. Choice C is incorrect because the primary focus of clubhouses is not on providing ongoing intensive psychotherapy. Instead, they emphasize socialization, skill-building, and vocational support in a non-clinical setting.

Correct Answer: C

Rationale: The correct answer is C because validation therapy involves acknowledging and validating the person's feelings and reality. By reiterating the patient's desire to go home and prepare dinner for her husband, the nurse validates the patient's emotions and reality, which can help reduce distress and agitation. Choice A is incorrect because it simply redirects the patient without acknowledging her feelings or reality. Choice B is incorrect because it focuses on the patient's widow status rather than validating her current feelings and beliefs. Choice D is incorrect because it introduces a potentially negative and untrue statement about the patient's husband, which could escalate the situation rather than providing validation.