A nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?
Remain silent and add the suggested outcome to the plan
Formulate a more appropriate outcome without the patient’s input
Explore with the patient possible consequences of the outcome
Educate the patient that the outcome is not realistic
The Correct Answer is C
Choice A reason: Silently adding an inappropriate outcome disregards patient safety and autonomy. Outcomes must align with neurobiological needs, like serotonin modulation for depression. This approach fails to engage the patient in decision-making, risking ineffective treatment and neglecting evidence-based collaborative care principles.
Choice B reason: Formulating outcomes without patient input violates autonomy. Collaborative goal-setting, considering neurobiological factors like dopamine imbalances, ensures patient engagement and effective treatment. Excluding the patient disregards their perspective, reducing adherence and therapeutic alliance, making this approach contrary to evidence-based psychiatric nursing.
Choice C reason: Exploring consequences respects autonomy while guiding patients toward safe outcomes. Discussing implications, like medication non-adherence worsening dopamine-driven symptoms, fosters informed decisions. This collaborative approach aligns with cognitive-behavioral principles and neurobiological treatment needs, ensuring effective, patient-centered care in psychiatric practice.
Choice D reason: Educating that an outcome is unrealistic may dismiss patient autonomy. While addressing neurobiological realities, like serotonin deficits, is important, unilateral education risks disengagement. Collaborative exploration of consequences is more effective, promoting informed choices and adherence, making this option less suitable than discussion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Medication education addresses self-actualization or esteem needs in Maslow’s hierarchy, which are lower priority. Psychotic symptoms like hallucinations, driven by dopamine dysregulation, pose immediate safety risks, taking precedence over education, which assumes cognitive stability not yet achieved in acute psychosis, per Maslow’s prioritization.
Choice B reason: Alienation relates to belongingness needs, third in Maslow’s hierarchy. While important, psychotic hallucinations, linked to hyperactive mesolimbic dopamine pathways, indicate a safety threat, a basic physiological need. Addressing safety precedes social needs, as unresolved psychosis can exacerbate isolation, making this a lower priority.
Choice C reason: Reluctance for social activities reflects belongingness needs, lower in Maslow’s hierarchy. Hallucinations, driven by neurochemical imbalances like excess dopamine, pose immediate safety risks, a physiological need. Social participation requires cognitive stability, which is compromised in psychosis, making this issue secondary to urgent safety concerns.
Choice D reason: Hearing voices urging self-protection indicates a safety threat, a basic physiological need in Maslow’s hierarchy. Hallucinations, linked to dopamine overactivity in the mesolimbic pathway, can lead to harmful behaviors. Addressing this stabilizes the patient, taking priority over higher-level needs like social connection or education, per Maslow’s framework.
Correct Answer is A
Explanation
Choice A reason: Blocking norepinephrine at alpha-1 receptors inhibits vasoconstriction, reducing vascular tone. This disrupts baroreceptor-mediated blood pressure regulation, causing orthostatic hypotension when standing. The autonomic nervous system fails to compensate for positional changes, leading to dizziness and fainting, a common side effect of alpha-1 blockers like prazosin.
Choice B reason: Increased psychotic symptoms are linked to dopamine dysregulation, not alpha-1 receptor blockade. Norepinephrine blockade affects autonomic functions, not psychosis, which involves mesolimbic dopamine hyperactivity. This side effect is unrelated to alpha-1 receptors, making this option scientifically inaccurate for the described mechanism.
Choice C reason: Appetite disturbance is typically associated with serotonin or histamine receptor effects, not alpha-1 norepinephrine blockade. Norepinephrine at alpha-1 receptors regulates vascular tone, not appetite control, which involves hypothalamic signaling. This side effect is not a direct consequence of alpha-1 blockade, rendering this option incorrect.
Choice D reason: Hypertensive crisis results from excessive norepinephrine activity, often due to monoamine oxidase inhibitors, not alpha-1 receptor blockade. Blocking alpha-1 receptors causes vasodilation, lowering blood pressure, not raising it. This makes hypertensive crisis an unlikely side effect, contrary to the pharmacological mechanism of alpha-1 blockers.
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