A patient presenting with delusions of persecution about being poisoned has refused all meals for 3 days. Which intervention will most likely be acceptable to the patient?

Offer to taste each portion on the tray for the patient.

Obtain a doctor's order for tube feedings or total parenteral nutrition.

Allow the patient to telephone a local restaurant to deliver meals.

Allow the patient to have supervised access to food vending machines.

Answer and Explanation

The Correct Answer is A

Choice A reason: Delusions of persecution in schizophrenia involve hyperactive dopamine pathways in the mesolimbic system, leading to irrational fears like poisoning. Tasting food directly addresses the delusion by demonstrating safety, potentially reducing anxiety and engaging the patient’s trust, which can modulate amygdala hyperactivity and promote acceptance of nutrition without invasive measures.

Choice B reason: Tube feedings or parenteral nutrition are invasive and may reinforce the patient’s delusional fears of harm, as they bypass voluntary control. Schizophrenia’s dopamine dysregulation heightens suspicion, and forced interventions could exacerbate paranoia by stimulating the amygdala, increasing stress responses and potentially worsening the patient’s mental state and compliance.

Choice C reason: Allowing restaurant delivery does not directly address the poisoning delusion, as external food sources may still be perceived as unsafe due to hyperactive dopamine-driven paranoia in schizophrenia. This option fails to engage the patient’s trust or reduce amygdala-driven fear responses, making it unlikely to resolve the refusal to eat.

Choice D reason: Supervised vending machine access may not alleviate the patient’s delusional belief in poisoning, as the source remains external and unverified. Schizophrenia’s dopamine excess in the mesolimbic pathway sustains mistrust, and this intervention does not directly counter the delusion, potentially leaving amygdala-driven fear responses unaddressed, reducing its effectiveness.

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Correct Answer is C

Explanation

Choice A reason: Providing resources and legal assistance is practical but secondary in crisis intervention. Intimate partner violence triggers amygdala-driven fear and cortisol surges, requiring immediate emotional stabilization to restore prefrontal cortex regulation before addressing long-term resources.

Choice B reason: Emotional growth is a long-term goal, not the focus of acute crisis intervention. Violence-induced stress heightens amygdala activity and cortisol, needing immediate stabilization of emotional security to restore neural equilibrium, not developmental growth.

Choice C reason: Crisis intervention prioritizes emotional security and equilibrium, reducing amygdala-driven fear and cortisol surges from violence. Supporting prefrontal cortex regulation restores coping capacity, addressing the immediate neurochemical and emotional impact of the crisis effectively.

Choice D reason: Long-term resolution is not the focus of acute crisis intervention, which targets immediate stabilization. Violence causes acute amygdala hyperactivity and cortisol release, requiring short-term emotional security, not prolonged resolution of underlying issues, which comes later.

A. Notify the provider for a restraint order and assessment. B. Advise the cafeteria staff of plastic utensils that can be used as weapons. C. Ask staff members how the patient was able to acquire the utensil. D. Notify the house supervisor for further direction.

Correct Answer is A

Explanation

Choice A reason: Notifying the provider ensures legal and medical oversight for restraints, addressing self-harm risk driven by serotonin deficits and amygdala hyperactivity. This prioritizes patient safety and evaluates underlying psychiatric causes, ensuring appropriate intervention to stabilize neural dysregulation.

Choice B reason: Advising cafeteria staff is a preventive measure but not the priority during acute self-harm. Serotonin-driven impulsivity requires immediate medical assessment, and addressing utensil access is secondary to stabilizing the patient’s acute neurochemical crisis.

Choice C reason: Investigating utensil acquisition is important for future prevention but not urgent. The patient’s self-harm, driven by serotonin deficits and amygdala hyperactivity, requires immediate medical intervention to ensure safety and address acute psychiatric needs first.

Choice D reason: Notifying the house supervisor is administrative, not clinical, and delays direct intervention. Self-harm reflects serotonin dysregulation and amygdala-driven impulsivity, requiring immediate provider assessment for restraints and psychiatric evaluation, making this less urgent.

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A patient presenting with delusions of persecution about being poisoned has refused all meals for 3 days. Which intervention will most likely be acceptable to the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A victim of intimate partner violence comes to the crisis center seeking help. The nurse uses crisis intervention strategies that focus on what?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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