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: The amygdala is primarily involved in emotional processing, particularly fear and aggression. While it may influence sleep indirectly through emotional arousal, it is not the central regulator of the sleep-wake cycle.
Choice B reason: The hypothalamus plays a critical role in regulating the sleep-wake cycle. It contains the suprachiasmatic nucleus (SCN), which serves as the body’s master circadian pacemaker. The SCN receives light input from the retina and synchronizes physiological processes, including melatonin release and sleep timing.
Choice C reason: The cerebellum is responsible for coordination of voluntary movements, balance, and motor learning. It does not have a direct role in sleep regulation.
Choice D reason: The frontal lobe is involved in executive functions, decision-making, and personality. Although sleep deprivation affects frontal lobe performance, it is not the primary center for sleep-wake regulation.
Correct Answer is B
Explanation
Choice A reason: This describes the pathophysiology of macular degeneration, not diabetic retinopathy. Macular degeneration involves the breakdown of photoreceptor cells in the macula, leading to central vision loss, but is not directly caused by diabetes.
Choice B reason: Diabetic retinopathy is caused by chronic hyperglycemia leading to microvascular damage in the retina. This includes capillary leakage, microaneurysms, and neovascularization, which can result in retinal edema, hemorrhage, and ultimately vision loss. It is a leading cause of blindness in adults with diabetes.
Choice C reason: This describes the pathophysiology of cataracts, where lens proteins become denatured and coagulated, leading to opacity. While cataracts are more common in diabetics, this is not the mechanism of diabetic retinopathy.
Choice D reason: This describes the pathophysiology of glaucoma, which involves increased intraocular pressure due to impaired aqueous humor drainage. Although glaucoma can co-occur with diabetes, it is not the primary mechanism of diabetic retinopathy.
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