How can nurses best support the mental health principle of confidentiality for clients with mental illness?
Ensuring all hospital staff are aware of a client's diagnosis
Restricting access to client records to only those directly involved in their care
By sharing health Information only with the clients immediate family
Posting client schedules in the common areas for all to view
The Correct Answer is B
Choice A reason: Sharing a client's psychiatric diagnosis with all hospital staff, regardless of their role or involvement in the case, is a significant breach of confidentiality and HIPAA regulations. Only staff members with a legitimate clinical "need to know" to perform their specific job duties should have access to sensitive mental health information.
Choice B reason: Confidentiality is maintained by ensuring that protected health information is only accessible to the multidisciplinary team actively managing the client's care. This minimizes the risk of unauthorized disclosure and protects the client's privacy, which is especially critical in mental health due to the continued social stigma surrounding psychiatric disorders.
Choice C reason: Nurses cannot unilaterally share health information with a client's family without explicit, written consent from the client, unless there is a legal mandate or emergency. Autonomy and privacy rights dictate that the client controls who has access to their medical records, even regarding close relatives or immediate family members.
Choice D reason: Posting client schedules in common areas where other patients or visitors can see them is a violation of privacy. Such actions can inadvertently disclose the identity of clients receiving treatment and the nature of their activities, failing to maintain the professional standard of a secure and confidential therapeutic environment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: The reduction of hallucinations and delusions is a primary therapeutic goal of antipsychotic therapy, indicating pharmacological efficacy. However, it does not measure the client's internal coping mechanisms for the specific stressors or physical discomforts caused by the medications themselves, such as extrapyramidal symptoms or anticholinergic effects.
Choice B reason: Medication adherence is a behavioral outcome that suggests the client is following the prescribed treatment plan. While adherence is necessary for stability, it can occur without the client having effective coping strategies for the secondary stress or physiological burden that typical antipsychotics often impose on the body.
Choice C reason: Typical antipsychotics are associated with a high incidence of distressing side effects, including dystonia, akathisia, and dry mouth. Evaluating the client's ability to identify, report, and manage these adverse effects demonstrates functional coping and self-efficacy, which are critical for long-term psychological resilience and treatment success.
Choice D reason: Improved family communication is a positive outcome of psychosocial rehabilitation and family therapy. While it provides a support system that can mitigate stress, it is a broad social metric rather than a specific evaluation of how the individual client copes with the pharmacological challenges of their medication.
Correct Answer is D
Explanation
Choice A reason: Increasing the dose of risperidone would likely exacerbate pseudoparkinsonism. These symptoms are caused by the blockade of dopamine D2 receptors in the nigrostriatal pathway; adding more of the offending agent would worsen the imbalance between dopamine and acetylcholine, leading to increased rigidity and tremors.
Choice B reason: While education is important for long-term management, it is not the priority action when a client is suffering from acute, distressing extrapyramidal symptoms. The immediate goal is to alleviate the physical discomfort and functional impairment caused by the drug-induced parkinsonian symptoms through pharmacological intervention.
Choice C reason: Monitoring symptoms over time is insufficient because pseudoparkinsonism typically does not resolve without intervention as long as the antipsychotic remains at the same dose. Delaying treatment can lead to decreased medication adherence and prolonged physical distress, which may negatively impact the client's overall psychiatric prognosis.
Choice D reason: Pseudoparkinsonism results from a relative deficiency of dopamine and an excess of cholinergic activity. Administering an anticholinergic medication, such as benztropine or trihexyphenidyl, restores the chemical balance in the basal ganglia, rapidly relieving the muscle stiffness, shuffling gait, and tremors associated with the antipsychotic medication.
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