A 21-year-old man who has schizoaffective disorder tells his PMHNP that he wants to discontinue his psychiatric medications. He is not currently psychotic and he does not pose a danger to himself or others. What should his nurse practitioner do next?
Explain to him that this is not a good idea, and try to convince him to keep taking his medication.
Tell him that if he stops taking his medication, he will more than likely need to be hospitalized again
Respect his right to make his own medical decision, since he is currently competent
Tell him he is obviously not in his right mind, since he is thinking about stopping his medication, and that you will have to involuntarily commit him to the hospital if he does not agree to continue taking the medication
The Correct Answer is C
Choice A reason: While education and discussion about the risks of discontinuing medication are important, trying to convince the patient without respecting autonomy may undermine trust. This approach is paternalistic and does not honor the patient’s legal rights.
Choice B reason: Predicting hospitalization may be perceived as coercive and fear-inducing. It is not appropriate unless there is clear evidence of imminent risk. The patient is currently stable and competent, so this approach is not justified.
Choice C reason: Competent adults have the legal right to refuse medical treatment, including psychiatric medications. The PMHNP should assess the patient’s decision-making capacity and, if intact, respect his autonomy. The provider can offer education and support but must honor the patient’s informed choice.
Choice D reason: This response is inappropriate and stigmatizing. It assumes incompetence without assessment and threatens involuntary hospitalization without cause. Such actions violate ethical and legal standards in psychiatric care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Von Willebrand disease is indeed a hereditary bleeding disorder caused by a deficiency or dysfunction of von Willebrand factor (vWF), which plays a crucial role in platelet adhesion and stabilization of factor VIII. This statement is accurate.
Choice B reason: This statement is incorrect. Von Willebrand factor does not function independently of factor VIII. In fact, vWF serves as a carrier protein for factor VIII, protecting it from degradation in circulation. A deficiency in vWF can lead to secondary reductions in factor VIII levels, contributing to bleeding symptoms.
Choice C reason: vWF mediates platelet adhesion to the subendothelial matrix by binding to glycoprotein Ib-IX on the platelet surface. This interaction is essential for the initial steps of hemostasis. The statement is correct.
Choice D reason: VWD typically causes mild to moderate bleeding symptoms, such as easy bruising, nosebleeds, and prolonged bleeding after minor injuries. Severe bleeding is less common, especially in type 1 VWD. This statement is accurate.
Correct Answer is B
Explanation
Choice A reason: Individuals with fair skin, light hair, and light eyes are at higher risk for melanoma. However, brown hair and brown eyes are not considered high-risk features. This statement is inaccurate and may mislead the patient.
Choice B reason: This explanation reflects current understanding that sunscreen use may give a false sense of security, leading to prolonged sun exposure. Additionally, many sunscreens primarily block UVB rays, while UVA rays—which penetrate deeper into the skin—can still contribute to melanoma risk. This statement provides a scientifically grounded rationale.
Choice C reason: While there is some correlation between higher socioeconomic status and increased melanoma rates due to lifestyle factors like frequent sun exposure, this explanation is indirect and not the most accurate or helpful for the patient.
Choice D reason: Although improper sunscreen application or failure to reapply can reduce protection, this statement is speculative and lacks the broader context of UVA exposure and behavioral patterns associated with sunscreen use.
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