A healthcare provider prescribed long-acting antipsychotic medication injections every 3 weeks at the clinic for a client with a history of medication non-adherence.
For this plan to be successful, which factor will be of critical importance?

Nutrition services in the client's neighborhood.

The level of trust between the client and nurse.

The attitude of significant others toward the client.

The availability of transportation to the clinic.

Answer and Explanation

The Correct Answer is D

Choice A rationale

While nutrition is important for overall health, it is not the most critical factor for the success of a scheduled medication regimen. The client's ability to receive their long-acting antipsychotic injection at a specific time and location is dependent on their ability to get there, not on the availability of nutrition services. Missing a dose due to a lack of transportation directly impacts the medication's therapeutic effect, increasing the risk of symptom relapse.

Choice B rationale

Trust is foundational to any therapeutic relationship, but in this specific scenario of medication non-adherence, the most critical factor is the physical ability to receive the medication. While trust is necessary for the client to accept the injection, the plan's success hinges on their presence at the clinic every three weeks. Without reliable transportation, the highest level of trust will not enable the client to receive their dose.

Choice C rationale

The attitude of significant others can be supportive and influence a client's adherence, but it is not the most critical factor for the logistical success of this treatment plan. A positive attitude from family and friends cannot overcome the barrier of a lack of transportation to the clinic. The physical act of arriving for the injection is the primary hurdle that must be overcome for the plan to be successful, regardless of social support.

Choice D rationale

This is the most critical factor for the success of this treatment plan. Since the client must physically go to the clinic every three weeks to receive their injection, a lack of reliable transportation would make it impossible to adhere to the schedule. Medication non-adherence is a primary reason for symptom relapse in clients with schizophrenia; therefore, ensuring they can get to the clinic is paramount to maintaining therapeutic drug levels and preventing relapse.

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Correct Answer is C

Explanation

Choice A rationale

While a questionnaire could be a useful tool, it was not Dr. Hans Selye's primary contribution. His work was foundational in defining the physiological response to stress itself, not just in creating a measurement instrument. He described the biological, not just the psychological, mechanisms involved in the body's reaction to stressors.

Choice B rationale

The Social Readjustment Rating Scale (SRRS) was developed by psychiatrists Thomas Holmes and Richard Rahe, not Hans Selye. This scale measures stress based on life events and is a tool to assess the psychological impact of stressors. Selye's work focused on the physiological, nonspecific response of the body to any stressor, regardless of its nature.

Choice C rationale

Dr. Selye's seminal work established the General Adaption Syndrome (GAS). He described the three distinct stages that the body undergoes in response to a stressor: the alarm stage (initial shock and mobilization of resources), the resistance stage (coping with the stressor), and the exhaustion stage (depletion of resources and potential for illness).

Choice D rationale

Selye described the resistance stage as the body's continued physiological response to cope with the stressor, where it attempts to return to homeostasis. This stage is not defined by the use of psychological defense mechanisms to avoid confrontation, but rather by the sustained physiological effort of the body to adapt to the ongoing stress.

A. "You may be paying more attention to your mother since your father died and noticing more things such as minor illness.”. B. "It is probably a coincidence. Emotions and physical responses travel on different tracts of the nervous system.”. C. "So far, research on emotions or stress and becoming ill more easily is unclear. We do not know for sure if there is a link.”. D. "Research shows a definite connection between stress and the body's ability to fight off illness.”.

Correct Answer is D

Explanation

Choice A rationale

This response minimizes the client's experience by suggesting her observations are biased. Prolonged stress and negative emotions directly impact the immune system's function. The HPA axis and sympathetic nervous system are activated, leading to the release of cortisol and catecholamines. These hormones suppress the immune system, making the body more susceptible to infections like shingles and the flu. Suggesting it's just a matter of "noticing more" disregards this established physiological link.

Choice B rationale

This statement is scientifically inaccurate. The nervous system is a complex, integrated network. The sympathetic and parasympathetic divisions, part of the autonomic nervous system, directly influence physiological responses, including the immune system. The hypothalamic-pituitary-adrenal (HPA) axis, a key component of the neuroendocrine system, is a prime example of the interconnectedness of emotions, stress, and physical health, proving that these systems do not travel on separate tracts.

Choice C rationale

This rationale is not a correct reflection of current scientific knowledge. Extensive research in psychoneuroimmunology (PNI) has demonstrated a clear and well-documented connection between psychological stressors and physiological health outcomes. The field studies how the central nervous system, endocrine system, and immune system interact, showing that chronic stress leads to a compromised immune response, increasing susceptibility to illness. The link is not unclear.

Choice D rationale

Stressors, both psychological and physical, activate the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system. This activation leads to the release of hormones such as cortisol and epinephrine. Cortisol, in particular, is a potent immunosuppressant that, when chronically elevated, reduces the number and activity of white blood cells, such as lymphocytes and natural killer cells, thereby weakening the body's ability to mount an effective immune response against pathogens.

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A healthcare provider prescribed long-acting antipsychotic medication injections every 3 weeks at the clinic for a client with a history of medication non-adherence. For this plan to be successful, which factor will be of critical importance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What was Dr. Hans Selye's contribution to the study of stress?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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A healthcare provider prescribed long-acting antipsychotic medication injections every 3 weeks at the clinic for a client with a history of medication non-adherence.
For this plan to be successful, which factor will be of critical importance?