A client diagnosed with schizophrenia is prescribed clozapine. The nurse teaches the client and family to call the physician immediately if:

There are any signs of infection.

There is a decrease in hallucinations.

Appetite continues to decrease after one week.

Insomnia occurs for more than two nights.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Clozapine is known to cause agranulocytosis, a potentially life-threatening condition where the white blood cell count drops significantly, leading to a higher risk of infection. Patients on clozapine must have regular blood tests to monitor their white blood cell count. Any signs of infection, such as fever, sore throat, or flu-like symptoms, should be reported to a physician immediately as they could indicate agranulocytosis.

Choice B Reason:

A decrease in hallucinations is generally a positive sign indicating that the medication is working effectively. It is not a reason to call the physician immediately. Instead, this should be discussed during regular follow-up appointments to assess the overall effectiveness of the treatment.

Choice C Reason:

While a decrease in appetite can be a side effect of clozapine, it is not typically an emergency unless it leads to significant weight loss or malnutrition. This should be monitored and discussed with the physician during regular visits. If the decrease in appetite is severe or persistent, it may warrant a call to the physician, but it is not as urgent as signs of infection.

Choice D Reason:

Insomnia can occur with clozapine use, but it is usually managed with adjustments to the medication regimen or additional treatments for sleep. While it is important to address insomnia, it does not require immediate medical attention unless it severely impacts the patient’s well-being.

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Correct Answer is A

Explanation

Choice A Reason:

Seclusion is used in psychiatric settings primarily to manage patients who are exhibiting aggressive or severely disturbed behavior. The reduced sensory input in a seclusion room helps the patient to regain control over their emotions and behavior by minimizing external stimuli that could exacerbate their condition. This controlled environment can be crucial in preventing harm to the patient and others, and it allows the patient to calm down in a safe space. The goal is to provide a therapeutic setting that aids in the patient’s recovery and stabilization.

Choice B Reason:

While communication is an essential part of psychiatric care, seclusion is not intended to encourage interaction with others. In fact, seclusion is used when a patient needs to be isolated to prevent harm to themselves or others. Encouraging communication is more appropriate in other therapeutic settings where the patient is stable and can engage safely with others. Therefore, this statement does not accurately explain the purpose of seclusion.

Choice C Reason:

Forcing clients to be responsible for themselves is not the primary goal of seclusion. Seclusion is a measure taken to ensure safety and to help the patient regain control over their behavior in a controlled environment. Responsibility and self-management are important aspects of psychiatric treatment, but they are typically addressed through other therapeutic interventions and not through seclusion. Thus, this statement is not an accurate explanation of the use of seclusion.

Choice D Reason:

Managing the unit with fewer staff is not a valid reason for using seclusion. The primary purpose of seclusion is to ensure the safety of the patient and others, not to reduce staffing needs. In fact, the use of seclusion requires careful monitoring and adherence to strict protocols, which can actually increase the need for staff attention. Therefore, this statement does not correctly explain the rationale behind the use of seclusion.

A. Autonomy B. Justice C. Beneficence D. Veracity

Correct Answer is A

Explanation

Choice A Reason:

The statement “Autonomy” is correct. Autonomy is the ethical principle that respects an individual’s right to make their own decisions and act on their own values. By allowing clients to choose whether or not to attend group therapy, the unit manager is preserving the clients’ autonomy. This approach acknowledges the clients’ ability to make informed decisions about their own treatment and respects their personal preferences and values1. Autonomy is a fundamental principle in healthcare, emphasizing the importance of respecting patients’ rights to self-determination.

Choice B Reason:

The statement “Justice” is incorrect. Justice refers to the ethical principle of treating individuals fairly and equitably. While justice is an important consideration in healthcare, the policy of allowing clients to choose whether or not to attend group therapy is more directly related to respecting their autonomy rather than ensuring equitable treatment. Justice would be more relevant in ensuring that all clients have equal access to group therapy sessions and resources.

Choice C Reason:

The statement “Beneficence” is incorrect. Beneficence is the ethical principle that involves acting in the best interest of the client and promoting their well-being. While encouraging group therapy can be seen as an act of beneficence, the specific policy of allowing clients to choose whether or not to attend is more aligned with respecting their autonomy. Beneficence focuses on doing good for the client, whereas autonomy emphasizes the client’s right to make their own choices.

Choice D Reason:

The statement “Veracity” is incorrect. Veracity refers to the ethical principle of truthfulness and honesty in interactions with clients. While veracity is crucial in maintaining trust and transparency in the therapeutic relationship, the policy of allowing clients to choose whether or not to attend group therapy is primarily about respecting their autonomy. Veracity would be more relevant in ensuring that clients are fully informed about the benefits and potential risks of group therapy.

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A client diagnosed with schizophrenia is prescribed clozapine. The nurse teaches the client and family to call the physician immediately if:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in orientation is rotating to a psychiatric unit where they observe a client in seclusion. Which of the following statements by the nurse’s preceptor best explains the use of seclusion on a unit?

Correct Answer is A

Explanation

Group therapy is strongly encouraged, but not mandatory, in an inpatient psychiatric unit. The unit manager’s policy is that clients can make a choice about whether or not to attend group therapy. Which ethical principle does the unit manager’s policy preserve?

Correct Answer is A

Explanation

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